1. Don’t Judge

Developing an eating disorder is not a choice. There are many factors that can lead to the development of an eating disorder. Some of these factors are genetics, family members who have struggled with an eating disorder, or disordered eating, societal pressure, trauma, and style of upbringing.

Eating disorders are complex mental health conditions characterized by unhealthy eating habits and preoccupations with body image. The most common types include:

• Anorexia Nervosa: Characterized by extreme restriction of food intake, an intense fear of gaining weight, and a distorted body image leading individuals to see themselves as overweight even when they are underweight.

• Bulimia Nervosa: Involves episodes of binge eating followed by compensatory behaviors such as vomiting, excessive exercise, or use of laxatives to prevent weight gain.

• Binge-Eating Disorder: Marked by recurrent episodes of consuming large quantities of food in a short period, often accompanied by feelings of loss of control, guilt, or shame, without subsequent purging behaviors.

• Orthorexia: An obsession with eating foods that one considers healthy, which can lead to restrictive eating and the exclusion of entire food groups, impacting overall nutrition and social functioning.

• ARFID (Avoidant/Restrictive Food Intake Disorder): Involves a lack of interest in eating or aversion to certain foods based on sensory characteristics or past negative experiences, which can lead to significant weight loss or nutritional deficiencies.

2. Support

No matter the type of eating disorder, it is crucial that the individual working on recovery feels accepted and supported by family and friends. Eating disorders thrive in isolation. Support can show up in many forms:

• Accountability: “Did you eat breakfast yet today?”

• Emotional support: “I can tell you are upset about something, you can talk to me about it and I won’t judge you

• CBT reframing: “You said you think you will gain a crazy amount of weight if you eat breakfast, is that evidence based?” or “You feel you will never be happy again, I think you will be.”

• Distraction: “I’ll help prepare dinner and we can watch something together or play a game while we eat”.

3. Getting Help

There are 5 different levels of care for a person struggling from an eating disorder.

1. Inpatient – This is a hospital setting. In this level of care, the client’s bloodwork and vitals are often unstable. Clients are sometimes fed through an NG feeding tube because their eating disorder will not allow them to eat enough food that their bodies need to recover.

2. Residential - At this level of care clients are a bit more stable than inpatient level. Clients are watched 24/7 for any urges or attempts at self-harm and are given meal support at all their meals.

3. Partial Hospitalization Program (PHP) – This program is usually 5 or 6 days a week, usually 8:30am to 2:30pm. Each day includes breakfast, lunch and a snack with meal coaching available. Clients take part in skill-based groups, usually comprising of CBT and DBT skills such as reframing thoughts, interpersonal effectiveness, emotion regulation and relapse prevention. Clients do not stay at the facility, but rather arrive in the morning and leave when it is over. Included in this level of care are 2 weekly individual sessions, one individual session with an APRN or psychiatrist for med management and one weekly individual session with a registered dietitian.

4. Intensive Outpatient Program (IOP) – The lowest level of care is just 3 or for days a week, usually 3 hrs. each day. The program would include 1 coached meal and 2 skill-based groups. This is ideal as a preventative measure for someone struggling with eating disorder thoughts and urges to act on them or after stepping down from a higher level of care.

5. Outpatient – An outpatient team for an individual recovering from an eating disorder would ideally include an APRN or psychiatrist, a therapist with experience treating eating disorders, and a registered dietitian. This level of care is for when a client is doing well in their eating and functioning well.

When deciding on getting help for someone struggling with an eating disorder, it is important for a licensed health professional to assess and decide the appropriate level of care for this individual in their current state.

4. Maintenance and Relapse Prevention

Recovering from an eating disorder might be one of the most difficult things a person will do in their lifetime. Maintenance and relapse prevention is an important part of the recovery process, ensuring that progress is sustained and setbacks are managed effectively.

When choosing a therapist to assist you or a loved one with eating disorder recovery, there are a few things to look for:

• Specialization: Find a therapist who has extensive experience with eating disorders. Their expertise can make a critical difference in navigating the complexities of this unique condition.

• Commitment: A therapist who is deeply committed to their client’s recovery can be a lifeline for someone struggling with an eating disorder. Their dedication can be a deciding factor in overcoming challenges and achieving lasting change.

• Case Management: An ideal therapist will not only meet for individual sessions, but they will also be in contact with the rest of their client’s care team. They will also be available for regular check-ins with their client, as well as meetings with the client’s family to discuss everyone’s role in a client’s eating disorder recovery.

• Meal Coaching: Meal coaching helps individuals establish regular eating patterns, overcome fear foods, and manage disordered eating behaviors. By offering practical guidance and support during meal times, meal coaching facilitates the development of a balanced relationship with food and promotes overall recovery. It also helps clients practice mindfulness and self-regulation, which are essential for long-term success.

I am dedicated to providing a holistic approach to recovery, tailored to your unique needs. My practice emphasizes achieving behavioral stability through Dialectical Behavior Therapy (DBT), which helps manage emotions and build resilience. I also use Cognitive Behavioral Therapy (CBT) to boost self-esteem and increase awareness of thinking patterns. By guiding you in making informed choices and taking actionable steps, I aim to strengthen your path to wellness. I also understand the religious needs of frum patients, including the unique challenges related to Shabbos and kosher observance.

With a combination of clinical expertise and personalized care, I am committed to supporting you throughout every stage of your recovery, working towards lasting improvements and a higher quality of life.