Living With Food: The Science Supporting Eating Disorder Treatment

In addition to providing the most effective evidence-based treatment, it is our mission to support and educate children, teens and adults suffering from an eating disorder. So starting today, CCED will scour some of the best (in our opinion) eating disorder blogs to bring you the latest posts and articles each week on this devastating illness. Our hope is to walk with you, hand in hand, on your journey to a worry-free, healthy lifestyle.

Some of the topics we’ll cover include:

• Recovery advice
• Treatment
• Parental advice
• Research
• News on food, weight and body image

Here are our top picks of the week:

I AM Recovered
Author Jenni Shaefer shares with us an inspiring eating disorder recovery message she received from Karine Berthou, founder and CEO of the Succeed Foundation. The letter talks about life after an eating disorder: a joy of food, the compassion for herself and an end to the fear of failure.

I am an (Eating Disorder Research) Junkie
Dr. Marcia Herrin, founder of the Dartmouth College Eating Disorders Prevention, Education and Treatment program, has been trained in Maudsley Family Based Therapy  techniques and truly believes patients make greater strides when their parents are involved in treatment. She strongly encourages parents to ask their child’s therapist if they have training in FBT or have studied the FBT treatment manuals. If so, parents should take advantage of these important resources, she says.

People-Pleasing and Emotions
Psychotherapist Karen Koenig writes about the frequent urge of disregulated eaters to not appear emotionally different from others. She sees so often patients trying to adjust their moods to someone else’s so much so that they lose focus of their own feelings. But, there’s good news: patients can relearn to connect with their true emotions. She walks readers through the steps to understanding you’re entitled to your own feelings.

Navigating Phase II
Psychologist and trained scientist-practitioner Dr. Sarah Ravin writes about common benchmarks she recommends families use to know when their child is ready to enter Phase II of Maudsley Family Based Therapy. In the second phase of treatment, parents return control over eating to the child, helping him/her return to normal development. Some of these benchmarks include: the patient’s weight is fully restored, the metabolism has normalized and the patient is no longer engaging in eating disorder behaviors.

If you have any questions or comments regarding this post, or if you spot a great blog or article you think we should share with our readers, please email us at blog@eatingdisorderscleveland.org.

By Dr. Mark Warren

Like many other eating disorder facilities, CCED offers multiple levels of care. In terms of higher levels of care these include our Day Treatment Program (“DTP”) which is a minimum of 30 hours/week spread out over 5 days, and our Intensive Outpatient Program (“IOP”), which is a minimum of 9 hrs per week spread out over 3 days. These programs are quite different from each other. When someone is looking into treatment, often one of the first thoughts they have is “How do I find an eating disorder program that will not interfere with my day to day life?” “Will it allow me continue with school, work, family and other activities while still trying to get better?” As a result of these questions, IOP seems like an attractive option. To be in an IOP you must be medically stable, able to eat on your own, and able to function in your normal day to day life without significant risk of behaviors or relapse. As a result, for most people with an eating disorder who have never been in treatment, IOP is usually not the most effective level of care to begin with. The reasons for this are clear - the very things that must be better for an IOP to be successful are usually the problems people present with when their eating disorder starts to take over their life: difficulty with eating, having behaviors, and medical complications due to the eating disorder. DTP, a higher level of care, provides accountability and support that is not available at the IOP level of care. This includes supervised meals, regular psychiatric visits, daily access to nutritionists, and daily contact with therapists. Medical monitoring is also different in a DTP as vital signs, including orthostatic vital signs, are checked on a regular basis. At CCED we tend to view IOP as a step down from DTP, rather than as a starting point for treatment. Certainly there are situations where an IOP may be an effective entry point, such as when patients are coming from an outside DTP, are currently at a lower level of care but require a step up to IOP, or if someone has previously been in DTP and is and is looking for additional support to maintain their progress. However for the majority of patients, in particular those coming out of a hospital or residential setting, or those with medical instability and active behaviors, DTP is a minimum level of care to truly see progress.

Should you have any questions or comments regarding this post please email blog@eatingdisorderscleveland.org.

Contributions by Sarah Emerman

The Los Angeles Times recently posted an article, “She’s Trying to End a Destructive Cycle,” about cyclist Dotsie Bausch, who has served as a source of hope and support to many others who suffer with debilitating eating disorders. The article talks of Bausch’s struggle with drug abuse and an eating disorder, and how she gained her freedom from this illness. She then set out to help start a foundation, Courageous Voice, to help others cope with their eating disorders.

Bausch is a medal contender in the woman’s track cycling team pursuit in London during this summer’s Olympic Games. She hopes an Olympic medal will give her the unique platform she needs to speak out about eating disorders.

“If I can just help one person, then that makes sense of why I had to go through all that suffering,” she says.

Check out the full article here.

By, Mark Warren

In our conversations about eating disorders we sometimes forget to state the obvious, which is that it’s horrible to have an eating disorder. It is always horrible for the person that has it and the pain of the disorder often extends far past the individual to their family, friends and community. Eating disorders affect everything about us. They affect the way we think, the way we feel, our self image, our experience in our bodies, our minds, and who we are in the world. They destroy our health, our hearts, our brains, and ultimately can take our lives. Eating disorders affect our relationships, school, work, and ability to have the lives we want to have. They are illnesses in the truest sense of the word. They disable us and take our health and well being. Part of the awfulness of having these disorders is that they are not well understood or appreciated for how terrible they are and the pain they cause. Layered into all of this is that the treatment for the disorder often causes more pain. Trying to refeed, stop behaviors, change self image, and work on body image can take us to places that are both painful and frightening. Yet there is no other choice. So what do we do? We find strength from each other, find ways to feed ourselves and make our bodies healthy, and find a community that is healing. We need to believe in and seek out the evidence based care that can help us and trustworthy providers, family, and friends who will be there with us. In Marsha Linehan’s writings she talks about the pain of living in hell and how the only way out of hell is to get on our hands and knees and crawl through the fire until we reach the sunshine. So we acknowledge the pain and acknowledge how awful these disorders can be, but also know that if we keep moving forward we can find the light that will give us our lives back and let us escape the disorder.

Should you have any questions or comments regarding this post please email blog@eatingdisorderscleveland.org.

Contributions by Sarah Emerman