BPD and Eating Disorders

In this video, we will discuss four types of eating disorders and related criteria. Then we will examine the intersection of BPD and eating disorders. These are complex disorders to identify and treat and a caring and compassionate approach is central to both.

Key points and tactical tips:
Anorexia nervosa - People with anorexia generally view themselves as overweight, even if they’re dangerously underweight. They tend to constantly monitor their weight, avoid eating certain types of foods, and severely restrict their calories.

There are two types of Anorexia— the restricting type and the binge eating and purging type. Individuals with the restricting type lose weight solely through dieting, fasting, or excessive exercise. Individuals with the binge eating and purging type may binge on large amounts of food or eat very little. In both cases, after they eat, they purge by forcing vomiting, taking laxatives or diuretics, or exercising excessively.

Bulimia nervosa - People with bulimia frequently eat unusually large amounts of food in a specific period of time. Each binge eating episode usually continues until the person becomes painfully full. During a binge, the person usually feels that they cannot stop eating or control how much they are eating.

Binge eating disorder - Individuals with this disorder have symptoms similar to those of bulimia or the binge eating subtype of anorexia. They typically eat unusually large amounts of food in relatively short periods of time and feel a lack of control during binges.

Unspecified Feeding or Eating Disorder, used to be called Eating Disorder NOS. This includes symptoms characteristic of a feeding and eating disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the feeding and eating disorders diagnostic class.

From a core and surface content perspective: Core content can be a variety of things for those with eating disorder or BPD, but there are some that are common. BPD common core content areas are emptiness and abandonment and those with eating disorders it tends to be control. Addressing this core content and building insight is a great first step but not the final step. We need behavior change, to help with this we need a stabilized perception of self but we know those with BPD often see the world through their BPD lens that is distorted. Eating disorders are complex to treat and require treatment with a knowledgeable and skilled professional. DBT has been found to be an effective treatment for eating disorders.

Daniel J. Fox, Ph.D., is a licensed psychologist in Texas, international speaker, and a multi-award winning author. He has been specializing in the treatment and assessment of individuals with personality disorders for over 15 years in the state and federal prison system, universities, and in private practice.

He has published several articles in these areas and is the author of:

[tristanoelle]

I was literally just thinking the other day “I wonder if Dr. Fox will ever do a video on BPD and its correlation with eating disorders”

[ItisI_B]

This comment section is so shocking. Some of you (or maybe a lot) have experienced such horrible things, it's just awful. No one deserve that. I hope you find a way to cope with it all in a healthy way. Big hug to all of you.

[humaali]

My binge eating disorder definitely goes in hand in hand with that empty feeling I get. It was my first way of filling that void which I learnt as a child. Till i found more ways etc drugs/alcohol. The eating disorder is my biggest problem

[kvtiebug]

would you be able to do a video on BPD and sensory overload? (: i love your videos and your workbook

[rodeorm]

at age 53 i just got diagnosed with quiet bpd and i look at my whole life in a total different way now - many things make sense started therapy and i know i got a long way ahead of me and your videos as well do help me in you very much from germany, danke.

[zrcioct]

I have BPD & I struggle with chronic binge eating, thank you for giving me hope!☺️

[kitdixon]

I had anorexia for 7 years and my BPD symptoms didn’t really show up noticeably until I recovered at age 24. It’s like the semi starvation blunted my emotional processing or provided a way to manage myself. Once I no longer had that numbing technique, my mood swings became much worse as well as other symptoms.

[mavsyers]

I discovered that my EDNOS was another form of self harm. I experienced a remission of 3.5 years, then during the pandemic, I was diagnosed with atypical anorexia. I’m currently in recovery! With my BPD, I didn’t want others to know that I was self harming, so I punished myself by making myself purge after eating normal meals. I needed my family and friends to think I was eating, but I didn’t believe I deserved sustenance so I forced myself to purge in order to hurt myself.


It’s so not worth it! I am still dealing with acid reflux, tooth enamel damage, and digestive issues.

[delphinium]

I was hanging one every word right up until the end so really appreciated the caring words from this amazing doctor. I've no-one to help me so it was lovely to hear him believing in me. Back on the plan and going to look after myself better. Eating good healthy foods as regular intervals, exercise and sleep! For me the binge eating is using the food as a drug. I don't have any other vices but carbs has always hit the spot. Need to break that habit now. Am a grandmother but it's never to too late to start.

[kelseylul]

I wish you could be my counselor bc all counselors around here aren’t educated on BPD but I literally relate to everything you say about BPD

[lumijasminasmr]

I watch your videos to relax. You have such a calming, caring, compassionate nature. ♥️

[mesopotamianprincess]

I’m in Houston. This doesn’t mean anything but you’ve helped me alot to stay alive when I couldn’t afford the doctor appointments and have been so depressed I called suicide hotline but couldn’t even carry my voice through to ask for help.. I WANT help and to get back to school (Cullen) and work (TA at UH) before I’m fat, homeless, and old on top of being lonely but I’m so broken! You help! Thank you.

[amynaddra]

I was diagnosed with BPD and complex PTSD. I suffered with an eating disorder for 4 years and when I finally told my family that’s when I got better. They had no idea I was purging. I didn’t binge eat though. I truly believe when we bring our struggles to the light, there is healing. I learned in Celebrate Recovery we are as sick as our secrets. Very interesting video!!! You’re exceptional!!!

[mochiwaffles]

Dr. Fox, you inspire me (who's working on becoming a therapist) to be more compassionate and understanding towards people with BPD and other PDs. You show me how to be accepting and non-judgmental with the way you empathize with people who are struggling. Thank you so much, you're an amazing psychologist.

[ainsleyblack]

I am In Australia and your the first person I recommend to ppl seeking accurate information on BPD. You get us.

[le_th_]

Your Borderline clients must absolutely adore you. You seem so positive, motivating, and supportive.

[bigtimefans]

That last bit made me smile so hard. Thank you so much, Dr. Fox for all the work and dedication you've put into educating us and helping so many others learn more about themselves.

I had AN when I was younger but now in my 20s, I'm starting to notice that it's very possible I could have an Unspecified Eating Disorder that's related to my BPD. It's definitely going to be a conversation between my therapist and me. I often binge eat when I feel empty (as this is part of having BPD) but also starve myself on purpose to either "distract" myself from the intense emotions and (I can't believe I'm finally admitting this because it's been really hard and uncomfortable to even think about its mere possibility but) being so shameful after binge eating that I'll restrict to prevent gaining more weight...shit, this disorder is really fucking debilitating.

I'm trying to remind myself that there is hope, as you've _never ever_ failed to remind us. Thank you, from the bottom of my Borderline heart<3

[bigray]

I had bulimia when I was a teenager. I exercised 8 hours a day. The excessive exercise and purging caused spine problems and lost more eyesight in one of my eyes, that eye cannot see in the dark. I was a teenager and denied having problems though, self harm and vomiting and eating laxatives were normal making it difficult to actually help me. The poor eating and huffing caused brain damage, I lost my memories, 3.5 GPA became special Ed. Still denied it being problematic though. They put me on meds that increased my appetite, with the back pain and weight gain, I couldn't throw up anymore without experiencing intense pain. 100 pounds went up to 315 pounds. Had to use a walker. The consequences from bulimia can be very grave, and I hope if anyone reading this has bulimia to reach out for help. It turned out I was born with spine problems and the bulimia accelerated them, when you're young you sometimes just don't know. If you're eating laxatives and purging what you eat, it IS a problem. Now I'm working on it, I still seem to not eat or binge at times, when pain gets bad it can take away all hope. Doctors helped, gaining insight, awareness, helped. Seek help, I used to say I'd rather die than be overweight. Bulimia didn't kill me, suicide attempts didn't kill me, and now I'm stuck trying to fix mistakes I made from the past that make life worse. Send you love, you DO deserve it. 💜

[sirenachantal]

BPD and rage turned inward. The shy BPD.

[jazisajoke]

Thank you so much for all that you do for us. You’re one of the few Doctors I’ve seen that treat us like human beings worthy of understanding and special care. You’re an amazing person. Please keep it up!! 💕💕