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Do people actually recover? What does full recovery look like? Is it like alcoholism that once you’ve had an eating disorder you’ll always have an eating disorder? Clients, loved ones, and even the general public have often asked me these questions repeatedly over the years that I’ve specialized in treating eating disorders. We often hear the grim statistics that eating disorders have the highest mortality rate of any mental health diagnosis and that the average length of treatment is 4-7 years. There is even a new subset of eating disorders garnering attention in the treatment world known as Severe and Enduring Eating Disorders (SEED), which are chronic forms of eating disorders lasting 10 or more years that are unresponsive to multiple attempts to treatment.

However, there is hope! An often overlooked statistic is that with treatment, 60% of patients recover from eating disorders. Early intervention improves outcomes. And thanks to mental health parity, increased advocacy efforts, and the growing need, access to treatment is more widely available.

Recovery is not one size fits all. It looks different for each individual. The latest research suggests that a full year without eating disorder behaviors is a strong indicator of recovery. There are also broad phases of recovery that have been identified: physical recovery, behavioral recovery, and psychological recovery. Physical recovery includes medical stabilization, restoring a healthy weight, and overcoming symptoms related to malnourishment. Behavioral recovery involves symptom cessation, while psychological recovery addresses underlying issues contributing to the development and maintenance of an eating disorder. Psychological recovery may include treatment for comorbid mental health problems, resolving trauma, addressing family or relationship issues, overcoming perfectionism, letting go of food rules, and developing healthier body image.

Recovery 101:

  • Recovery is best achieved with a multidisciplinary team approach that includes a therapist, dietitian, medical doctor, and psychiatrist (when indicated) who specialize in eating disorder treatment.
  • The involvement of loved ones is also crucial; having a strong support network of family, friends, and others in recovery improves outcomes.
  • Realistic goals and patience are vitally important in the recovery process. Expect that lapses or relapses can be part of the recovery process- after all, a person with an eating disorder has to face every single day, multiple times per day, what they struggle with the most. Research has shown we make 200+ food related decisions per day. Imagine how overwhelming that can be to someone new to recovery!
  • Being able to identify and minimize or handle triggers is yet another part of the recovery process. A person in recovery is vulnerable to triggers at any time, but especially during times of life stress or transition.

Part of what inspired me to write on this topic was an email I received last month from a former client. She ended treatment with me approximately 8 years ago. She’d battled a severe eating disorder for many years, compounded by a complex trauma history spanning much of her lifetime. She’d been to inpatient or residential treatment at least 5 times when I started working with her and during our time together, she did go to a higher level of care to a center that could address both her trauma and eating disorder. Today, she is a happily married mother of 3 with a thriving career in a helping profession (which even affords her the opportunity at times to work with patients with eating disorders). Here is an excerpt from what she wrote to me (shared with her permission). It speaks volumes more than any professional writing or scholarly article on recovery ever could:

“Perhaps the most humbling experience I have had over the course of the last several years was what previously seemed like a hopeless endeavor–the pursuit of true recovery.  I humbly say that I know with no uncertainty whatsoever that recovery, true recovery, from an eating disorder is possible.  I consider myself fully recovered and am so grateful that the eating disorder is no longer a part of my life. I share this with you because I want to encourage you to keep going.  Keep doing what you’re doing because it is worth it.  Your belief in me and the unconditional support that you provided helped to allow all of the amazing things above to occur, including what I hope to ultimately be the recovery of many more individuals that have never even met you, through (in part) the work that I am able to do with them at this point in time (which never would have been possible without your presence in my life).”

The final workshop I attended this year at the International Association of Eating Disorder Professionals Conference was entitled, “The Neuroscience of Hope in Eating Disorder Recovery”. In this talk, Dr. Ralph Carson spoke about the fact that humans can actually increase the density of cells in their left prefrontal cortex, the part of the brain responsible for positive emotions. He stated that hope requires continuous renewal and recommended the following: keep a gratitude journal, surround yourself with supportive people, ask for help when challenged, avoid people and media that diminish hope, and identify your personal strengths and values and use them! These are wise recommendations for anyone, but essential for everyone in the recovery process. It’s important to remember it’s just that- a process- and to have HOPE that it will happen.

 

Kelly Broadwater is a Certified Eating Disorders Specialist with over 15 years of experience in the field. In that time, she has proudly walked beside numerous clients in their journeys to full recovery.



As we wrap up National Eating Disorder Awareness week, with this year’s theme of “Let’s Get Real”, a major focus of the campaign is on ending stigma. One group of people who struggle with being stigmatized the most are males with eating disorders. It is a common stereotype that only women struggle with eating and body image issues, when in reality 1 in 3 people with an eating disorder is male and 10 million males in the United States alone will be impacted by an eating disorder at some point in their lives. There is also a commonly held misperception that the only males who suffer from eating disorders are homosexuals; actually, the majority of men with eating disorders are heterosexual.

Men and boys of all backgrounds experience eating disorders, and there is a high prevalence rate amongst athletes. Just this week, Seattle Mariner’s catcher Mike Marajma opened up about his battle with an eating disorder (https://www.nationaleatingdisorders.org/blog/seattle-mariners-catcher-mike-marjama-has-message-men-struggling-eating-disorders). Sports that focus on weight restriction as a means for improving performance create increased vulnerability for the development of eating disorders. Gymnasts, runners, body builders, rowers, wrestlers, jockeys, dancers, and swimmers are at risk when pressure is put on them to achieve a certain weight.

Men often go undiagnosed or untreated for a variety of reasons. They are less likely to seek treatment and more likely to be overlooked by medical professionals. Eating disorders in general have the highest mortality rate of any mental health condition and studies have shown that males have an even greater risk of dying from an eating disorder than their female peers; again, a lag in proper diagnosis or barriers to seeking treatment can contribute. To highlight this, the last male with anorexia that I encountered clinically had been seeing a therapist for a year for anxiety and had undergone extensive medical testing for reported GI issues. He’d lost over 40 pounds in a short period of time and was at roughly 65% of his ideal body weight when I encountered him in the hospital (he was there for flu and dehydration). No one had recognized that what he was dealing with was in fact an eating disorder. He ended up requiring months of inpatient hospitalization to help him restore weight.

Luckily there are more intensive treatment options for men with eating disorders available as the field recognizes the need to offer gender inclusive treatment. In fact, a review of hospitalizations for men with eating disorders showed a 53% increase over a 10 year period from 1999-2009. If you are a male struggling with an eating disorder, or know a male who is, know that help is available!

A few resources:
www.nationaleatingdisorders.org/learn/general-information/research-on-males
www.namedinc.org
www.mengetedstoo.co.uk
“Man Up To Eating Disorders” by Andrew Walen

 



This Monday, October 9th, a years long dream will become a reality. Chrysalis will begin offering our IOP for adults 18 and older with all forms of eating disorders. IOP is considered a step up from outpatient care and a step down from partial hospitalization, residential, or inpatient eating disorder treatment. It is appropriate for those who are able to live independently, but require more structure and support than typically achieved by attending once weekly individual and nutrition therapy. It is also a useful way for those who’ve been at a higher level of care, with nearly constant supervision, to transition back to “the real world”. For those who’ve been away at treatment, IOP serves to help prevent relapse and sustain recovery.

Our mission is to offer expert level, evidence-based treatment to our clients dealing with all types of eating disorders (including anorexia, bulimia, and binge eating disorder), while also addressing co-occurring issues such as anxiety, depression and other mood disorders, trauma, and substance use. Our goal is to provide individualized care that targets every aspect of the client’s well-being in order to improve medical, nutritional, psychological, and interpersonal functioning. We seek to understand and challenge the underlying and maintaining factors of the eating disorder in order to achieve and sustain lasting recovery. It is our desire to restore hope and health to clients by empowering them to fulfill their goals, make positive changes, and prevent relapse. We believe that collaboration amongst the treatment team, clients, families, and the community will facilitate a path to successful outcomes.

Our program will be offered Monday, Wednesday, and Thursday from 3pm-7pm and will include a variety of group therapies, ending each day with a supportive meal led by a registered dietitian. These meals will rotate between catered options, “brown bag” or potluck dinners, and restaurant outings so that clients experience a variety of exposures to food challenges in different environments. Therapy groups include the ACT/DBT informed Mindful Living, Staying Open about Recovery, Motivation for Change, and a general Process Group. Additional specialty groups for trauma survivors and those dealing with substance use will be available dependent on the needs of the clients enrolled at any given time. Yoga and art therapy groups will also be incorporated into our programming.

Those clients interested in IOP can self-refer or have their treating provider (therapist, dietitian, or medical doctor) make a referral. Pre-screening with our clinical director will be required to determine if IOP is the appropriate level of care. All clients will have to undergo a medical evaluation to ensure their physical stability prior to being admitted into the program. If a client is already connected with a therapist or dietitian, they can maintain their current treatment team while also attending our IOP program. Close communication and collaboration between the IOP team and the referring provider will occur. If a client does not have a treatment team (i.e. therapist, nutritionist, or psychiatric provider) in place, Chrysalis will offer those individual services as well to round out the treatment experience. As we are the only eating disorder specific IOP within a 130 mile range, we will also accept clients from out of town. Our director of professional relations will work with those clients to attain affordable lodging options.

Insurance typically covers IOP level of care with prior authorization. Our helpful administrative team will assist clients to determine their benefits and to obtain the authorization required to attend IOP. If we are not in-network with a particular insurance company, our utilization review department will strive to negotiate a single case agreement with the individual’s carrier. Once enrolled in the program, our hope is that at least 6 weeks of continuous care will be approved.

Our staff is a friendly, knowledgeable mix of experts in the field. Our clinical and nutrition directors are a certified eating disorders specialist and a certified eating disorders registered dietitian, both with previous experience working in higher levels of care for eating disorder treatment. Our IOP therapists and dietitians have specialized training and experience in the groups that they facilitate. Chrysalis’ program is licensed by the NC Department of Health and Human Services and accredited by the Joint Commission.

Making the decision to pursue IOP care is a big step in the recovery process and should be applauded. Visit http://chrysaliscenter-nc.com/iop/ for more information about the schedule, specific descriptions of the groups offered, and to meet our leadership team. If you have further questions about our program or to request a screening, please contact us at 910-790-9500 or iop@chrysaliscenter-nc.com.

Kelly Broadwater, LPA, LPC, CEDS is the founding executive director of Chrysalis Center. She is extremely grateful for the IOP leadership team who has put in countless hours of blood, sweat, tears to develop the program (and write more policies and procedures than she ever thought imaginable) and excited to see what the future holds as the IOP “takes flight”.



All too often when someone asks me what I do for a living and I tell them I’m a psychologist who specializes in treating eating disorders, they will jokingly say, “I have one those, I eat too much” and sometimes laugh and pat their stomach. As no laughing matter, in actuality, binge eating disorder is the most common eating disorder in the U.S. An estimated 3.5% of women, 2% of men, and 30% to 40% of those seeking weight loss treatments can be clinically diagnosed with binge eating disorder. The disorder impacts people of all ages (including children and adolescents), races, and levels of education and income.
According to the diagnostic criteria for binge eating disorder (BED), the behavioral and emotional signs or symptoms include:

• Recurrent episodes of binge eating occurring at least once a week for three months
• Eating a larger amount of food than normal during a short time frame (considered any two-hour period)
• Lack of control over eating during the binge episode (feeling you can’t stop eating or control what or how much you are eating)

Binge eating episodes are also associated with three or more of the following:
• Eating until feeling uncomfortably full
• Eating large amounts of food when not physically hungry
• Eating much more rapidly than normal
• Eating alone out of embarrassment over quantity eaten
• Feeling disgusted, depressed, ashamed, or guilty after overeating

It is important to note that people with binge eating disorder tend to have higher rates of depression and other mood disorders, greater incidence of other addictions, and significantly higher rates of traumatic experiences. Therefore, it is crucial that treatment providers understand how to treat not only the eating disorder, but the co-occurring issues that contribute to and maintain binging behavior. The following excerpt from one brave client’s testimony of battling binge eating disorder highlights some of these facts:

“My addiction to food started at a very young age, about 4 years old. The insanity of using food to numb the fear, shame, pain and abandonment by my parents, an active alcoholic and drug addict, worked at the time to bring me comfort and enabled me to survive and function in my dysfunctional home. As I grew older and attended school I was ridiculed for being a fat kid and had few friends, I isolated more and more with the food, usually sugary, fatty, high-carb items. I ate in secret, I ate in my bedroom especially at night. I wanted to stop but could not. By the time I was almost through my first year of college I ate myself up to 265 pounds – gaining almost 75 lbs. in less than 9 months. I was gaining weight so fast I used to fall down the stairs – my sense of balance was off in more ways than one.

I used drugs, nicotine, speed and crystal meth as my own treatment to curb ‘my appetite’ and it worked for a while. When I was 23, I was introduced to the 12- step program Overeaters Anonymous; I was so unhappy with myself and my weight, but I wasn’t ready and left the program. I finally went back at 31. I was desperate and surrendered to the 12-step program, doing everything they told me, lost about 100 pounds, and kept almost all of it off for about 12 years. However, I relapsed when I thought I could try a little compulsive eating and some of my favorite sugary foods. This started the insanity of food addiction for me again, put on about 80 pounds, then my husband died in 2006 and I gained more and more weight until I weighed 330 lbs.

My primary care physician suggested I consider weight loss surgery and I met with a surgeon and a therapist. I started counseling for my eating disorder in 2010. After about 6 or 7 months of soul searching and therapy I decided to have Gastric Bypass surgery in February of 2011. The surgery, along with a recommitment to the Overeaters Anonymous program saved my life. I lost a little over 180 pounds and have maintained at least a 160 weight loss for about 5.5 years.

Regarding maintaining my recovery, I knew I didn’t have brain surgery (although sometimes I’d wish I had!) and it really helped me to see my counselor, attend support groups, and be very committed to my OA program. The gastric bypass, my new commitment to taking care of myself, and following all the weight loss surgery eating guidelines have been a life saver – I am much more aware of my actions and sometimes unhealthy behaviors with food and my 12-step program reinforces the fact that I truly have a food disorder, a compulsive eating disease that tells me “it’s okay” to start down that destructive eating path again! One day at time I do my best to choose not to do that.”

If you or someone you love is struggling with binge eating disorder, know that you are not alone and that help is available. The Chrysalis Center’s team of experts offers both therapy and nutritional counseling for binge eating disorder.

Additional resources:
https://bedaonline.com/
https://www.eatingrecoverycenter.com/conditions/binge-eating
http://www.midss.org/sites/default/files/yale_food_addiction_scale.pdf

Kelly Broadwater, LPA, LPC, CEDS is a certified eating disorder specialist whose clinical practice is strongly focused on binge eating disorder, weight loss surgery patients, trauma, and addiction.



 

Today kicks off National Eating Disorder Awareness Week 2017 (February 24- March 3) with this year’s theme appointed, “It’s Time to Talk about It”.

It’s time to talk about the public health crisis that eating disorders pose, as 30 million individuals of all ages and genders suffer from these illnesses in the United States. If you think you could be one of them, take a few minutes to complete this confidential online screening. http://nedawareness.org/get-screened

It’s time to talk about the fact that eating disorders have the highest mortality rate of any other mental health disorder; more people die from eating disorders than any other psychiatric condition. http://www.something-fishy.org/memorial/memorial.php

It’s time to talk about binge eating disorder being the most common eating disorder, greatly contributing to our country’s obesity epidemic. http://bedaonline.com/resources/

It’s time to talk about the inadequate funding for eating disorder research. According to the National Institutes of Health in 2011, research dollars spent on Alzheimer’s averaged $88 per affected individual. For autism, the amount was $44. For eating disorders, the average amount of research dollars per affected individual was just $0.93.  In response, the Eating Disorders Coalition is an organization whose mission is to advance the recognition of eating disorders as a public health priority. To learn more about how you can get involved: http://www.eatingdisorderscoalition.org/inner_template/get_involved/take-action.html#/

It’s time to talk about the messages that Americans are bombarded with about food, weight, and unachievable body ideals that add to the prevalence of eating disorders. Why else would 47% of elementary school girls who look at popular magazines say the pictures make them want to lose weight? Body positivity campaigns need to be the norm, not the exception. http://selfesteem.dove.us/

It’s time to talk about the loved ones who are impacted by their family members’ illness and the toll it takes on them. There is now more support than ever out there for caregivers. http://www.feast-ed.org/

It’s time to talk about how to get help. The earlier a person seeks treatment for an eating disorder, the greater the likelihood of full physical and emotional recovery. To search for treatment near you, https://www.edreferral.com/treatment. Locally if you are looking for support, Chrysalis Center offers individual, group, and nutritional counseling for people with any type of eating disorder. Our SOAR group (Staying Open about Recovery) and dietitian led meal support groups are currently open to new participants.

Most importantly, it’s time to talk about hope for the recovery process. As a certified eating disorders specialist, I’ve learned the most over the years not from scholarly articles or expert led workshops, but from my amazing clients and their families who have battled these deadly diseases and overcome them. To honor those who are walking this path, this week our blog and Facebook page will be publishing writing from the real experts- those in the process of recovery. Thank you to these brave individuals for sharing their powerful stories, taking the time to “talk about it”.

From a client:

“For the first time in my life, I don’t have to work to find the positives.

In high school, when the dark thoughts and voices began to take over, I challenged myself to sit down every night and make a list of three positive things that happened that day. Most nights, I struggled to come up with one.

It wasn’t easy, but after time, this helped me focus on the positives in my life instead of the negatives. I began to see treatment and therapy as an opportunity to grow instead of a punishment. I began to view my eating disorder as a challenge to radically love myself and the world around me. I began to have hope again.

The hardest part is talking about it. I kept my eating disorder a secret for three years before I confided in a friend. I stayed quiet for another two years before I reached out for help. I let five years go by while I suffered silently.

I’m working today on unapologetically being open about my experience. I have nothing to be ashamed of. It has taken me six years to believe that my eating disorder is not something I need to hide.

You have the strength to talk about it. You have the ability to take back control over your life. One small step towards recovery today will amaze you in the future when you look back on your journey.

This life is so beautiful and you deserve to enjoy it.”

 

Kelly Broadwater, LPA, LPC, CEDS is a psychologist and professional counselor who holds the distinction of Certified Eating Disorders Specialist from the International Association of Eating Disorder Professionals. She co-founded the Chrysalis Center in 2003 and is proud of the team of experts she’s assembled to treat eating disorders and other mental health concerns.


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At Chrysalis, we believe that a supportive, healing environment is essential in order for change and growth to occur. We seek to offer such an environment to clients and help them create that in their lives and relationships. Read More

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