The goal of today’s article is to provide an overview of Eating Disorders, describing their characteristics, diagnostic classification according to the DSM-5, and how to intervene through Single Session Therapy.
What are Eating Disorders?
When we talk about Eating Disorders, we are referring to alterations in a person’s eating habits. These alterations, which often begin during adolescence, manifest as difficulties in maintaining a balanced relationship with food, leading to dysfunctional behaviors that affect the person’s well-being and various life domains.
Diagnostic Classification according to the DSM-5
The DSM-5 describes eight diagnostic categories used to classify Eating Disorders: Pica; Rumination Disorder; Avoidant/Restrictive Food Intake Disorder; Anorexia Nervosa; Bulimia Nervosa; Binge Eating Disorder; Other Specified Feeding or Eating Disorder; Unspecified Feeding or Eating Disorder.
Among these, the most common are Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.
What are their characteristics?
Anorexia Nervosa involves food intake restrictions, sometimes accompanied by purging behaviors. Consequently, the person shows a decrease in body weight, a preoccupation with and fear of gaining weight or becoming fat, and a distorted body image. Bulimia Nervosa, on the other hand, is characterized by recurring episodes of binge eating followed by inappropriate compensatory behaviors such as purging. Binge Eating Disorder is characterized by recurring episodes of binge eating without compensatory behaviors. Unlike the first two disorders, the person shows less concern about weight and body image (American Psychiatric Association, 2014).
How to intervene?
In a Single Session Therapy intervention, the professional focuses on defining the problem in operational terms to allow the person to restructure their perception of the issue, providing them with a new lens to see what is happening.
The next step is to define the goal, which must be determined together with the person.
The intervention will also focus on exploring the individual’s resources and exceptions to the problem, i.e., situations in which the person managed to address the issue differently (for example, managing to avoid purging after a binge).
Finally, dysfunctional behaviors, or “Tried Solutions,” that the person has implemented in an attempt to solve the problem but have made it worse, are identified.
What are the typical dysfunctional Tried Solutions for Eating Disorders?
Typical dysfunctional solutions adopted by individuals with eating problems include: forbidding themselves from consuming caloric foods, following long-term diets, binge eating, consuming more than what is needed, and engaging in compensatory behaviors such as vomiting, etc. (CannistrĂ F. & Piccirilli F, 2018).
Why request a quick therapy?
Since the start of the COVID-19 pandemic, requests for treatment for Eating Disorders have increased considerably, and with them, waiting lists and wait times have quadrupled. In this context, the use of a therapy that involves only one session has been very positive.
Has Single Session Therapy been proven effective for Eating Disorders?
The results of a study by Schleider et al. (2023) highlighted a reduction in symptoms and decreased impairment in individuals with Eating Disorders treated with Single Session Therapy, although additional studies are needed to further investigate whether this therapeutic approach can lead to a reduction in drop-out rates and symptomatology. Furthermore, Schleider and colleagues suggested that combining Single Session Therapy with more traditional treatments may increase the intervention’s effectiveness (Linardon J. & Fuller-Tyszkiewicz M., 2023). They presented evidence from 60 clinical studies supporting the effectiveness of Single Session Therapy interventions for various mental health issues. However, further research is needed as studies on interventions for Eating Disorders are currently limited (Wade T., 2023).
Conclusion Eating Disorders are an increasingly widespread issue, and the demand for intervention is growing. This suggests the need to reduce waiting times. This could be addressed through the use of Single Session Therapy, whose effectiveness has been demonstrated through various studies and research, though further investigation is needed.
Sara Schippa Psychologist in training at the
Italian Center for Single Session Therapy
Bibliography
American Psychiatric Association (2014). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. DSM-5. Raffaello Cortina.
CannistrĂ F. & Piccirilli F (2018). Single Session Therapy: Principles and Practices. Giunti Editore.
Wade T. (2023). Developing the “single-session mindset” in eating disorder research: Commentary on Schleider et al., 2023 “Realizing the untapped promise of single-session interventions for eating disorders.” International Journal of Eating Disorders. 56:864–866.
Linardon J. & Fuller-Tyszkiewicz M. (2023). The promise of single session interventions for eating disorders: Lessons to be learned from research on digital mental health. Commentary on Schleider et al. (2023). International Journal of Eating Disorders. 56:867–870.