Philosophy of the treatment

Marino Therapy Centre treatment is based upon belief that Eating Distress is reaction to environment and affects the whole person, physically, emotionally and spiritually, therefore we need to adopt a holistic view of each person and address all these areas. The practitioners of Marino Therapy Centre are all highly qualified professionals specialising in the area of Eating Distress. Due to the medical complications of this illness a GP is also attached to the centre.

The client’s family is offered to meet with the practitioner for family education sessions and learn more about the condition, explore its origin and discuss the effect it has on the family. This will help open the lines of communications between the client and the family.

The centre organises group discussions concerning topics associated with Eating Distress, including self-esteem, interpersonal relationships, communication, body awareness and nutrition. Each person is given the opportunity to develop emotionally with increasing responsibility for daily living.

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We have been hearing a lot about Eating Disorders in the media over the years, but very little about Eating Distress. What is the difference?


Eating Disorders such as Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder and Eating Disorders Not Otherwise Specified, as described in psychiatric manuals, are just labels which concentrate mostly on the description of a person’s behaviour. Different types very often overlap and even the top experts agree that it is difficult to make a clear diagnosis. But all of these are only the symptoms of the condition known as Eating Distress (ED). Eating Distress is a disease where the mind culminates all of the negative assumptions the person has about him or herself. The negative mind becomes more powerful than the positive mind and has much more influence on the person’s thinking, feeling and behaviour. This state of mind develops subconsciously and the person is not always aware that they are victims of this negative condition. Often we read that sufferers have low self-esteem. However, in reality, he or she has no sense of self at all. Therefore, this condition is extremely abusive and manifests itself with highly self-destructive symptoms in which an eating disorder is one. They are all different manifestations of one basic condition.

People suffering from Eating Distress have difficulty with the simple act of eating when hungry, and stopping when they are full. The condition takes over the control of their food intake. Often it can be recognisable by an unhealthy obsession with food and body, which comes to occupy centre stage in the sufferer’s life. Food becomes the most important relationship – but it is never a happy one or an easy one. Slowly and surely everything is eventually excluded while thoughts constantly centre on food or the body.

Eating Distress is not a problem; it is a solution of other underlining issues. It is a way of communicating with inner unhappiness. Controlling the body is a way of controlling life. Control is the centre of the sufferer’s life. Eating Distress is very preoccupying. That is the function of the disease. It occupies the mind fully and excludes other issues. It is a cushion against painful reality. Eating Distress is a symptom of how the person relates to the world. Obsessive thinking about food is only a lonely substitute. Eating Distress is a very private disease and is usually not brought voluntary to the attention of health professionals.

A person with Eating Distress wants to be trusted, wants to be liked, and wants to communicate. But, like many people he or she is afraid. Eating Distress is their language and their solution to the problems in their lives. It is a connection between eating, emotions and state of mind. No single personality type has so far been associated with Eating Distress. But statistics show that sensitive and vulnerable people are more susceptible. A person suffering from Eating Distress relies more than most on other peoples’ opinions of him or her. Reflections of him or her determine how he or she feels about himself or herself. The Eating Distress person is terrified of criticism. It means that others do not approve of something that the sufferer did or said. Very often it is taken as a personal judgement. The Eating Distress victims are not only in need of approval from others, but inside they are ‘’hungry’’ for care and affection as well. Despite the feeling of dependency, people with an Eating Distress don’t want to rely on or need other people. Feeling dependent or needy leaves them feeling weak or like a failure, and it is avoided at all costs. For some people there is an intense fear that others will be overwhelmed by their needs and leave them, or stop loving them. To avoid this they try to be perfect inside and out. The strain is enormous. They feel that to be loved, they need to be perfect. People with an Eating Distress want to be like everybody else. However, they find it much more difficult to be aware of their real needs and feelings. They do not feel their worth as a person. They struggle to make sense and express their feelings about their life.

Remember, anyone can suffer from Eating Distress at any age.

Coping with Eating Distress in the Family

  • If someone in a family develops an Eating Distress (ED), it is time to listen, not to blame.
  • Neither the sufferer nor the family can be blamed or criticised for developing an ED.
  • Families need to learn about the ED in order to be a positive support.
  • A family’s involvement can speed up the process of recovery greatly.
  • Friends and family members are often the forgotten victims of ED. It is often difficult for the carer to know what to do for the person or for themselves.
  • Work with ED Families is a slow process that involves a lot of education, communication and patience.


The term ‘family’ describes ‘a unique cluster of people who enjoy a special relationship by reason of love, marriage, procreation, and mutual dependence.’ The family plays a primary role in how we develop as a person and how we see ourselves in relation to other people. The family acts as a ‘mini -society’ with its own governing system, politics, economics, culture and beliefs. Our experiences with how we operate in this first structure influences how we operate out in the world because the family is vital to helping to develop belief systems and values. However, this does not mean that the family is responsible for all developmental problems that may emerge in a person’s life.

There are no Typical ED Families. The presence of an ED in a family does NOT mean that the family or its members are dysfunctional! Over the years, families have been studied and re-studied to determine the causes of ED. However, there is nothing conclusive to say that dysfunctional families breed ED. Many sufferers come from loving families without trauma or upset.

There is no perfect family, parent, sibling or environment. The only conclusive absolute that links sufferers is their sensitivity. The negativity of the sufferers’ condition is similar, yet the sufferers and their families and environments are all unique and individual. Work with the family is firstly educational. The key to successful recovery is improve their knowledge of the condition.

Many family members enter treatment with shame, guilt and fear. In the practitioner’s first session with the family, it is necessary to address the fears, shame and guilt. Fear of the ED, and shame and guilt for causing it all get in the way of helping to get rid of it!! Fear usually effects boundaries and rules. Parents are afraid to set rules and/or boundaries for fear that the sufferer will react poorly. Therefore, they become too flexible or too rigid.

The most important thing to impart on carers is to help them to let go of trying to change their loved one’s behaviour. The family member needs to come to terms with understanding that they have power only over their own behaviour. Not understanding this can set the family on a dangerous course. If we only concentrate on controlling the eating behaviour, the Eating Distress gets worse. Stressing that carers need to care for themselves just as much as they do for the sufferer is a difficult concept for most family members. And, when they understand in theory, it is often difficult to put into practice.


A Study of Heablon and Andersen (1981) examined 73 consecutive ED families, more than 2/3 showed not the slightest sign of imbalance or unhealthy functioning. Family issues need to be addressed through evaluation and treatment.

  • burdens of guilt
  • self-blame
  • Anger and exhaustion.

Family Involvement in Recovery

It is important for family members to express concerns, fears and observations, but in a loving and non-judgemental manner, even if this is not received very well. Remind them over and over not to give up!

Denial is often the first stage of the illness for the sufferer. However, it is also very present in the family. Many family members do not want to hear that recovery takes time and needs the family members to change. Thus, there are many families that do not want to be involved in the treatment process.

However, it is necessary that family and friends are at least seen as trying to reach out to a suffering loved one in order to facilitate the person getting help and support during recovery. Often the fact that family members make appointments to learn about the condition is a relief to sufferers. On the surface, many ED clients express resistance to allowing their family members and or carers’ involvement. Family members must show their willingness by making appointments taking a stand.

Family members often think that they are doing the right thing when they ask how the sufferer is feeling, or getting on in therapy? It takes a long time before the sufferer knows the answer to these questions. Therefore, these direct questions asking how they are doing can overwhelm them and make them feel mis-understood. It is up to the practitioner to explain this to families and sufferers. The practitioner takes the responsibility from the client to explain the condition.

Magazines, newspaper, television, radio programmes and books do describe Eating Distress as mostly female’s issues. Males do develop this condition as well and not only in resent times. This was observed over three hundred years ago. In 1964 London physician Richard Morton for the first time reported case of anorexia nervosa in 16-year old male. Admitting to an eating disorder is difficult to anyone, but even more difficult for males due to the perceived notion that only females suffer from these illnesses. The number of female being open to treatment exceed that of males, males do suffer much more in silence and isolation.

The National Centre for Health Statistics (USA) states that 48% of males are trying to lose weight. Men undergo 25% of all cosmetic surgeries in USA.

Male suffers were overlooked and understudied. Many programs are treating female suffers only. Males struggling with Eating Distress were often teased more about their bodies while growing up and were preferred less for athletic teams. Last twenty years reported cases of males with Eating Distress have been steadily increasing. Media and professionals are paying more attention to this issue. An Article in the Los Angeles Times /1995/ on this subject, stated that roughly one million males in USA are suffering from Eating Distress. 1996 Dennis Brown, Super Bowl defensive end, reveal that he used laxative, diuretics, and self-induced vomiting to control his weight. He was reprimanded by coaches and team officials that he was embarrassing the organisation.

Men’s bodies are more frequently the targets of advertising campaigns; leanness for men is increasingly being emphasised, and the number of male dieters and males reporting eating disorder continues to rise. Very often men with eating disorder are intensely athletic and to have begun dieting in order to attain greater sports achievement or from fear of gaining weight because of sport injury. Many men may fit another proposed but not yet accepted diagnostic category, referred to as compulsive exercise, compulsive athleticism.

According to Dr.Arnold Andersen, who wrote book on this subject, Males with Eating Disorders/Brunner/Mazel, 1990/ definitive answers are not available, but sociocultural influences appear to play a much bigger role than biological ones. Because a male suffer does not have a loss of a period as a symptom, it is common to misdiagnose or overlook them. Men with medical and health problems tend to be overly sensitive to eating disorders. Under nutrition also affects the male’s ability to procreate/Keys/, loss of sexual interest.

Men with Eating Distress exhibit an over-whelming fear of fatness and desire to maintain a masculine appearance or shape. It’s neither surprising nor uncommon to see males with Eating Distress overuse anabolic steroids to improve muscle tone and build strength. Side effects of steroid abuse may include several psychiatric symptoms, such as hallucinations, manic symptoms and depression. Medical side effects may include reduced sexual functioning. Characteristics of men who exercise extensively are similar to those of the female ones. Men become obsessed with exercising and view their worth according to how much they exercise. It becomes an addiction. Male jockeys, wrestlers, swimmers, and dancers see physical appearance as being vital to their success. This makes them more vulnerable to Eating Distress. Males who were wrestlers in high school and college often continue their bulimic trends after they give the sport.

It is difficult for men to reach out and ask for help because this condition is still very much considered as a ’women disease’. They may not want to come forward for fear that people will think the are gays. Many people automatically assume if a man has as eating disorder, then he must be gay. That is not true at all. Someone’s sexual preference has nothing to do with them developing as Eating Distress.

The reason men develop Eating Distress are no different then why a woman, child or anyone else would. They are super-sensitive and were subjected to more anxiety and negativity in the past. They experience the same feelings as anyone else. They have very low self-esteem, are perfectionists, over achievers and use this condition for expressing their emotions because they do not know any better way.

Recovery is a ‘finding’ or ‘re-discovery’ of the self that has only been experienced under the crippling and distorting influence of an Eating Distress. The focus needs to be placed on developing new ways of coping with stress other than through dysfunctional eating behaviours.

Providing care to clients with Eating Distress (ED) is a multifaceted endeavour. This includes attention to the physical, psychological, spiritual, environmental and social domains of health. Much has been written on the diverse range of treatment options, with supporting arguments and criticisms of each. However, there has been no consensus about the ‘best’ approach. This fuels the challenge, and possibly the sense of helplessness many practitioners experience when striving towards successful treatment. Working with clients with ED can be a highly rewarding, albeit challenging, experience. It is hoped that through the strategies suggested here, practitioners will feel comfortable and competent in providing care.

People with ED usually find it very difficult to acknowledge that they have a problem. Diagnosis can be difficult, since the symptoms of ED often occur in combination with other conditions and are very seldom clear. A multi-disciplinary approach is the most effective treatment route. This involves a through medical assessment, nutritional guidance and education, individual, group and family work, professional carework, and medical follow-up. Because ED has a profound negative impact on all family members, it is recommended that the whole family be part of this work. Caring practitioners and careworkers play an integral role in this process, not only in the development of treatment plans, but in their implementation. It is of paramount importance that people involved in this process have the knowledge and attitudes required for such client’s care.

Freedom stories: stories of recovery written by people who have experienced recovery


Recovery is more than just getting better. It’s more than just leaving the bad times behind. Recovery is a chance to embrace life and be the best you can be. Be inspired by stories of freedom written by recovered sufferers who have experienced an eating disorder and know what recovery is all about.