Yoga

Specialties

I specialize in the assessment and treatment of all eating disorders and related concerns. Eating disorders typically develop over time; initially symptoms are insidious and gradually become more consuming. You or your loved one may think the eating disorder symptoms are not severe enough to warrant treatment. However, if you suspect that you or a loved one may be on the path towards an eating disorder I urge you to seek treatment now. Don’t wait for it to get “severe enough” to seek treatment. Early intervention is one of the most robust predictors of full recovery. It is also important to note that there are many faces of eating disorders. Eating disorders occur across genders, sizes, shapes, ages, and ethnicities. You typically cannot tell that someone is struggling with an eating disorder by looking at them. These mistaken beliefs, such as eating disorders only affect white teen girls, and that you must be unhealthily thin to have an eating disorders, often prevents people from seeking treatment.

Anorexia Nervosa:

Anorexia Nervosa is a serious psychiatric illness characterized by losing more weight than is considered healthy for an individual’s age, height, and body type. Individuals with this illness typically eat very restricted diets in small portions. Anorexia often starts as a “diet” or a desire to eat more “healthy” but for individuals with a certain temperament, family history and circumstances, the obsession with thinness becomes all-consuming and dangerous. In addition to starving themselves, individuals with Anorexia Nervosa may over-exercise, self-induce vomiting, or abuse laxatives in an attempt to maintain an inappropriately low body weight. The psychiatric illness involves a persistent lack of recognition of the seriousness of maintaining an appropriate body weight for ones height. It is characterized by intense fear of gaining weight or becoming fat. One hallmark of the disorder is a distorted perception of the way in which one’s body weight or shape is experienced (i.e., despite low body weight, they may still see themselves as overweight). Anorexia has the highest risk of death compared to all of the psychiatric illness.

Binge Eating Disorder:

Binge Eating Disorder is characterized by recurrent binge episodes. A binge is defined as eating an amount of food in one setting that is “objectively large.” Classic objective binge episodes can be anywhere from 1-10,000 calories consumed within a couple of hours. What constitutes an objective binge episode will vary from person to person and so eating episodes will be assessed carefully to see if they meet criteria for an objective binge. For example, it may be perfectly appropriate for an athlete to consume over 1000 calories in one setting in a pre-workout or recovery meal, yet for another person, the same amount may feel out of control, would causes distress, discomfort, and feelings of guilt and shame, etc. Binge eating is often triggered by extreme dieting or “good food/bad food” mentality (restraint theory). When an individual who is dieting eats a “forbidden food” this often triggers feelings of defeat and distress, resulting in a binge on those forbidden foods. The mentality may be that the “diet” will start over tomorrow so eat this while you can. Binge eating also may become a way to cope with difficult emotions such as loneliness, anger, sadness, or stress (emotion regulation theory).

Bulimia Nervosa:

Bulimia Nervosa is characterized by recurrent bouts of objective binge episodes accompanied by purging. Purging is any extreme attempt to rid one’s body of the food that was consumed. Purging typically occurs via self-induced vomiting, laxatives, or extreme over-exercising. Similar to Anorexia Nervosa, Bulimia Nervosa also involves fear of weight gain, distorted body image, preoccupation with food, shape and weight, and significant, and can result in sometimes permanent health consequences, including greater risk of death due to complications of the disorder.

Avoidant and Restrictive Food Intake Disorder (ARFID):

This category of eating disorder is reserved for those who do not present with weight and shape concerns yet demonstrate extremely restrictive eating. This is often referred to as severely picky eating or food neophobia (afraid of new foods) and may result in poor nutrition, lower than normal body weight, and associated medical consequences.

Other Specified Feeding and Eating Disorders (OSFED).

This category is reserved for those eating disorders that do not meet the full criteria for the first three disorders outlined above and includes Subthreshold Anorexia Nervosa, Bulimia Nervosa or Binge Eating (behaviors are present, yet not at a frequency great enough to meet full criteria), Purging Disorder (purging in absence of bingeing), Chewing and spitting food, and Night Eating Syndrome.

Compulsive Eating/Emotional Eating/”Food Addiction:”

While not recognized as a psychiatric condition, constantly thinking about food and regularly eating in absence of physical hunger can be distressing and problematic. These conditions often lead to obesity and related medical conditions such as diabetes and heart disease. They are associated with feeling of helplessness, shame/guilt, low self-esteem, and poor body image.

Psychosocial Aspects of Bariatric Surgery:

Bariatric Surgery (or weight loss surgery) requires significant lifestyle changes in order to achieve optimal results. If you are seeking bariatric surgery, you may be required to undergo a psychological evaluation to determine if you are in a position to provide informed consent and are an appropriate candidate for surgery. Surgery is often associated with significant body changes, health changes, social and occupational changes, and mood changes. Some of these changes can be difficult to adjust to. It is important to work with someone who has experience in eating and weight related disorders. We offer psychological assessments prior to surgery, therapy services prior to surgery to help prepare for life after surgery, and post-operative therapy services.

**Most eating disorders and related conditions present with other mental health conditions and side-effects such as anxiety, depression, low self-esteem, perfectionism, impulsivity, and/or personality disorders. My associates and I are well equipped to work with these co-occurring conditions in addition to the eating disorder. These presenting conditions are assessed and taken into consideration when developing a treatment plan.

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