I am an expert in the eating disorder field and have over a decade of experience guiding adolescents, adults, and older adults toward recovery. I provide individual, family, and couples counseling as well as meal support therapy. I offer comprehensive consultations for you or your loved one, which include a thorough assessment, treatment planning, and treatment recommendations.
What Is An Eating Disorder?
An eating disorder is defined as a serious mental health condition that is characterized by an obsessive focus on weight, body shape, food, and eating. The sooner an eating disorder is identified and treated, the higher chance there is for full recovery. Given this correlation, it’s important to be aware of the warning signs. Common symptoms of eating disorders include:
Fluctuations in weight, both up and down
Preoccupation with weight, food, and calories
Strict food restrictions and/or food rituals
Skipping meals or avoiding eating around others
Withdrawal from friends and activities
Extreme mood swings
Stomach cramps or other gastrointestinal issues
Irregularities related to an individual’s menstrual cycle
Often feels cold
Trouble concentrating
Dizziness or fainting
Sleeping problems
Dry skin and hair as well as brittle nails
Dental problems, such as enamel erosion, cavities, teeth discoloration, and teeth sensitivity
Self-esteem directed related to body image
The four most common eating disorders are anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder.
Anorexia Nervosa
Anorexia nervosa is an eating disorder characterized by low weight, food restriction, body image disturbance, fear of gaining weight, and an obsessive desire to be thin. Adding to the list above, specific warning signs include dressing in layers to hide weight loss and/or stay warm; making comments about feeling “fat”; and following an excessive and strict exercise schedule. Anorexia has one of the highest overall death rates and the highest suicide rate of all psychiatric disorders.
Bulimia Nervosa
Bulimia nervosa is an eating disorder characterized by binge eating and purging as well as excessive concern with body shape and weight. Binge eating occurs when an individual consumes a large number of calories in a relatively short time with the inability to control their behavior. Compensatory behaviors may include self-induced vomiting, abuse of laxatives or diuretics, fasting, or excessive exercise.
To be identified as bulimia, the individual must engage in the binge-and-purge cycle at least once a week for three months. Possible warning signs include evidence of binge eating, such as the disappearance of large amounts of food in short periods of time; evidence of purging, like frequent trips to the bathroom after meals; excessive use of mouthwash, gum, and mints; and calluses on the back of hands from self-induced vomiting.
Binge Eating Disorder
Binge eating disorder (BED) is associated with three or more of the following markers: eating much more rapidly than normal; eating until uncomfortably full; eating large amounts of food when not physically hungry; eating alone because of embarrassment; and feeling disgusted, depressed, or guilty after overeating. It must occur at least once a week for three months and is not followed by compensatory behavior.
Avoidant Restrictive Food Intake Disorder
Avoidant restrictive food intake disorder (ARFID) was previously referred to as selective eating disorder. Like anorexia, individuals limit the amount and/or type of food consumed; however, there is no distress or fears about body shape or size. Although many children go through periods of picky eating, a person with ARFID does not consume enough calories to grow, develop, and/or maintain basic body function.
It’s important to note that no two eating disorders are alike. Every eating disorder is unique to the suffering individual — and so is the treatment plan and recovery process. If you are concerned about yourself or a loved one, pay close attention to the symptoms mentioned above and reach out for help.
Eating Disorder Treatment
Treatment plans require a strong support system (including a mental health professional, a registered dietitian, a medical specialist, and a loving group of family and friends) and include a combination of psychotherapy, nutrition counseling, medical monitoring, and/or medications. It’s important to remember that the levels of care work alongside each other, giving individuals the flexibility to “step up” or “step down” throughout their journey to recovery. The members of a treatment team will work together to determine the best level of care for each individual.
Inpatient Treatment
As the highest level of care, inpatient treatment or hospitalization includes around-the-clock supervision. Patients are both psychiatrically and medically unstable; they are constantly monitored for vital signs, lab work, potential complications, and other mental health issues, including depression and mood disorders. Here, the goal is for the individual to become well enough to step down to a lower level of care.
Residential Treatment
In a residential treatment program, an individual does not require 24/7 care but still needs a high level of support and monitoring. Clients engage in individual therapy, group therapy, and nutrition therapy as well as scheduled free time and visits from family and friends. They sleep at the treatment center, which ensures constant access to medical help.
Partial-Hospitalization Program
If a patient is medically stable but still struggling with disordered eating thoughts or unable to function in normal circumstances, a partial hospital plan (PHP) may be developed. These programs usually run for normal business hours, five to seven days per week. For this treatment method, the individual has more independence than an inpatient or residential treatment program but still participates in individual therapy, group therapy, nutrition therapy, and medical monitoring if necessary.
Intensive-Outpatient Program
If a patient is considered medically stable and does not require daily monitoring, an intensive outpatient program (IOP) is often effective. Symptoms are under control, and the individual can handle daily situations on their own. These clients engage in sessions three days per week for a few hours each day. IOP generally includes individual therapy, group therapy, and a supported meal. Evening meetings are often available to allow patients to return to work or school.
Outpatient Support
This treatment method offers the lowest level of support and the highest level of flexibility and freedom. Patients work towards recovery with an outpatient team, which includes a therapist who specializes in eating disorders, a dietician, and a primary care provider.
The Role of Therapy in Eating Disorder Treatment
As you can see, psychotherapy plays a role in every level of care and varies based on the individual and their recovery journey. Possible approaches include:
Acceptance and Commitment Therapy (ACT)
ACT encourages patients to identify their values and then create goals to help them fulfill those values. The idea is to change your actions or behaviors rather than your thoughts and feelings.
Cognitive Behavioral Therapy (CBT)
This relatively short-term and structured therapy focuses on beliefs, values, and cognitive processes. CBT allows the individual to become aware of negative thinking so they can respond to challenging situations more effectively.
Dialectical Behavior Therapy (DBT)
Evidence shows that DBT is successful for the treatment of anorexia, bulimia, and BED. It focuses on developing skills related to mindfulness, interpersonal relationships, and emotion regulation.
Family Therapy
Family therapy is an integral part of eating disorder treatment, especially for adolescents. However, individuals of all ages may find family involvement in their treatment to be beneficial. Some of the goals of family therapy can be to increase education regarding eating disorders, to improve communication and boundaries among family members, and to learn how parents and caregivers can provide support to their loved ones.
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