Being in the grip of an Eating Disorder or disordered eating behavior is like being in a psychological prison. Caught in a cycle of repetitive and distorted thinking, habitual behavior patterns, shame, guilt, fear and isolation, the sufferer may sink ever more deeply into self-destructive behavior until their life spirals out of control or their illness begins to affect their physical health in life-threatening ways. This is a serious, yet under-funded illness whose prevalence rate has significantly increased in the United States within the past two decades. Often, an Eating Disorder or disordered eating might begin with dissatisfaction with one’s body, dieting, trying different strategies for maintaining or losing weight, feelings of unease or even the presence of a mood disorder, like depression. But it can escalate into addictive and compulsive behavior around food as well as the desperate need to stay in control at all costs.
It is estimated that in the United States, some 20 million females and 10 million males will develop a “clinically significant” eating disorder at some point in their lives. Many others may experience pervasive feelings of dissatisfaction with their bodies and “sub-clinical disordered eating attitudes and behaviors,” factors which are known to contribute to the development of Anorexia and Bulimia Nervosa. A new, large-scale U.S. study of teens between the ages of 13 to 18 showed that the median ages for the onset of an eating disorder were about 12 to 13 years of age. The study also revealed that eating disorders in adolescents are often associated with suicide plans and suicide attempts. Research on Anorexia Nervosa reveals that this illness has the highest mortality rate of any psychiatric disorder. Females, particularly between the ages of fifteen and twenty-four years of age, are twelve times more likely to die from Anorexia Nervosa-related symptoms than any other cause of death.1
What is an Eating Disorder?
Eating Disorders include the presence of “extreme emotions, attitudes and behaviors surrounding weight, diet and food issues.”2 The three main types of Eating Disorders are Anorexia, Bulimia and Binge Eating Disorder, as well as other eating patterns that could be classified as “Disordered Eating.”
The main characteristics of Anorexia Nervosa are: self-starvation, extreme weight loss, obsession with food intake and the severe restriction of one’s diet to certain types of foods coupled with an inability to recognize the seriousness and consequences of one’s behavior. Some with this illness may also go through cycles of bingeing and purging. Typical onset of this illness is early to mid-teens and approximately 90-95% of all cases are girls and women.3 These individuals become so preoccupied with food and the need to control their food intake that they will start to withdraw socially from friends and family, engage in compulsive exercising to burn calories and start to monitor and measure all their food intake. Their body image is distorted and their denial of food gives them a feeling of control.
Unfortunately, anorexic behavior results in the body not getting adequate nutrients to function properly. Over a period of time, body functions start to slow down to conserve energy. Within a long enough period of time, anorexics may suffer from heart failure, as the heart rate and blood pressure decrease when the body is not getting enough nutrition. In fact, death rates of anorexia sufferers are between 5% and 20%. Other symptoms include loss of muscle, weakness, reduced bone density or even osteoporosis, dehydration that can lead to kidney failure, loss of menses in women, fatigue, fainting, low energy, hair loss, dry skin and hair, and in extreme cases a soft layer of hair called lanugo will grow all over the body to try to conserve heat.4
Bulimia Nervosa occurs in approximately 1-2% of adolescent girls and women and approximately 80% of patients are women. Although bulimia sufferers are usually of average body weight, they will go through periods of uncontrollable consumption of large amounts of food, followed by various strategies to try to atone for the bingeing to prevent weight gain, such as self-induced vomiting, excessive and regular use of laxatives and over-exercising past the point of exhaustion. Cycles of binging and purging become so draining of time and energy that the sufferer starts to withdraw from social connection and loses all perspective as to the effect of their behavior.5
Excessive use of laxatives and vomiting can severely compromise gastrointestinal health, causing irregular bowel movements and constipation, inflammation and possible rupture of the esophagus as well as tooth decay and erosion of tooth enamel because of the harsh stomach acids that are present in vomit.6 As binges usually involve a high consumption of carbohydrates and sweets, other gastrointestinal conditions are common with all eating disorders, such as overgrowth of unhealthy intestinal bacteria, fungal problems, intestinal parasites, indigestion, gas, bloating, ulcers, gastritis and Irritable Bowel Syndrome.7 In addition, the physical and emotional stress brought on by bingeing and purging, excessive exercise, and lack of body fat, in cases of anorexia, may result in cessation of menses or severe premenstrual syndrome.
The third type of eating disorder is Binge Eating. During frequent binge eating episodes, the individual feels as if they have no control over their behavior while eating large amounts of food. What distinguishes this disorder from Bulimia is that the individual does not resort to laxatives or vomiting to try to get rid of the food they have consumed, nor is the bingeing followed by intense exercise to burn off calories. They usually feel intense shame and guilt about their behavior, which tends to lead to social isolation, sneaking food and eating alone.
Prevalence of Binge Eating Disorder (BED) in the US represents approximately 1-5% of the population, affecting about 60% women and 40% men. BED is often associated with symptoms of depression and affect people whose weight is normal or heavier than average. Health risks related to this disorder are similar to clinical obesity: high blood pressure, high cholesterol levels, heart disease, diabetes, gallbladder disease and musculoskeletal problems. In addition, BED sufferers may experience the same gastrointestinal conditions mentioned above, especially as a result of ingesting excessive carbohydrates and sugar.8
People with patterns of “Disordered Eating” may not binge as frequently as bulimics, purge, take laxatives or severely restrict their food intake like anorexics, but nevertheless, food and/or their bodies have become a battle zone. They are using food to meet other needs besides fuel and nutrition. Underneath this behavior is emotional and psychological pain, usually brought on by challenges in several areas of their life, such as relationships, work or school.9
What Causes Eating Disorders and Disordered Eating?
A common perception of the cause of eating disorders, particularly anorexia, is the desire to have the perfect body shape and size in order to meet a cultural norm of beauty and desirability, especially for women. Our culture places more emphasis on outward appearance than inner qualities. Beauty magazines and advertisements display images of slim models and actors with airbrushed features depicting what a body should look like and what is considered “sexy” in our culture. These pictures have captured the imagination of many people, implicitly suggesting that these figures denote beauty. As a result, children and youth receive the message that how they look on the outside is most important. This can be devastating for children who are overweight or of different ethnic backgrounds. The National Eating Disorders Association published some startling statistics on their website about dieting and body image:
• 42% of 1st-3rd grade girls want to be thinner. (Collins, 1991)
• In elementary school, fewer than 25% of girls diet regularly. Yet, those who do know what dieting involves can talk about calorie restriction and food choices for weight loss fairly effectively. (Smolak, 2011; Wertheim et al., 2009)
• 81% of 10 year olds are afraid of being fat. (Mellin et al., 1991)
• 46% of 9-11 year-olds are “sometimes” or “very often” on diets, and 82% of their families are “sometimes” or “very often” on diets. (Gustafson-Larson & Terry, 1992)
• Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviours such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives. (Neumark-Sztainer, 2005)
• 35-57% of adolescent girls engage in crash dieting, fasting, self-induced vomiting, diet pills, or laxatives. Overweight girls are more likely than normal weight girls to engage in such extreme dieting. (Boutelle, Neumark-Sztainer, Story, &Resnick, 2002; Neumark-Sztainer&Hannan, 2001; Wertheim et al., 2009)10
Although dieting and preoccupation with weight can predispose an individual to develop an eating disorder, other psychological and interpersonal factors play a large, contributory role. Dr. Gregory Jantz, a certified eating disorder specialist and director of an Eating Disorders treatment center in the U.S., explains that behind all eating disorders are pain and an attempt to numb, control and divert pain. In fact, studies have shown that 80% or more of individuals with eating disorders have experienced some sort of verbal, emotional, physical or sexual abuse.11 According to Dr. Jantz, the cycle of disordered eating begins with feelings of “unease and dissatisfaction,” whether it is fear, anger, sadness, anxiety, stress, low self-esteem or loneliness. This is followed by the desire to suppress those feelings and use food, either restricting or consuming it, as a way of regaining control. Afterwards, the person may have feelings of guilt, shame and hopelessness, which then leads to self-hatred or over-perceived weakness. This sets them up to repeat the cycle of self-harm. Over time, disordered eating patterns start altering brain chemistry, which affects physical, emotional and psychological health, keeping the individual trapped in the addictive behavior.
Eating Disorders and the Brain
The neurobiology of addictive and compulsive behavior can offer some insight into what is happening in the brain. Our prefrontal cortex is responsible for the regulation of body systems, attuning to others, balancing emotions, modulating fear, responding flexibly, exhibiting insight and empathy, morality and paying attention to the body’s wisdom.12 We all have a window of tolerance for every emotion, which is highly conditioned by our early environment and past experiences. For example, a child might have learned to suppress their anger because they had an angry parent who unleashed their anger in irresponsible and unsafe ways and never effectively modeled self-regulation, the ability to self-sooth or offer self-compassion. So, whenever this person now feels anger, their window of tolerance is so narrow for the emotion of “anger” that they may have no idea how to internally support themselves and may slide into a fight/flight or freeze state quite easily. Without any means of self-regulating, they need some form of external support.
The best form of external support would be “transformational,” in that the anger-causing trigger would no longer cause any pain when the person brings the trigger back into their mind. Examples would be effective body-centered empathy or another kind of resonant therapy, feeling deeply heard, various types of bi-hemisphere stimulation (e.g. Neurofeedback, EMDR, Emotional Freedom Technique), communing with nature, meditation or prayer in a way that feels transforming. Another kind of external support, though not as effective, might be strategies to sooth the self, such as taking a hot bath, breathing, nature, exercising, ineffective empathy, sympathy, gossiping and complaining. This may give some relief, but the experience may still bother them emotionally. Other strategies such as meditation, prayer and communing with nature may either be soothing temporarily or transformational. The third kind of external support, any addiction or compulsion, offers the experience of temporary soothing, but with harmful long-term effects.13
Sarah Peyton, an Interpersonal Neurobiology expert based in Vancouver, WA, USA, points out that when we use food (particularly fat and sugar) as an external strategy to self-regulate keeps us from needing other people and even being aware that we need them. The consumption of fat and sugar produce endorphins in the body, which creates feelings of well-being. When a child does not learn how to self-soothe, as they get older they tend to reach out for external support that can help them self-regulate their emotions.”14
Let us take a closer look at what is happening in the brain.
When we are within our window of tolerance and open to social connection, our systems as well as our neurotransmitters, such as dopamine, serotonin and norepinephrine, which are responsible for our mood and cognitive function, are in balance. When we step outside our window of tolerance, which is what often happens with disordered eating behaviors, our serotonin levels drop. Or, there may already be a problem with serotonin functioning and the “stop eating” message that serotonin gives to some people may not be working. Since stress decreases all three main neurotransmitters, the “stop eating” message that inhibits overeating is impaired. When your serotonin levels drop you may feel depressed and your sensitivity to pain increases, which further decreases your window of tolerance. In this state, a person may crave carbohydrates. The neurotransmitter dopamine will then send the signal to search for food. Incredibly, eating carbs in high amounts will stimulate a complex chemical process that increases the blood levels of tryptophan in proportion to other amino acids competing for carriers to cross the blood-brain barrier. With more tryptophan in the brain, serotonin can be produced and released, creating feelings of calmness, drowsiness and ease from pain. The two foods that together stimulate a surge of serotonin production in the brain is milk and sugar, which are the key ingredients in ice-cream.15
In Anorexia Nervosa, brain chemistry is altered in such a way that food restriction can become addictive. First, serotonin levels drop because the body is not getting an adequate amount of the essential amino acid tryptophan, which causes an anorexic to temporarily feel better. Then, in response to low serotonin production, the brain will try to maintain balance by increasing the number of serotonin receptors and using serotonin more efficiently. When restricting food doesn’t feel as good the anorexic will eat even less. This starts a negative cycle that is hard to break.16
People with Bulimia Nervosa appear to have lower than average levels of serotonin in the brain which binge eating will temporarily increase. This can start an addictive cycle of altering brain chemistry that uses food in order to feel better. In addition, purging can have a euphoric and sedating effect by increasing levels of vasopressin, a hormone that regulates the body’s retention of water.17
It is likely that people with eating disorders have lower levels of endorphins. These hormones make us feel good, socially connected, sensitive and compassionate to others and ourselves; lowers our sensitivity to pain; and aids in maintaining high self-esteem and a balanced attitude towards sweet food. Sugar not only increases insulin levels, but also is connected to endorphin production. When we do not produce enough, we may experiences symptoms such as emotional overwhelm and reactivity, low self-esteem, low pain tolerance, cravings for sweets and feeling alone.18
During a presentation that Neurobiology Expert Sarah Peyton gave on Food Addiction, she cited Dr. Michael Kerr, Psychiatrist and Director of Georgetown University Family Center in Washington, D.C., who concluded the traits that are most often at the root of the addiction process are: “poor self-regulation, lack of basic differentiation, lack of a healthy sense of self, a sense of deficient emptiness, and impaired impulse control.”19 Furthermore, PET imaging studies done on drug and food addicts show both subjects have fewer dopamine receptors in the brain and a faulty incentive-reward circuit that continues to send signals to keep eating well beyond satiety. By engaging in binge eating behavior, a person will continue to prime oneself in expectation of a “reward” in much the same way that a drug user keeps searching for the next “high.”20
As noted earlier, self-regulation is an important skill for supporting the self in times of stress or emotional triggers. Effective self-regulation is the ability to self-sooth, make sense of our experience, transform our relationship to stressors and triggers, and develop self-compassion. We also gain greater trust, confidence and self-reliance when we have a “built-in system” of internal support or we know how to get effective external support when we need it. We learn strategies for emotional regulation through modeling, especially from our parents when we are children. Through consistent availability and emotionally attuned parenting, we develop and internalize a healthy sense of self. Lacking this type of parenting is a major source of stress for the child and the child may also end up learning ineffective or unhealthy coping strategies that deny or suppress emotions.21
Families may also be the source of rigid and perfectionistic ideas of success that place more value on achievement, meeting impossible goals and overly concerned with keeping up appearances. Children in these families may grow up feeling their value is based only on their looks and performance. They may be plagued by feelings of inadequacy, never feeling good enough, the fear of failure, rejection and constantly seeking outward approval and external validation. Dr. Jantz observed that anorexic behavior stems from a desire to maintain control over a fear that the person does not feel they can cope with, whether it be a fear of failure, abandonment, intimacy or sexuality.21
Two other important aspects of the addiction-prone personality is poor impulse control, which is also linked to self-regulation, as well as the absence of “differentiation.” Impulses arise from the lower centers of the brain where they are either permitted or inhibited by the cerebral cortex. Even in a well-functioning cortex, the lag time between awareness of the impulse and the muscle activation carrying out the impulse is only one-tenth to one-fifth of a second.22 Differentiation is “the ability to be in emotional contact with others yet still autonomous in one’s emotional functioning.”23 A poorly differentiated person has trouble forming healthy bonds with others and tends to feel anxiety, overwhelmed by their own emotions and those of others.24
Conventional Treatment Options for Eating Disorders
Depending on the severity of the eating disorder and the health condition of the person, treatment needs to be tailored to the needs of the individual and may require hospitalization for medical treatment. It is widely recognized that treatment requires a multi-disciplinary approach. This may include a physician, psychologist, psychiatrist, social worker and nutritionist as well as pharmaceutical drugs, such as anti-depressants or anti-anxiety medications. There are a number of residential and outpatient treatment centers throughout the US. It is important that the psychological, interpersonal and cultural issues contributing to the development of an eating disorder are also addressed.25Truly breaking free from an eating disorder requires a change in behavior, attitude and perception as well as the development of healthy self-esteem, a positive body image and effective life skills. The process takes time and depends on many factors. The National Eating Disorders website has published blog posts from a number of people who successfully overcame their eating disorder. A common experience that many shared was that even when they hit “rock bottom,” their healing journey was full of ups and downs, relapses and repeat stays at treatment centers before they were able to stabilize. Another shared aspect of their stories was they realized that in order to heal, they had to learn how to love and care for themselves.
A defining feature of any addiction is habitually self-destructive and self-harming behavior, internalized negative messages and intense feelings of shame, sadness and guilt. As one researcher put it: “when you’re operating in the habit mode you are feeling, but those feelings are not being reflected upon. They are too powerful, too habitual. So, the treatment of addiction requires the island of relief where a need to soothe pain does not constantly drive a person’s motivation. It requires a complex and supportive social environment.”26
Complimentary & Alternative Medicine
There is a wide range of complimentary and alternative healing modalities that can support an individual recovering from an eating disorder to address various aspects of the disorder. Acupuncture, for example, has been used in Eastern countries for drug addiction treatment and is being studied to better understand its effects in being able to modulate neurotransmitters in the brain, such as dopamine, that are implicated in addiction.27 Homeopathy, Naturopathic medicine, Traditional Chinese Medicine, Ayurveda, holistic nutritional therapy, herbs, vitamins, minerals and other nutraceutical supplements can be used to help address imbalances, nutritional deficiencies, infections, Candida and other gut and health issues.
Body-centered therapies and practices such a yoga, Qi-Gong, Tai Chi, massage and energy healing can feel nurturing, strengthen the mind-body-spirit connection, induce a state of relaxation, improve circulation, and increase focus and awareness of the present to help calm mental restlessness.
Bi-hemisphere stimulation such as Emotional Freedom Technique, Eye-Movement Rapid Desensitization and Neurofeedback are techniques that can help with trauma and to shift the brain out of emotionally triggered fight/flight/freeze states.
There is an alternative, therapeutic treatment modality that utilizes empathy to create new neural pathways in the brain combined with a neurobiological understanding of trauma, the brain and emotional regulation. During an emotionally stressful or triggering experience that knocks a person outside of their window of tolerance, the limbic system gets activated. The amygdala is part of the limbic brain that holds implicit, disconnected and painful memories. As the experience triggers painful memories, the person is supported with empathy to calm the amygdala and get unstuck from the intense emotions. This method opens access to those parts of their brain that helps to contextualize their experience and find a more creative, flexible response, namely the hippocampus and the pre-frontal cortex. When a person starts to have repeated experiences of calm after upsets, they begin to develop new neural connections between the amygdala and the pre-front cortex. Meditation has also been shown to help increase response flexibility as well as pre-frontal cortex activity.
Dr. Jantz, an Eating Disorders Treatment Specialist, believes that recovery is possible with a “whole-person” approach that must include spirituality and developing or re-establishing a connection to God. He adds that the effects of shame, guilt, frustration and even disgust with one’s relationship with food are devastating to the soul and spirit. The addictive eater turns to an “object” like food for comfort and support, rather than God. Food takes precedence over people. Social connections and emotions are not dealt with. An unhealthy, learned pride tells the disordered eater they can continue to engage in this behavior and keep getting away with it perpetuates an intense preoccupation with self that leads to a “false reality.” He concludes that the disordered eater must examine their past, face the truth of their experience, gain insight into how they explained things to themselves as a child and shift their perspective from their child self to their adult self.28
How The Trivedi Effect® and the Daily Transmission Program for Kids Can Help
The Trivedi Effect® and the Daily Energy Transmission Program for Kids, ages 0-18, can be of enormous and invaluable benefit in helping adults and young people with eating disorders to break out of the bondage of their addictive and self-destructive behaviors. The Trivedi Effect® has been proven with over 4,000 science experiments and many peer-reviewed scientific international publications in Agriculture, Microbiology, Biotechnology, Materials Science, Genetics and Cancer to impact everything on the cellular, molecular and atomic levels, thus altering the behavior and character of the recipient or material in a completely beneficial, scientifically incomprehensible and life-changing way (www.trivediscience.com). When applied to humans, The Trivedi Effect® has been able to impact a person on every level, including their relationships, finances, emotions, social interactions, sexual pleasure, mental health, physical health and overall outlook on life. The Trivedi Effect® has also shown incredible promise in the treatment of neurological, psychological and eating disorders.
The Trivedi Effect® is created through the process of “Energy Transmissions.” The daily Energy Transmissions are administered to the children each night as they sleep by Trivedi Master™ Alice Branton. The Infinite Intelligence of this energy creates a strong connection between the child and the Infinite Power of Nature, enabling the child to harness the energy and power needed to break bad habit patterns in order to balance and enhance their physiology and optimize their true potential on this planet. Parents of children receiving these Energy Transmissions have reported increased mental calmness and clarity, good sleep, increased self-confidence and overall physical, mental, social, spiritual and emotional growth. The intelligence of this energy offers support the child requires to clear emotional pain and eradicate hurt and negative internal dialogues. The Trivedi Effect® also enhances the effect of any psychotherapy or counseling the child is doing as part of their recovery from an eating disorder and enhances the ability of the child to learn new life skills and self-compassion.
Anyone with an eating disorder has been suppressing and denying their pain, emotions, and behavior. The longer that this has continued, the harder it can be for the person to accept they have created a false reality marked by delusion and self-obsession that has kept them stuck in a state of suffering and halted their growth, development, and consequently affected their relationships, school, career and health. In the Twelve Step program, which was initially used to help millions of people recover from addiction to alcohol and is now also used for drug, food and other addictions, reestablishing a connection with God is considered essential to recovery. The addict must admit that they have no control over their addictive or compulsive behavior. The first few steps read:
1. We admitted we were powerless over (alcohol)—that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
Receiving regular Energy Transmissions can “jumpstart” the connection with The Divine, stop the vicious cycle of addiction and begin the healing process. It is one of the fastest ways to raise consciousness and bring relief to a person stuck in addiction. The Energy Transmissions do not magically remove all distorted thinking and painful emotions or give an instant healing. Receiving regular Energy Transmissions helps the person to move through and integrate the pain and regain a feeling of hope and possibility. As the Energy Transmissions start to calm the brain and body, bring more mental clarity, presence, alertness and awareness, they help with emotional regulation and impulse control. These Transmissions of Divine Energy help to fill the hole of “deficient emptiness” associated with addictive behaviors and the drive to numb pain. A connection with God becomes a source of support, strength and nurturance. As Dr. Jantz clearly stated: addictions shut God out and spiritual renewal is necessary for healing. An addictive eater needs to learn to accept God’s grace and forgive themselves.29
As mentioned previously, it is thought that people with addictions have difficulty with differentiation in relationships and lack a healthy sense of self. Thousands of people who have experienced The Trivedi Effect® have reported that their relationships began to improve as they were able to come out of the “trance” of unworthiness and establish a deeper connection to their soul and spirit and start to love and respect themselves. As the Energy Transmissions help to connect your spirit and your Inner Guidance System with Infinite Intelligence, aspects of the false self that were creating inner turmoil and tension start to fall away with little effort. As the inner battle, negativity, and self-absorption lessens, the person will naturally seek out more positive and healthy ways of relating to others. The energy is very respectful and will not interfere with your own religion, practices, beliefs and free will to heal, change and grow. A defining aspect of healing from addiction is the person’s willingness to want to heal and leave their old and toxic coping strategies behind.
The Trivedi Effect® and the work of Mahendra Trivedi, Enlightened Master and founder of The Trivedi Effect®, as well as Trivedi Masters™ Alice Branton, Gopal Nayak and Dahryn Trivedi, show tremendous promise in helping to alleviate the symptoms and address the root causes of many neurological, psychosomatic and psychological disorders that pharmaceutical drugs are unable to treat. The eating disorders treatment specialist, Dr. Jantz, states that although anti-depressant medications have been shown to help bulimics to stabilize in the short-term, they “cannot treat the underlying causes of an eating disorder. It cannot improve your self-esteem, resolve past and present conflicts, or teach you healthy coping skills.”30 Healing at the spirit/soul level provides a new and clearer level of perception and deeper connection to a greater truth that our Soul and Spirit long for. As an addictive or disordered eater’s imagination is so fully captured by their self-destructive behavior and negative emotions, they lose connection with their essential nature—their inherent goodness and freedom. With the help of the Energy Transmissions and Mahendra Trivedi’s discourses that speak directly to your spirit, a longing for truth and wholeness begins to grow. Negativity begins to look less attractive and the desire to harm oneself fades as a person begins to experience deep nurturing by The Divine and grows in consciousness.
To learn more about The Trivedi Effect® and the Daily Transmission Program for Kids, visit www.trivedimasterwellness.com.
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13 Sarah Peyton, Teleseminar: Food, the Brain and Empathy: A Compassionate Look at Our Patterns of Eating, November 16,
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2010
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Eating, November 16, 2010
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Brain and Empathy: A Compassionate Look at Our Patterns of Eating, November 16, 2010
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Bulimia, and Disordered Eating (Colorado Springs, CO: Waterbrook, 2010), 194
30 Gregory J. Jantz, PhD, Hope, Help, & Healing for Eating Disorders: A Whole-person Approach to Treatment of Anorexia,
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31 Gregory J. Jantz, PhD, Hope, Help, & Healing for Eating Disorders: A Whole-person Approach to Treatment of Anorexia,
Bulimia, and Disordered Eating (Colorado Springs, CO: Waterbrook, 2010), 247
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