“I can’t stop thinking about my weight and body shape.” “Once I start eating, I can’t stop.” “I throw up after eating.” “I’m clearly underweight, but I still feel fat.” — If you are struggling with any of these concerns, they may be signs of an eating disorder.
An eating disorder is a condition in which a preoccupation with food and weight places a significant burden on both mind and body. It is never a matter of willpower or appearance — it is a serious illness that can be life-threatening and requires proper treatment.
Keldsen Family Clinic is a family-oriented clinic offering both Psychosomatic Medicine and Internal Medicine, a 1-minute walk from ‘Oizumi Yubinkyoku’ bus stop, accessible by Seibu Bus from Oizumi-Gakuen Station. We are open on weekends and holidays and also offer telemedicine. “Going to a clinic feels a little scary” — we’d love to help you take that first step.
About Eating Disorders
An eating disorder is a general term for conditions in which a preoccupation with weight and body shape, along with related abnormal eating behaviors, causes significant disruption to physical health, mental well-being, and daily life. There are three main types:
- Anorexia nervosa (anorexia): Severe weight loss well below the normal range, accompanied by an intense fear of gaining weight
- Bulimia nervosa (bulimia): Recurrent episodes of binge eating followed by compensatory behaviors to prevent weight gain (such as self-induced vomiting or laxative misuse)
- Binge eating disorder: Recurrent episodes of binge eating without compensatory behaviors
While eating disorders are most common among women in their teens and twenties, they can also affect men and older adults. Multiple factors are involved in their development, including genetic predisposition, personality traits, family dynamics, societal pressure (a culture that idealizes thinness), dieting history, and psychological stress.
Left untreated, eating disorders carry the risk of life-threatening medical complications, including general debilitation from low body weight, electrolyte imbalances, and cardiac complications. Seeking help early is the first step toward recovery.
Even when the individual feels “I can’t eat because I’m too fat” or “I can’t feel calm unless I purge after eating,” their nutritional status may objectively be at a dangerous level. When family members or those around them notice concerning weight loss or unusual eating behaviors, connecting with a specialist can be a vital step in protecting that person’s life.
What Are Eating Disorders?
At the core of eating disorders lies cognitive distortion — such as an intense fear of gaining weight and an extreme preoccupation with body weight and shape — which drives abnormal eating behaviors.
In anorexia nervosa (anorexia), even when a person is clearly underweight, they feel “I’m too fat” or “I need to lose more weight,” and severely restrict their food intake. Physical symptoms may include dangerously low body weight, amenorrhea (loss of menstruation), low body temperature, anemia, and decreased bone density. It is further classified into a restricting type and a binge-eating/purging type.
In bulimia nervosa (bulimia), episodes of consuming large amounts of food in a short period recur, followed by habitual compensatory behaviors driven by guilt — such as self-induced vomiting, laxative use, or excessive exercise. Because body weight often remains within the normal range, the condition tends to go unnoticed by those around the individual.
In binge eating disorder, episodes of binge eating occur repeatedly without compensatory behaviors. Weight gain and obesity become concerns, and feelings of self-loathing and depressive symptoms are common.
All types are known to frequently co-occur with depression, anxiety disorders, and obsessive-compulsive disorder (OCD). Behind eating disorders, factors such as perfectionism, low self-esteem, difficult family relationships, and significant experiences of loss may also play a role. Treatment therefore addresses not only eating behaviors but also these underlying psychological factors.
At Keldsen Family Clinic, we leverage our combined Psychosomatic Medicine and Internal Medicine practice to carefully assess physical health while developing an appropriate treatment plan.
Symptoms and Characteristics of Eating Disorders
The symptoms of eating disorders manifest across three areas: eating behavior, physical health, and psychological well-being.
Specific Symptoms
Eating Behavior Symptoms
- Extreme food restriction and calorie counting
- Binge eating (consuming large amounts of food in a short period)
- Self-induced vomiting and misuse of laxatives or diuretics
- Hiding food or refusing to eat in front of others
- Frequent weighing
- Meticulously recording everything eaten
Physical Symptoms
- Dangerously low body weight or rapid weight fluctuations
- Irregular menstruation or amenorrhea
- Low body temperature and cold hands and feet
- Fatigue, dizziness, and lightheadedness
- Hair loss and skin problems
- Stomach pain and constipation
- Low blood pressure, bradycardia, and arrhythmia
- Dental erosion (in cases of repeated vomiting)
Psychological and Behavioral Symptoms
- Intense preoccupation with weight and body shape
- Cognitive distortion — feeling “fat” despite being underweight
- Self-worth heavily dependent on weight and body shape
- Intense guilt when unable to control eating
- Reluctance to eat with others
- Low mood, anxiety, and irritability
One of the challenges of eating disorders is that the individual often lacks awareness of the illness. In many cases, it is family members or others around them who notice something is wrong and encourage them to seek help.
Treatment and Recovery for Eating Disorders
Treatment for eating disorders prioritizes physical stabilization, combined with psychotherapy, nutritional counseling, and family support. The treatment approach varies depending on the type and severity of the condition.
1. Medication
There is currently no medication that directly treats eating disorders, but medications may be used as a supplementary measure depending on co-occurring symptoms.
- SSRIs: When depressive symptoms, anxiety, or obsessive-compulsive symptoms are present
- Anti-anxiety medications and sleep aids: For short-term use when anxiety or insomnia is distressing
- Medical treatments: To address electrolyte imbalances, anemia, or osteoporosis
Medication alone is not sufficient — it is typically used in combination with psychotherapy and nutritional therapy.
2. Psychosocial Support
- Enhanced Cognitive Behavioral Therapy (CBT-E): A form of cognitive behavioral therapy specifically designed for eating disorders, which helps address cognitive distortions related to weight and body shape
- Family-Based Treatment (FBT): Particularly effective for adolescents, in which family members play an active role in supporting weight restoration
- Interpersonal Therapy (IPT): Helpful when interpersonal stress is a contributing factor
- Supportive psychotherapy: Rebuilding a sense of safety through feeling heard and understood
At Keldsen Family Clinic, we take the time to listen carefully during consultations and coordinate with specialized institutions as needed.
3. Adjustments at School or Work
- Share information about mealtimes and weight changes with family and your physician
- If sports activities or work involve excessive exercise or pressure to diet, discuss this with your physician
- Consider taking a leave of absence from school or work when necessary
- If informing others about the situation, a medical certificate from your physician can be helpful
4. Support at Home
Family support plays a tremendously important role in the treatment of eating disorders.
- Avoid criticizing or closely monitoring the type and amount of food eaten
- Refrain from using words like “thin” or “fat”
- Respect the individual’s pace while following the physician’s treatment plan
- Family members themselves should also seek support — through family groups or healthcare professionals
- In severe, life-threatening cases, discuss the option of inpatient treatment with the physician
It is also important for family members not to take on too much alone. Please make sure to take care of your own well-being as well.
5. Self-Care in Daily Life
- Regular meals: Aim for three meals a day, even in small portions
- Reduce frequent weighing: Try to distance yourself from the scale
- Limit exposure to diet culture on social media: Content that glorifies thinness can hinder recovery
- Pay attention to changes in your body: If you experience lightheadedness or shortness of breath, seek medical attention promptly
- Be kind to yourself: Recovery is not a straight line. Celebrate the days when things go well
Eating disorders are conditions from which recovery can be expected with appropriate treatment and ongoing support. Before the situation becomes life-threatening, please don’t try to cope alone — reach out to Keldsen Family Clinic. We are a 1-minute walk from ‘Oizumi Yubinkyoku’ bus stop, accessible by Seibu Bus from Oizumi-Gakuen Station, open on weekends and holidays, and offer telemedicine.