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Eating Disorder Awareness Week

For the National Eating Disorder Association (NEDA)’s Eating Disorder Awareness Week (February 26-March 4), the theme is “Let’s Get Real.” The goal is to highlight the stories we don’t hear as often and to open the conversation to everyone.

For more info from NEDA, please go to https://www.nationaleatingdisorders.org/, and if you are concerned you might have an eating disorder, use their Helpline 1-800-931-2237 or their screening tool https://www.nationaleatingdisorders.org/screening-tool.

According to statistics provided by NEDA, 30 million Americans struggle with a “full blown” eating disorder, and countless more struggle with eating and body image concerns. Because of the stereotypes and stigma attached to mental illness and eating disorders, a lot of people don’t reach out for help.

Last year, the theme was “It’s Time To Talk About It” and Kelly Broadwater, LPA here at Chrysalis Center highlighted the high mortality rate, the lack of funding for research, the negative messages about food and weight we get bombarded with every day, getting help, and having hope. To read more from this blog post, go to https://chrysaliscenter-nc.com/its-time-to-talk-about-it/.

Truths About Eating Disorders

There are a lot of stereotypes about eating disorders. How many of those are even real? Instead of going through all the myths about eating disorders, here are some truths:

  • An eating disorder is not a choice; it is a mental illness with serious physical, cognitive, and psychological implications.
  • It is not possible to “just snap out of it.”
  • There is no one cause for an eating disorder, it is a different root for every person.
  • It is a big deal.
  • Anorexia is not the only eating disorder, even if it is the one we think of most often – bulimia, binge eating disorder, and avoidant/restrictive food intake disorder are also serious, life threatening illnesses that need to be taken seriously.
  • Just because you don’t see it physically, doesn’t mean it’s not there or that you should ignore signs because it doesn’t fit the stereotype.
  • There are a lot of other issues linked to eating disorders, including anxiety, depression, and trauma.
  • People need their support system, including friends, family, and treatment team, to recover.
  • Men can have eating disorders, and the CDC found that about 1/3 of all eating disorder sufferers are male.
  • Children as young as five can develop eating disorders, and many people who struggle with eating disorders as a child or adolescent will continue to struggle with them as an adult unless they receive help.
  • It is not just about food.

For people with these disorders, one of the biggest obstacles is the secrets and shame that go along with those behaviors.

Say Something!

Too often, loved ones will see something wrong and not say anything – if we are going to “Get Real” that needs to change. People are afraid to bring things up, but that is one of the things that keeps the stigmas about mental health and eating disorders alive.

Why not ask, or express concern? What is wrong with talking about it, really? It can be a difficult topic, but if it is approached with concern, caring, and empathy, people will rarely shut down the conversation.

If this seems too stressful or delicate to do on your own, seek help from a professional (a therapist or dietician who specializes in eating disorders) to help you have the conversation.

As an eating disorder specialist, the most important message I want people to hear is that truth and honesty is necessary from everyone affected – the person with the eating disorder and their loved ones.

Don’t walk on eggshells – but don’t smash them either. If you try to get real, make sure you are coming from a genuine place of caring before you try to open the conversation. If it is approached with compassion, the conversation has a much better chance of being productive for the person with the eating disorder and their loved ones.

#NEDAwareness

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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 https://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.



The journey towards recovery can take many forms, but every person has to follow their own path towards health and make choices along the way. Some of these choices may come in the form of different treatment centers or levels of care to address the difficulties someone is having at that stage of their recovery. Every person’s process is different.

Eating disorders are very complex illnesses that require specialists to treat not only the emotional and behavioral facets of an illness, but the medical one as well. For these reasons, the American Psychological Association (APA) established guidelines for appropriate levels of care with eating disorders.

Chrysalis Center is an outpatient program and will soon be adding intensive outpatient (IOP) services. The other levels include partial hospital (PHP), residential, and inpatient levels; these last two are sometimes combined into an “IP-Res” format. To see the full APA criteria for eating disorders, click here. There are some other resources for eating disorder treatment in North Carolina, including Veritas Collaborative, Carolina House, and UNC’s Center for Eating Disorders.  Other treatment centers around the country specialize in eating disorders as well, and sometimes these other programs are a better fit for clients in terms of their individual needs and experiences.  Though not for eating disorders, there are several other levels of care in the Wilmington area for adolescents and adults in general psychiatry.

Usually, these difficult conversations start when we as clinicians recommend a higher level of care for someone who we do not think is appropriate for outpatient or IOP treatment. To be appropriate for outpatient or IOP, a person must be:

  • Medically and psychologically stable to the point that they are not a danger to themselves or others
  • Motivated to recover
  • Cooperative
  • Self-sufficient
  • Able to control their thoughts and behaviors using appropriate social support

 

When someone needs a higher level of care, they are usually:

  • Medically compromised (by weight, bloodwork, EKG, etc.)
  • Unable to manage their behavior
  • Un- or under-motivated
  • Not functioning in their lives in some significant way (work, family, relationships, etc.)
  • Unable to manage a co-morbid condition (psychological or medical) because of their eating disorder

Levels of care indicate how much structure, support, and observation a client requires at that stage in their recovery.

When someone needs a higher level of care, it can be a very difficult discussion between provider and client. Sometimes, we all know it is coming and have been trying to avoid it but it just is not working. Other times, clients may take a sudden turn. This could be for many reasons, but the important thing is that clients get the help that they need to recover from their eating disorder and co-occurring disorders. Our goal is always to help our clients and keep them focused on living healthy and productive lives, and we try to balance all their individual needs while keeping the goal of a full recovery foremost in our minds.

It is important to use the right tool to complete a task, and sometimes that tool needs to be a higher level of care in order for someone to truly recover. Often, IP-Res levels of care can get clients back on track faster than outpatient could and sometimes that is necessary for someone’s well being or even survival. PHP and IOP levels can provide support to keep someone out of the hospital or they can provide support as a step-down program. The transition between inpatient and home can be very stressful and there are a lot of facets to consider including social, family, academic, or work stressors. All of these are affected by or contribute to eating disorder behavior. A person cannot live in a vacuum so all of these need to be managed before someone goes back to their regularly scheduled lives.

By adding IOP services, Chrysalis hopes to provide a bridge for clients on their journey in recovery. It is an important stage or facet in that process. If you need us, we will be honored to work with you on that journey.

 

Kendra is a Senior Staff Therapist and soon to be Clinical Director of Chrysalis’s new Intensive Outpatient (IOP) program with 13 years of experience working with eating disorders in various settings, including inpatient, PHP, IOP, and outpatient treatment facilities.



 

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.


chrysalis
16/Feb/2017

It’s easy to shy away from learning about health insurance – it’s overwhelming just to get past all the acronyms that flood your mailbox when your new insurance cards arrive. Between ACA, EAPs, EOBs and HSAs, sometimes it’s easier to throw our hands up in the air and avoid determining how to best use health insurance. Instead, take a few minutes to look for key terms in your benefits booklet, talk with your HR representative, or the representative who sold you the policy.

In order to determine your cost for health care services, here are some questions you’ll want to ask your potential healthcare provider:

  • What type of service am I receiving?
  • Where will I receive this service?
  • Who is performing that service?
  • Does my insurance company consider the provider IN or OUT of network?

These are questions that any provider’s office will be able to answer, so ask them! Then you will be able to find out from your health insurance company what you’ll need to pay to receive specific services. You can call the number on the back of your health insurance card, go to the website for members, or look in the benefits booklet you received when your policy began.

Your insurance company will be able to provide you with your individual benefit for different types of services. Unless your insurance company covers certain services at 100%, you will be expected to pay a co-payment, co-insurance or the full amount for a service which will go toward your deductible. So what’s the difference between all these things? Let’s define these terms.

  • Co-payment: A fixed amount required by a health insurer to be paid by the insured for each visit or drug prescription.
  • Deductible: A specified amount of money that the insured must pay before an insurance company will pay a claim.
  • Coinsurance: A specified percentage of the total cost of the medical expenses after a deductible has been reached.

It’s important to understand that these rates are determined by your insurance carrier, not your health care provider. Healthcare providers can determine the amount they will bill your insurance company or any non-billable fees they may require from you, but your insurance company determines the amount you are required to pay as long as you see an IN-network provider.

The Chrysalis Center offers mental health counseling and nutrition counseling in an office setting with licensed therapists and registered dietitians. Mental Health counseling and Nutrition Counseling are separate benefits.  Our administrative staff will help you determine the cost you are responsible for when it comes to either service. We are in network with Blue Cross/Blue Shield, United Healthcare, Aetna, Medcost, Tricare and Medicare.

If you are considering mental health or nutrition services, take the time to find out how you can use your health insurance to pay a portion or even cover it in full. You may just find out that you have excellent benefits for these services!

About the author

Alexis is the Practice Manager at Chrysalis Center and performs multiple functions to support the business. Among those are supervising the administrative staff, acting as the Intake Coordinator, Human Resources and Marketing. Alexis was born and raised in Wilmington, graduating from NC State University in 2003. While not leading the team at Chrysalis Center, she enjoys spending time with her husband, Wes and her two boys: Mason (5) and Banks (2)

Alexis Hunter Practice Manager

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