Eating Disorders

Eating disorders are serious but treatable mental and physical illnesses that can affect people of every age, sex, gender, race, ethnicity, and socioeconomic group. National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives. At Max Psychiatry, we

treat an eating disorder through a combination of psychological and nutritional counseling, along with medical and psychiatric monitoring. Our team monitors improvement in disorder symptoms through out the treatment. Max Psychiatry has helped hundreds of patients in Cary, Raleigh, Durham, Fuqua-Varina, Wake Forest, Holly Springs area treat their eating disorders symptoms and bring happiness and confidence back in their lives.


Eating Disorders Q & A

What are Eating Disorders?


Eating disorders are serious but treatable mental and physical illnesses that can affect people of every age, sex, gender, race, ethnicity, and socioeconomic group. National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives.

While no one knows for sure what causes eating disorders, a growing consensus suggests that it is a range of biological, psychological, and sociocultural factors. 


What are the health consequences of Eating Disorders?


Eating disorders are serious, potentially life-threatening conditions that affect a person’s emotional and physical health. They are not just a “fad” or a “phase.” People do not just “catch” an eating disorder for a period of time. They are real, complex, and devastating conditions that can have serious consequences for health, productivity, and relationships. 


Eating disorders can affect every organ system in the body, and people struggling with an eating disorder need to seek professional help. The earlier a person with an eating disorder seeks treatment, the greater the likelihood of physical and emotional recovery. 


What are some common symptoms of Eating Disorders?


Emotional and behavioral

In general, behaviors and attitudes that indicate that weight loss, dieting, and control of food are becoming primary concerns

Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting

Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)

Appears uncomfortable eating around others

Food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)

Skipping meals or taking small portions of food at regular meals

Any new practices with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)

Withdrawal from usual friends and activities

Frequent dieting

Extreme concern with body size and shape 

Frequent checking in the mirror for perceived flaws in appearance

Extreme mood swings


Physical 

Noticeable fluctuations in weight, both up and down

Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)

Menstrual irregularities — missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)

Difficulties concentrating

Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)

Dizziness, especially upon standing

Fainting/syncope

Feeling cold all the time

Sleep problems

Cuts and calluses across the top of finger joints (a result of inducing vomiting)

Dental problems, such as enamel erosion, cavities, and tooth sensitivity

Dry skin and hair, and brittle nails

Swelling around area of salivary glands

Fine hair on body (lanugo)

Cavities, or discoloration of teeth, from vomiting

Muscle weakness

Yellow skin (in context of eating large amounts of carrots)

Cold, mottled hands and feet or swelling of feet

Poor wound healing

Impaired immune functioning


How can Max Psychiatry help?


It is important that people with eating disorders seek professional help. There are differing approaches to treatment and no one-size-fits-all approach. Our psychiatrists at Max Psychiatry, offer treatment options that work best for your emotional, mental and physical condition. Couple of treatment techniques are :


ACCEPTANCE AND COMMITMENT THERAPY (ACT)


The goal of ACT is focusing on changing your actions rather than your thoughts and feelings. Patients are taught to identify core values and commit to creating goals that fulfill these values. ACT also encourages patients to detach themselves from emotions and learn that pain and anxiety are a normal part of life. The goal isn’t to feel good, but to live an authentic life. Through living a good life, people often find they do start to feel better.


COGNITIVE BEHAVIORAL THERAPY (CBT) AND ENHANCED COGNITIVE BEHAVIORAL THERAPY (CBT-E)


A relatively short-term, symptom-oriented therapy focusing on the beliefs, values, and cognitive processes that maintain the eating disorder behavior. It aims to modify distorted beliefs and attitudes about the meaning of weight, shape, and appearance, which are correlated to the development and maintenance of the eating disorder.


COGNITIVE REMEDIATION THERAPY (CRT)


CRT aims to develop a person’s ability to focus on more than one thing. CRT targets rigid thinking processes considered a core component of anorexia nervosa through simple exercises, reflection, and guided supervision. As of 2017, CRT is being studied to test effectiveness in improving treatment adherence in adults with anorexia; it has not been tested in other eating disorders.


DIALECTICAL BEHAVIOR THERAPY (DBT)


A behavioral treatment supported by empirical evidence for treatment of binge eating disorder, bulimia nervosa, and anorexia nervosa. DBT assumes that the most effective place to begin treatment is with changing behaviors. Treatment focuses on developing skills to replace maladaptive eating disorder behaviors. Skills focus on building mindfulness skills, becoming more effective in interpersonal relationships, emotion regulation, and distress tolerance. Although DBT was initially developed to treat borderline personality disorder, it is currently being used to treat eating disorders as well as substance abuse.


EVIDENCE-BASED TREATMENT


It is important to note that while all of these therapies are frequently used to treat individuals with eating disorders, they have varying levels of efficacy and research supporting their use. Many professionals now recommend the use of evidence-based treatment, which is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” In eating disorder therapies, evidence-based treatment usually means that the therapy has been used in a research study and found to be effective in reducing eating disorder symptoms, encouraging weight restoration in underweight patients, and decreasing eating disorder thoughts.


Classifying a therapy as “evidence-based” doesn’t mean that it automatically works for everyone; just that it works for many patients. Do some research and evaluate which types of treatments would best target the relevant symptoms and psychological concerns. Also keep in mind that not all therapists who say they utilize a type of treatment actually use it in all of their sessions. Some CBT therapists, for example, might have a primarily psychodynamic approach and only occasionally use CBT principles. Ask about how strictly the therapist adheres to treatment guidelines, what a typical session might consist of, how much training the therapist has received in this particular treatment modality, the rough percentage of patients who they treat using this form of psychotherapy, and how current their ED knowledge base is.


FAMILY-BASED TREATMENT (FBT)


Also known as the Maudsley Method or Maudsley Approach, this is a home-based treatment approach that has been shown to be effective for adolescents with anorexia and bulimia. FBT doesn’t focus on the cause of the eating disorder but instead places initial focus on refeeding and full weight restoration to promote recovery. All family members are considered an essential part of treatment, which consists of re-establishing healthy eating, restoring weight and interrupting compensatory behaviors; returning control of eating back to the adolescent; and focusing on remaining issues.


INTERPERSONAL PSYCHOTHERAPY (IPT)


Interpersonal psychotherapy (IPT) is an evidence-based treatment for bulimia nervosa and binge eating disorder. IPT contextualizes eating disorder symptoms as occurring and being maintained within a social and interpersonal context. IPT is associated with specific tasks and strategies linked to the resolution of a specified interpersonal problem area. The four problem areas include grief, interpersonal role disputes, role transitions, and interpersonal deficits. IPT helps clients improve relationships and communication and resolve interpersonal issues in the identified problem area(s), which in turn results in a reduction of eating disorder symptoms. Just as interpersonal dysfunction is linked to the onset and maintenance of eating disorder behaviors, healthy relationships and improvements in interpersonal functioning are linked with symptom reduction.


PSYCHODYNAMIC PSYCHOTHERAPY


The psychodynamic approach holds that recovery from an eating disorder requires understanding its root cause. Psychodynamic psychotherapists view behaviors as the result of internal conflicts, motives and unconscious forces, and if behaviors are discontinued without addressing the underlying motives that are driving them, then relapse will occur. Symptoms are viewed as expressions of the patient’s underlying needs and issues and are thought to be resolved with the completion of working through these issues.


Max Psychiatry has helped hundreds of patients in Cary, Apex, Raleigh, Durham, Fuqua-Varina, Wake Forest, Holly Springs area treat their eating disorders symptoms and bring happiness and confidence back in their lives.


What will it cost me ?


We accept most of the major health insurances such as Aetna, Cigna, Medicare, BCBS, United, Humana etc.  Here is a full list of insurances that we participate with. Please call our office at 919-386-0402 or email us at doctor@maxpsychiatry.com to ask about your out-of-pocket expenses.