Delaware County Medical Society Summer/Fall 2020 - 22

FEATURE
excessive exercise, and increased negative comments
or thoughts about food and bodies. For an even more
extensive list of potential eating disorder symptoms, visit:
https://www.nationaleatingdisorders.org/warning-signsand-symptoms.
If a patient is struggling with disordered eating and poor
body image begin a conversation immediately. These
individuals can be very defensive and embarrassed. As
such, come to any conversations about their potential
struggles with compassion and an open mind; it can
be difficult for the struggling individual to recognize
disordered eating. Let the person know you are there to
support them and are worried for their well-being and
health, and work on validating their experiences while
continuing to verbalize your concerns. Coming from the
position of being a physician will increase your credibility,
but the cultural pressure on appearance and approval
of restricting behaviors can make these challenging
discussions indeed.
If there is any suspicion of an eating disorder, consider
recommending an assessment by one of the ED treatment
programs in the area. There are many different kinds of
treatment options, and eating disorder specialists are
trained to help clients navigate this difficult experience.
Most initial screenings and assessments are free of charge
or covered by insurance. A list of local programs follows
this article.
For emerging food and weight challenges brought on by
COVID-19, there are some tools you can recommend
if you are worried about a patient's eating patterns and
body image. Implementing these tools can help mend the
relationship between food and the body. It is important to

understand and then pull apart the entanglement that leads
to disordered eating and unhealthy emotions.
First, encourage the patient to begin taking notice and
writing down their thoughts about food. Have them ask
themselves, "What feels authentic to me, and what feels like
diet culture talking?" Once identified, the individual can
begin practicing challenging these thoughts. For example, if
the thought is, "I have to work out every day or else I can't
eat dinner," have them practice challenging this thought
by saying, "I know that every person needs and deserves to
eat throughout the day, regardless of how much movement
they engaged in. I wouldn't tell my best friend not to eat
dinner to punish themselves for not exercising enough."
Another helpful strategy is to practice putting space
between automatic thoughts and any action urges that
follow them; for example, people who struggle with binge
eating may have the thought or impulse, "I need to eat to
cope right now." Instead of completely denying this desire,
which in turn can drive the brain to crave the behavior even
more, have the patient set a timer for 5-10 minutes to allow
time to practice another coping skill. Once the timer goes
off, they can then decide if they still want to use food as a
coping mechanism (which everyone does sometimes) or if
they feel like they were able to cope in a different way.
Additional benefits to this waiting tactic is that it builds in
time for the triggering neurotransmitters to diminish and
also breaks the reinforcement cycle by giving control back
to the individual's conscious self. For a list of coping skills
to try, visit: https://www.eatingdisorderhope.com/recovery/
self-help-tools-skills-tips/effective-coping-for-eatingdisorders.

Eating disorders can feel scary to begin dealing with, and are best addressed in concert with mental health
treatment. The partnership between a caring physician and evidence-based mental healthcare is the best
predictor of a positive outcome for these individuals. For more information on types of treatment in the eastern
Pennsylvania area, visit:
https://seedsofhope.pyramidhealthcarepa.com/
https://renfrewcenter.com
https://drexel.edu/coas/academics/departments-centers/well-center/clinic/
https://www.montenido.com
https://www.centerforhopeandhealth.com

20 DELAWARE COUNTY MEDICINE & HEALTH

summer/fall 2020


https://www.nationaleatingdisorders.org/warning-signs https://www.eatingdisorderhope.com/recovery/ https://seedsofhope.pyramidhealthcarepa.com/ https://www.renfrewcenter.com https://www.drexel.edu/coas/academics/departments-centers/well-center/clinic/ https://www.montenido.com https://www.centerforhopeandhealth.com

Delaware County Medical Society Summer/Fall 2020

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