Anorexia Nervosa (AN)
Anorexia is a disorder characterized by an intense drive for thinness, significant weight loss, body image disturbances, fear related to food, and refusal to eat appropriately. There are often significant health consequences associated with anorexia, making collaboration with a specialized dietitian and primary care provider essential to comprehensive treatment.
Bulimia Nervosa (BN)
Bulimia is characterized by a drive for thinness, body image disturbances, consuming large amounts of food in a short period of time, feeling out of control during these binge episodes, and engaging in compensatory purging behaviors to prevent weight gain, such as self-induced vomiting, laxative or diuretic abuse, and unbalanced exercise. Often, individuals with bulimia are of normal weight range, but bulimia carries significant health consequences, and requires close collaboration with a specialized dietitian and primary care provider.
Binge-eating Disorder (BED)
Binge-eating disorder is characterized by eating large amounts of food in a short period of time, feeling out of control during the binge, feeling guilty, poor self-perception, but no use of compensatory behaviors related to binges. Sometimes, these individuals are overweight and have health concerns related to the effects of being overweight. Again, collaboration with medical and dietary providers is essential to comprehensive care.
Avoidant/Restrictive Feeding Intake Disorder (ARFID)
ARFID is characterized by fear and distress related to specific food, food textures, and acts associated with eating, such as swallowing or fear of vomiting. These individuals often struggled with feeding issues in infancy or early childhood and presentation is more common among children and younger adolescents. Treatment includes targeting the intense fears and phobias related to eating, and active collaboration with family members, teachers, and school personnel is essential to ensure resumption of normal eating. Collaboration with other professionals is commonly indicated as there may be medical concerns, such as low weight or malnutrition.
Subclinical Eating Concerns
Subclinical eating concerns are typically similar to the eating disorders, but have a less devastating impact on daily functioning. Typically, individuals are still engaged in daily living, although functioning may be somewhat compromised. It is important to intervene early so as to avoid eating concerns becoming more severe.
Body Image Disturbances
Body image disturbances include a poor body image, misperception of one’s body, identity focused on the body, and comparing self to others. Often these individuals can feel plagued by the expectations they have for their body or their perceived expectations from others and hold the belief that if their body were different they would be happy.
Body Dysmorphic Disorder
Similar to body image disturbances, body dysmorphia is a condition wherein an individual has a significant misperception of the body, believing it is flawed in a significant way, whether that be related to weight, appearance, or function. These individuals tend to experience significant anxiety related to their body and what others may think of them.
Unbalanced exercise can be a component of eating disorders and subclinical eating concerns and is characterized by intense, frequent exercise despite injury, illness, or other important life events. These individuals tend to be quite rigid about their exercise and have difficulty altering their regimen. Exercise can often be used as a compensatory behavior to prevent weight gain or in response to eating due to fear of fat.
Eating Concerns in Sport
Athletes have special considerations when it comes to eating, body image, and physical activity. By virtue of their identity as an athlete, they often view their bodies in terms of sports instrumentality, and can sometimes lose perspective about what it means to have balanced health. Athletes can be hesitant to seek treatment out of a fear that their sport will be blamed and they will be asked to discontinue sports participation. The athlete identity is an important and valuable identity, therefore a focus on safely participating in sport is of primary importance while also teaching more balance with regard to food and training expectations.
Sometimes individuals struggle to cope with specific dietary restrictions, such as celiac disease and other nutritional concerns. While it is important to work with an experienced medical provider, therapy can help individuals cope with emotions and cognitions related to these health concerns, which can in turn empower the individual in taking charge of their health concerns.
Depression is among the most common mental health concerns and is characterized by sadness, loneliness, lack of interest, depressed mood, difficulty concentrating, and social withdrawal or isolation. Cognitive distortions often accompany depression, and comprehensive treatment works to address not only the behavioral manifestations of depression but also focuses on challenging the cognitive distortions and regaining hope in oneself and the future.
Anxiety manifests in many ways, including specific fears or phobias, panic disorder, including panic attacks, social anxiety, obsessive-compulsive disorder, and generalized anxiety disorder, which includes worry about many things, difficulty controlling worry, and feeling keyed up or on edge much of the time. Therapy can be very helpful in uncovering the roots of anxiety and helping individuals address anxiety in systematic ways wherein they are able to move toward life goals and values despite anxiety and can decrease the overall experience of anxiety on a daily basis.
It’s not uncommon for individuals to have difficulty in relationships, whether it be communication concerns, fear of vulnerability and connection, or difficulty committing. At times, individuals may feel they lose themselves in relationships or experience other attachment concerns. Treatment can be very helpful in identifying specific patterns that may be ineffective or contrary to one’s values and goals.
Trauma is a reality of the world we live in, be it interpersonal violence, sexual or physical abuse, accidents, or natural disasters. The faces of trauma are varied, and the symptoms are real and can be debilitating if not addressed thoroughly. Evidence-based PTSD treatment is essential to full recovery.
Adoption is a deeply meaningful experience that brings great joy, but also brings challenges, not only for adoptive children, but also for biological and adoptive parents. Sadly, individuals often feel guilty for the feelings they may have, and don’t feel able to discuss their concerns openly. Therapy can provide an important outlet for discussing the very real challenges associated with adoption.
Existential questions, including what is the meaning of life, why am I here, and what is my purpose can create fear and anxiety. We understand that one’s spiritual identity is complex, that some questions of faith have no easy answers, but that there is value in clarifying the concerns with a purpose of moving toward a more value-driven life.