Instead of engaging with the negative thoughts, try to redirect your thoughts to something more gentle. You could listen to your favorite playlist or podcast or read a book that engages your mind.
If you need something a bit more active, try calling a friend, practicing progressive muscle relaxation, or taking a bath. Bingeing and purging are serious behaviors that have negative health consequences. For specialized eating disorder treatment, reach out to The Emily Program at Get help.
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Delays work best when paired with an alternative: an activity that takes the place of bingeing or purging. These tools, which stem from cognitive-behavioral therapy CBT , are also a component of dialectical behavior therapy DBT commonly referred to as distress tolerance. You may also think of alternatives as coping skills.
Many patients with eating disorders can benefit from increasing their repertoire of coping skills. Have you ever had an urge to binge or purge that was unexpectedly interrupted so that you could not carry out the intended behavior? Maybe you had planned a binge but then were interrupted by the arrival of a family member?
Or maybe you intended to purge, but could not due to unexpected lack of privacy. If you had this experience, did you find that the urge to binge or purge grew increasingly stronger and persisted indefinitely? If so, you have already had experiences that you will be able to reference to help you develop skills for reducing bingeing and purging. Urges and anxiety commonly mount and then subside like a bell curve.
During the time they are mounting, they often feel like they will increase indefinitely. This is an illusion: when time elapses, these feelings and urges usually gradually subside on their own.
The person who binges or purges, however, tends to surrender to their behavior at the point at which they feel most distressed near the apex of the curve , and immediately starts to feel some brief relief from anxiety. This experience prevents them from discovering that the anxiety and urge would have subsided on its own in the absence of the binge or purge.
Responding to the urge time and time again reinforces the belief that the problematic behavior is the only way to feel better. It may even feel as though the behavior is out of one's control because of how automatic the response becomes. Behavioral reinforcement then leads the person to repeat these behaviors whenever negative emotions or urges threaten. They become habitual. Imagine by way of contrast that every time you had an intense negative emotion or strong urge to binge or purge, that you stood on your head.
You would probably love standing on your head because it would always be associated with a drop in anxiety! This is one of the problems with maladaptive coping skills; they may provide some temporary relief, but they usually make you feel worse in the long run.
Feeling bad may increase your anxiety to the level it was previously making you vulnerable to future binges and purges, and so the cycle repeats. It is helpful to develop a list of alternative behaviors to binge eating and purging. These alternative behaviors can range from distracting to actively soothing. It is helpful to have a varied list of activities so that you have options to consider depending on the situation, where you are, the time of day, and so on.
For example, if it is the middle of the night and calling friends is on your list, friends may not be available to call; if you are at work, taking a shower will likely not be an option. It is best to choose an activity that is incompatible with the behavior you are trying to prevent. Thus, if you tend to binge eat in front of the television, watching television would not be a good choice. For people who purge, painting their nails is often a good option because it is not physically possible to purge at the same time.
Here are some alternative behaviors that some patients with eating disorders have found helpful:. Purging disorder is defined as engaging in purging behaviors without it being in response to a binge-eating episode.
As a recognized eating disorder, purging disorder can be identified by many of the same symptoms as other eating disorders. Symptoms might include:. You can be any shape or size and have an eating disorder.
If you think you or a loved one may have an eating disorder, you can take an online-self assessment to determine if you have any behaviors that could potentially result in an eating disorder. If you think you have an eating disorder, speak with your doctor. Stereotypes that eating disorders only affect teenage girls are both incorrect and damaging. This idea can often discourage people from seeking treatment.
There are certain factors that might contribute to higher rates of eating disorders among certain people. Sexual and physical abuse, or participating in appearance or weight-focused sports, are potential risk factors. Men are also at risk for eating disorders. A recent review concluded that at least 25 percent of people with eating disorders are male. Plus, eating disorders like purging disorder are actually increasing at a faster rate among males than females.
People who have an eating disorder are also more likely to have another mood disorder at the same time. One study concluded that as many as 89 percent of individuals with eating disorders often have concurrent mood disorders, such as:. Eating disorders are a serious mental health condition, not a choice. Treatment for purging disorder can vary based on each person.
Some people may benefit from more intensive inpatient treatment and recovery programs, while others might prefer outpatient therapy options. Inpatient treatment is more common in cases that require medical monitoring or daily assessments. Outpatient treatment might include psychotherapy and nutrition counseling. Rather, they may be prescribed to treat concurrent mood disorders that may be causing additional stress or making it harder to cope with recovery.
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