Eating disorders are mental health conditions that cause maladaptive eating habits, usually marked by an obsession with food, body weight or body shape.

The American Psychiatric Association’s mental health manual lists four main types of eating disorders:

  • Anorexia Nervosa
  • Bulimia Nervosa
  • Binge Eating Disorder
  • Eating Disorder Not Otherwise Specified (EDNOS).

The most common cause of eating disorders is dissatisfaction with one’s body image – either as a whole or particular parts. People who suffer from eating disorders are usually obsessed with reaching a particular body shape and size and frequently suffer from denial – refusing to admit there is a problem.


People with anorexia see themselves as overweight even when they are underweight. Typical symptoms of anorexia nervosa are:

  • People constantly monitor their weight, they show an intense fear of gaining weight and seriously restrict their calories to avoid putting on weight.
  • Sufferers are considerably underweight compared with people of similar age and height.
  • They exhibit a distorted perception of their body and are obsessively preoccupied with being thin.
  • Their self-esteem is extremely closely linked to their weight so much so that their body weight and body shape causes them persistent anxiety and depression.
  • Extremely rigid food patterns such as weighing all food or keeping a calorie diary.


People suffering from bulimia eat unusually large amounts of food (usually foods they would normally avoid) in a relatively short period of time until the person becomes painfully full. Their eating becomes uncontrollable as they feel they cannot stop. Each bulimic episode is followed by purging behaviours – such as forced vomiting, fasting, laxatives, diuretics or excessive exercise – in order to compensate for the consumed calories.

Common symptoms of bulimia nervosa include: dysfunctional body-image; heavy influence of body shape and weight on self-esteem; fear of gaining weight; recurrent cycles of overeating, followed by inappropriate purging behaviours to avoid weight gain.

Binge-Eating Disorder

People with binge eating disorder typically suffer from medical issues linked to excessive weight or obesity. They tend to eat large amounts of food on a regular basis and in short periods of time. As opposed to people with bulimia they do not purge.

Binge eating disorder is characterised by the following behaviours:

  • Episodes of uncontrollable binge-eating, indulging in consuming large amounts of foods very fast, usually in secret and until painfully full, despite not feeling hungry.
  • Feeling ashamed or guilty about their binge-eating episodes, but without compensating for the calorie intake through purging behaviours: calorie restriction, vomiting, using laxatives or diuretics or excessive exercise.

How We Treat Eating Disorders and Addiction over Many Months

Eating disorders are difficult to treat and it takes a lot of time and patience to address the complex issues surrounding an eating disorder. Our team of therapists are skilled and experienced in identifying unhealthy eating patterns and adapting patient treatment plans to ensure help is received quickly.

The eating disorders that occur most often with drug abuse are bulimia nervosa and EDNOS. It has also been shown that dormant eating disorders that a patient has been suffering from in the past may re-emerge after substance addiction treatment because alcohol or drugs are no longer used to cover negative feelings or body image.

Our Castle Health treatment programme includes all the necessary resources and on-site medical expertise to treat dual-diagnosis patients with complex needs that present eating disorders alongside addiction problems.

Both substance abuse and eating disorders have similar features: they both negatively impact a patient’s normal, everyday functioning; they are both chronic diseases, characterised by compulsive behavioural patterns, denial, secretiveness, obsessive preoccupation with a chemical substance (e.g. drugs, food) and sufferers often move from one disorder to another as a way to manage undesired feelings and symptoms.

A Comprehensive Treatment Programme

Specialised Therapy for Eating Disorders and Addiction

The first step in treating people with alcohol and drug addiction who also experience the complication of an eating disorder is a thorough assessment. Patients are assessed according to several, expert diagnostic tests that help us establish a clear diagnosis. After this a comprehensive, personalised treatment plan is drawn up by our multidisciplinary, medical and therapeutic team, as guided by the Consultant Psychiatrist and our Eating Disorders Specialist. The most effective therapy in treating eating disorders is cognitive behavioural therapy (CBT). CBT takes place both in individual sessions and a group setting where patients are assisted in identifying negative behavioural and thought strategies and replacing them with beneficial coping mechanisms. CBT is also supported by 12-step treatment model meetings, where patients work through the 12 steps of Obsessive Eaters Anonymous (OEA).  The psycho-educational nature of group therapy assists patients to resolve shame, guilt, low self-esteem and other psychological issues. Other types of therapy such as trauma therapy or grief therapy may be recommended for certain patients that are dealing with particular psychological challenges.

Diet and Nutrition

Another important element in treating patients who suffer from eating disorders is diet and nutrition. We have in-house chefs that prepare healthy and nutritious meals and snacks for patients every day. We also cater for special dietary requirements or religious restrictions.

Patients learn to adhere to healthy eating habits and have three meals and three snacks daily. Sometimes meals may be plated and therapy staff members may eat with patients in a caring and friendly environment.

Medical Supervision

Our medical supervision includes prescription of food supplements, electrolyte monitoring, weight monitoring and electrocardiogram testing where necessary.

Throughout treatment patients’ eating behaviour is closely monitored and weights checked. At Castle Health we treat patients successfully when we see them growing in self-acceptance and recovering from obsessive-compulsive behaviours. Our patients receive ongoing, gentle support from our trained and knowledgeable staff, guiding each patient on their personal recovery journey.