Marilyn Riesz, MA, RP - Registered Psychotherapist

Specializing in the treatment of eating disorders

Frequently Asked Questions (FAQs)

What is an eating disorder?
What is anorexia?
What is bulimia?
What is bingeing?
What is purging?
What is overeating?
What is emotional eating?

Should I exercise to stay healthy?
What are the dangers and costs of eating disorders or disordered eating?
How do I know if I (or someone I know and care about) has an eating disorder?
What should I do if someone I know and care about shows signs of an eating disorder?

What is psychotherapy?
What approach to psychotherapy does Marilyn use?
What does it mean to use an Adlerian approach?
How long does psychotherapy take?
What are the benefits of psychotherapy?
Do I need to be on medication?
What is the difference between psychotherapy and counselling?
What are the elements of treating eating disorders?


What is an eating disorder?
An eating disorder refers to a group of disorders that is characterized by patterns of disturbed eating.  For example, if I have a habit of eating in ways that are harmful rather than helpful and nurturing, then that may be an indication of an eating disorder.  The most common eating disorders are anorexia, bulimia, and binge eating. While not part of eating disorders per se, depression, anxiety, obsessive-compulsiveness, work, and relationship difficulties can occur together with eating disorders.

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What is anorexia?
Anorexia refers to restricting one’s food intake in order to lose weight or to prevent gaining weight.  It generally involves some or all of the following:

  1. Being underweight (at least 15%) for a person’s age, height, and body build
  2. Intense fear of gaining weight
  3. Disturbance in how a person perceives his or her own body shape or size
  4. Overexercising to lose weight
  5. In females, possible loss of menstruation

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What is bulimia?
Bulimia refers to alternating patterns of binge eating and purging.  It generally involves a sense of being out of control while bingeing.  Unlike anorexia, people with bulimia generally are not underweight for their age, height, and body build.

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What is bingeing?
Bingeing refers to a pattern of out-of-control eating, or repeated overeating.  There is generally a sense of being unable to control the overeating.  This does not refer to occasions when one may have a large meal, such as at a wedding, other celebration, or on religious occasions.

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What is purging?
Purging refers to a number of methods that a person may use to remove food from his or her body in unhealthy ways.  These may include vomiting, using laxatives or enemas, or over-exercising.

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What is overeating?
Overeating refers to eating for reasons other than physical hunger.  Generally, when overeating, there is a sense of being out of control or unable to stop, as if one is driven by other forces to continue eating.

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What is emotional eating?
Emotional eating is a main contributor to overeating.  When caught in patterns of overeating and feeling out of control regarding their eating, underlying emotional reasons usually contribute to the overeating.  For example, overeating may be a learned pattern so that sadness or anger are covered up by the overeating.

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Shouldn’t I exercise to stay healthy?
Absolutely.  The over-exercising that is a part of disordered eating, though, is harmful and not about staying healthy.  Exercising becomes harmful to a person rather than helpful when it becomes excessive, when it interferes with other aspects of life such as work and relationships, or when it becomes damaging to one’s self-esteem.

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What are the dangers and costs of eating disorders and disordered eating?
The dangers and costs of eating disorders and disordered eating can be varied.  They can impact on family and intimate relationships, friendships, work satisfaction and productivity, spirituality, and your sense of self-esteem and self-worth. In the United States, the National Institute of Mental Health reported that the mortality rate among people with anorexia is "about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population" ( http://www.nimh.nih.gov/publicat/eatingdisorders.cfm). Such deaths are most commonly attributed to complications from the eating disorder, including cardiac arrest, electrolyte imbalance, and suicide.

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How do I know if I (or someone I know and care about) has an eating disorder?

Just as there are different eating disorders, the signs of eating disorders can be many and varied.  The following list represents some of the more common signs that someone has an eating disorder:

  1. Frequent trips to the bathroom
  2. Isolating oneself from others
  3. Food disappearing from the kitchen unexpectedly or quickly
  4. Wearing baggy clothes
  5. Distant or impulsive in behaviour
  6. Picky around foods
  7. Not eating with others
  8. Sudden weight loss or weight gain
  9. Secrecy
  10. Lying

For more on this topic, click here.

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What should I do if someone I know and care about shows signs of an eating disorder?
First and foremost, make a distinction between the person and the actions.  Avoid judging the person for the difficulties associated with the disordered eating.  Be supportive and ensure the person that help is available.

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What is psychotherapy?
Psychotherapy is a process of self-discovery and understanding with a view to minimizing and preventing difficulties from occurring or continuing.  The ultimate goal of psychotherapy is to help a person understand both long-term and short-term goals that he or she wants to achieve and to find ways to help achieve those goals in healthy and fulfilling ways.  Often in psychotherapy, the therapist and client will examine both personal and situational factors that contribute to a difficulty and collaboratively find and practice more effective ways of achieving those goals.

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What approach to psychotherapy does Marilyn use?
Marilyn’s approach to psychotherapy is grounded in Adlerian theory, an approach that emphasizes choice, goals, and action.  From this foundation, Marilyn uses a variety of modalities and techniques in her treatment approach depending on individual client needs. Some common techniques are based in Adlerian theory, and include cognitive, behavioural, and drama and art techniques. As each individual is unique , Marilyn works togther with each client to maintain an optimal individual approach to therapeutic change. For more information about Marilyn's approach to psychotherapy, click here.

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What does it mean to use an Adlerian approach?

An Adlerian approach is based on the work of Alfred Adler, a contemporary of Sigmund Freud. According to this approach, we are all striving for significance, striving to be important in some way, and what is significant or important is different for each of us. As we strive for short-term and long-term goals, we may use methods to achieve our goals that are not as effective as we think they are or as effective as they used to be. Therapy from this view, then, involves finding more effective and satisfying ways of meeting our goals.

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How long does psychotherapy take?

There is no single answer to this question. The duration of psychotherapy can depend on a number of factors and is linked to the willingness of a client to explore issues in therapy. Some issues may be resolved after a few weeks while others may take more than two years to fully resolve. Most issues are resolved within a year. Throughout the course of therapy, the goals of therapy are revisited so that a client can better appreciate therapeutic progress and to help remain focused on the therapeutic goals, which have been mutually decided on between therapist and client.

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What are the benefits of psychotherapy?

On a fundamental level, resolving issues in therapy results in a decrease in disturbing symptoms and an increase in overall level of satisfaction. Clients typically report that family and intimate relationships are more satisfying and that communication is enhanced. After resolving issues in therapy, clients tend to see things from a new and healthier perspective than they once did. It is not uncommon for this new perspective to be so different from the previous outlook on life that the phrase "Was I really like that?" often can be heard as issues become resolved.

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Do I need to be on medication?

It is possible that prescription or non-prescription medication may help to alleviate some symptoms. However, only a medical doctor can prescribe medications, and your doctor also can recommend any non-prescription medications that could assist you. Medications are most useful over the short term, though. Long-term changes are best accomplished through psychotherapy. Using medications and receiving psychotherapy often are used together so that immediate difficulties are addressed so that the underlying repair work can take place.

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What is the difference between psychotherapy and counselling?

Psychotherapy examines personal factors that contribute to difficulties. These factors can include examining patterns in thoughts or behaviours, and understanding how inappropriate or disturbing thoughts, behaviours, and feelings are maintained. Changes achieved through psychotherapy tend to be long-lasting.
Counselling looks at factors in a situation or environment that contribute to difficulties. Examples of issues addressed in counselling could include time management, communication with family members, and stress management techniques.
Psychotherapy and counselling often go hand in hand. The reality of many situations is that both personal and situational factors contribute to a presenting problem, and so it is beneficial to examine both aspects throughout the course of therapy.

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What are the elements of treating eating disorders?

Treating eating disorders typically involves four aspects:

Individual psychotherapy
One-on-one individual sessions are used to explore underlying issues that contribute to and maintain the eating disorder. More effective ways of meeting current goals are addressed and investigated in a safe and supportive environment.
Couple or family counselling
When appropriate or helpful, a spouse or significant other may be a part of the therapy session. This can serve a number of purposes, including allowing either person an opportunity to explore issues or concerns with his or her loved one present. These sessions also may allow the client and therapist to be more aware of relationship dynamics that may contribute to the eating disorder.
Meal planning
Part of recovery from an eating disorder involves learning healthy eating habits. Meal planning is an integral component of a comprehensive eating disorder treatment program.
Contact with medical doctor
Depending on the severity of the eating disorder, the therapist may need to speak to a client's medical doctor to receive information or gain a better understanding of the client's medical situation insofar as it may impact on the eating disorder. A therapist can only speak to a client's medical doctor about that client's situation with expressed written permission from the client.

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