Eating Disorders and disordered eating are common yet extremely misunderstood by society. Media often portrays eating disorders as a disorder that only occurs in young, white, heterosexual females in smaller bodies. It is also often portrayed in TV/movies as restricting and/or purging with the expectation to look a certain way. However, this is not the case. Due to these stereotypes eating disorders are often underdiagnosed in older adults, men, people of color, individuals in larger bodies and within the LGBTQ+ community.
Also, most eating disorders are rooted in anxiety, depression, trauma and/or self-esteem (not solely due to body image). This is compounded by societal standards, expectations, learned behaviors and neurobiological changes that occur when eating patterns are altered for prolonged periods. The process to recover from an eating disorder can be time consuming and often has potential dangerous medical complications if not treated and treated appropriately with professional monitoring.
It is not about the food or weight, but about what either or both of those things mean to the
individual struggling. Selecting the right treatment approach, normalizing eating patterns,
incorporating thoughtful exposures while also addressing underlying issues can be
overwhelming. However, having a specialized team (including a therapist, dietitian and
physician/psychiatrist) skilled in eating disorder treatment can help you and/or your loved one navigate this complicated arena.
Types of Eating Disorders
Anorexia Nervosa – patterns of restrictive eating (may also include binging/purging behaviors) that leads to a lower-than-expected healthy weight and malnutrition for that individual. There is also an intense fear of weight gain/body changes.
Bulimia – patterns of binging/purging with the intention to control weight, or body shape.
Weight is not lower than expected, but there can be electrolyte abnormalities due to frequent purging.
Binge Eating Disorder – patterns of binging on foods while feeling out of control and feeling
guilt and shame after.
Avoidant Restrictive Food Intake Disorder (ARFID) – restrictive eating to a point where one
becomes malnourished, however, restriction is not due to fears of weight gain. Common ARFID causes are sensory issues, fears of vomiting/getting sick, fears of choking, etc.
Other Specified Feeding or Eating Disorders (OSFED) – Other eating disorders that significantly impacts one’s relationship with food/eating but does not fit into the above categorized.
Treatment at Main Street
No eating disorder is the same and therefore treatment is personalized to each individual under our care. Some of the treatment approaches that may be utilized in your treatment here:
Cognitive Behavioral Therapy – Enhanced (CBT-E) – specialized treatment to challenge
thoughts/behaviors with a focus on the eating disorder
Radically Open Dialectical Behavioral Therapy (RODBT) – Most eating disorders are inherently overcontrolled and demanding on a person. This therapy teaches an individual skills in practicing flexibility and being vulnerable
Acceptance and Commitment Therapy (ACT) – It can be hard being vulnerable about your
eating disorder and ACT focuses on helping you identify and live by your values while also
practicing self-compassion
Exposure and Response Prevention (ERP) – We are mindful that often to challenge the eating
disorder you may have to do things that can feel scary. Creating a safe place and plan to
challenge some of these fears is important in any treatment
Family Based Treatment (FBT) and Supportive Parenting for Anxious Childhood Emotions
(SPACE) – are two treatments we use jointly when helping parents/guardians support their child in overcoming an eating disorder, particularly if the child is reluctant to recover. They teach skills and provide tools for parents to help their child at home with meals/snacks respecting that family is the best tool in a child’s recovery.
Helpful Websites
National Eating Disorder Association – https://www.nationaleatingdisorders.org/
Project HEAL – https://www.theprojectheal.org/
National Association of Anorexia Nervosa and Associated Disorders (ANAD) – https://anad.org/
Eating Disorder Hope – https://www.eatingdisorderhope.com/
Helpful Books
The Radically Open DBT Workbook for Eating Disorders: From Overcontrol and Loneliness to
Recovery and Connection, by Karyn D. Hall PhD , Ellen Astrachan-Fletcher PhD, et al.
8 Keys to Recovery from an Eating Disorder: Effective Strategies from Therapeutic Practice and Personal Experience, by Carolyn Costin , Gwen Schubert Grabb, et al.
How to Nourish Your Child Through an Eating Disorder: A Simple, Plate-by-Plate Approach®
to Rebuilding a Healthy Relationship with Food, by Casey Crosbie , Wendy Sterling, et al.
When Your Teen Has an Eating Disorder: Practical Strategies to Help Your Teen Recover from Anorexia, Bulimia, and Binge Eating, by Lauren Muhlheim PsyD and Laura Collins Lyster-Mensh
The Intuitive Eating Workbook: Ten Principles for Nourishing a Healthy Relationship with Food by Evelyn Tribole MS RDN , Elyse Resch MS RDN , et al.