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If you struggle with your relationship to food, you are not alone. Eating disorders are serious but treatable conditions, and they are more common than you might think. Unfortunately, eating disorders are surrounded by social stigma and dangerous myths that prevent those struggling with them from seeking help. Cultural glorification of thinness and fitness can fuel eating disorders by provoking cycles of shame and helplessness, or supply individuals with perverse incentives to avoid treatment (for instance, receiving social praise for “self-control”).
At Union Square Practice, we take a compassionate and individualized approach to treating eating disorders. Our clinicians appreciate the complexities of these conditions and the need for sustained, holistic treatment. We work as a team to provide you with necessary support, including psychotherapy, medication management, and any needed coordination with medical professionals. We see clients in person in our Midtown Manhattan offices as well as by telehealth throughout New York State.
Find out more about our approach to eating disorder therapy for adults. We also treat eating disorders in children and teens.
Eating disorders are complex mental health conditions marked by a dysregulated relationship with food. This commonly takes the shape of “out of control” eating such as frequent binging, or highly controlled eating, such as extreme calorie counting and tightly restricted food intake. Eating disorders typically result from or occur alongside mental health problems such as anxiety disorders, PTSD, mood disorders, and substance use disorders.
Nearly 1 in 10 Americans experiences an eating disorder at some point, yet eating disorders remain misunderstood and stigmatized. In the public imagination, eating disorders are primarily a health problem of adolescent girls. In reality, they aren’t limited by age, gender, or other demographic factors, and those who struggle with them in adolescence often continue to do so in adulthood if they don’t receive help. Eating disorders can also be invisible from the outside, with no definitive evidence of an eating disorder in a person’s appearance or observable actions.
Food is an integral part of human existence and health, and for most people eating carries social significance, from business lunches to eating out with friends to dinner at home with family. Disordered eating can have profound implications for a person’s physical health, mental health, and social relationships. Left untreated, some eating disorders can be fatal. Around 10,000 Americans per year die due to health complications from eating disorders.
Most eating disorders fit into one of the following categories, or combine different aspects of them:
People with anorexia typically experience an intense fear of gaining weight and a distorted body image, perceiving themselves to be overweight when they are average or underweight. Symptoms of anorexia include severely restricted eating patterns and calorie counting, sometimes accompanied by obsessive exercise routines. People commonly assume anorexia to be an easily recognized condition, but this is not always the case. Someone with anorexia is not necessarily visibly underweight or malnourished. By the time the symptoms cause visible issues, the condition may be quite advanced.
Bulimia involves episodes of binge eating followed by purging. Purging can take the form of vomiting shortly after a meal or using laxatives. Some people with bulimia also exercise excessively, and some people vacillate between bulimia and anorexia, or move over the long term from one to the other. As with anorexia, bulimia does not necessarily result in any visible health symptoms, especially in the relative short term.
This disorder is defined by recurring episodes of compulsive overeating, typically by consuming large amounts of food quickly. People with this disorder do not compensate through purging, but typically experience feelings of distress, lack of control, and often shame after an episode of binging. Binge eating is commonly done in private, and as with anorexia and bulimia, this disorder cannot be diagnosed from outward appearance.
Avoidant Restrictive Food Intake Disorder (ARFID) is a recently defined eating disorder typically associated with children, but it can also affect adults. It is less linked than other EDs to body image or underlying mental health issues. People with ARFID eat too little or too narrow a range of foods due to a lack of interest in eating or because they are avoiding many foods based on sensory sensitivities. This can lead to serious nutritional deficiencies and physical health problems.
While not a formal clinical term, orthorexia was coined to describe a disordered relationship with “clean” eating. Orthorexia goes beyond healthy lifestyle choices such as prioritizing whole and organic foods. People with orthorexia tend to become obsessed with engineering the perfect diet and may experience a deep fear of foods they deem “bad.” Orthorexia can result in dangerously restricted eating patterns, extreme anxiety or shame over diverging from these patterns, and avoidance of social eating situations.
Not everyone with a difficult relationship to food has a diagnosable eating disorder. Subclinical disordered eating may not be fatal, but if your relationship to eating causes you emotional distress or physical unhealth, it’s important to address. Subclinical disordered eating can also be an outward sign of various mental health issues, so therapy is a good place to explore and address any underlying problems.
Eating should be a regular, enjoyable part of life that does not cause anxiety, distress, or overthinking. Consider getting professional help if your relationship to food provokes shame, helplessness, social avoidance, physical health issues, or a preoccupation with eating or physical activity that interferes with your life. Symptoms of disordered eating include:
Eating disorders can be tricky to identify. Some of the symptoms above are simply a disordered version of otherwise healthy habits such as exercising regularly, reasonable portion control, and choosing healthy foods. Furthermore, people with a distorted body image may not be aware of this distortion, genuinely perceiving themselves to be overweight when they are not. If you suspect something might be off, or if people who care about you have voiced concerns, professional assessment can help.
Yes, we have clinicians with expertise in this field who can determine if you have an eating disorder. We also work with clients who may not have a clinically diagnosable eating disorder. If your relationship to eating causes you distress or occupies too much space in your life, help is available. Developing a better relationship with food now can prevent disordered eating patterns from reaching the level of a clinical eating disorder.
Eating disorders typically don’t occur in isolation, meaning there are underlying causes that need to be addressed alongside the disordered eating patterns. Holistic treatment is essential for long-term remission versus temporary positive results.
A good clinician understands that eating disorders don’t arise in a vacuum, and at the same time, once they begin, they take on a life of their own. Unlike substances such as drugs or alcohol, food cannot be avoided, so there is no equivalent “detox.” Everyone needs to eat daily, so some kind of relationship with food is inevitable. As with substance use disorders, though, thoroughly addressing the situation includes treating concurrent mental health concerns while actively replacing addictive/compulsive habits with healthy ones.
This process will look different for each individual. Your USP therapist will work closely with you to understand the origins and current context of the eating disorder. Then they will help you address both the root causes and the present reinforcement mechanisms driving the disorder. By coming at the problem from multiple angles, they’ll develop a comprehensive treatment plan. This might include trauma therapy, behavioral therapies, medication for anxiety or depression, dietary guidance, and/or other interventions.
Medication alone does not solve an eating disorder, but can in some cases be part of a holistic treatment plan. Eating disorders commonly co-occur with mood disorders such as anxiety and depression, so antidepressants and anti-anxiety medications can help. All medication management should be handled by a qualified psychiatric professional, and this is especially important with eating disorders. Medication can interact dangerously with physical health conditions caused by eating disorders. Union Square Practice practitioners gain a thorough understanding of a client’s mental and physical health state before prescribing any medication, and monitor them closely to ensure safety as well as efficacy.
Each person overcoming an eating disorder has their own timeline. Factors affecting this include how early in life the disorder began, how long it has been going on, underlying causes, current life stressors, and available social support. Recovery can take months or years, and it is not a linear process. It’s important to celebrate early progress while taking long-term management seriously. Part of successful recovery is anticipating how eating pattern struggles can resurface under stressful circumstances, and developing an ongoing support plan.
Treating eating disorders is a team effort. The complex nature of eating disorders can require specialty knowledge and experience in a number of intersecting mental health fields. This is where USP’s diverse and deeply integrated practice offers crucial client benefits. Our psychology and psychiatry professionals collaborate extensively, drawing on the expertise of 60+ practitioners to address mood disorders, neuropsychological conditions, and other factors often intertwined with eating disorders.
In addition to our cumulative expertise, we operate with shared values focused first and foremost on a great therapist-client relationship. Our first priority is connecting with you and establishing trust. With that foundation, we work to understand your context, challenges, and priorities so we can tailor treatment to fit you.
Union Square Practice is a group of psychologists, psychiatrists and therapists who empower individuals to be the best versions of themselves using the latest science has to offer.
It’s possible to find freedom from the hold food has on your daily life. At Union Square Practice we offer caring, nonjudgmental treatment to help our clients transform their relationship to eating. If you are ready to seek help, you’ve already made great progress. Identifying the need for help is often the first big barrier to eating disorder recovery, and reaching out to get that help is the next one. Our compassionate, professional clinical coordinators are ready to answer all your questions and discuss treatment options with you.
Reach out to us using any of the contacts below or our general contact form.
