Eating disorders can affect anyone, at any time – people of any age, gender, culture, ethnicity or economic status. There are several eating disorders, but the most common are:

• binge eating disorder – eating large amounts of food in a short period of time, often in private, and with the feeling that your eating is out of control
• bulimia – binge eating followed by fasting, vomiting, excessive exercise or the use of laxatives
• anorexia – restricting eating, a fear of weight gain, distorted body image and trying to maintain an unhealthily low weight

It’s sometimes hard to identify an eating disorder – lots of people are on strict diets or exercise a lot. It can be hard to admit you have a problem, but there are some warning signs:

• being preoccupied with food, to the point of being unable to concentrate on other things
• secret eating
• hiding food
• being extremely strict with food and feeling distressed if you break the rules
• binging, purging or using laxatives
• not attending social or work events in order to avoid food or excessively exercise
• significant weight loss or gain
• feeling anxious and self-conscious about your body shape, size or weight
• avoiding foods that you used to enjoy

Eating disorders can become compulsive, which means the unhealthy behaviours occur automatically or are very difficult to stop. It can be difficult to admit you have an eating disorder, and to ask for help. DBT is an effective treament for eating disorders (there is a specialist version of DBT which has been adapted for eating disorder, called Radically Open Dialectical Behavior Therapy, but this is not widely available yet).

Eating disorders are vicious cycles, stemming from emotional and mood dysregulation. The eating provides a temporary escape from these feelings, this is usually a brief escape and often followed by feelings of shame, guilt or failure.

Using the four key skills of DBT, and the healthy coping skills you will learn, you can break this cycle and make change. Using the chain analysis element of DBT, you can review the problem behaviours (overeating, purging, etc), and examine the actions, thoughts and feelings that led to that behaviour. You can then identify healthy solutions to the problem behaviour, and plan how you can reduce this behaviour in the future. 16