When people think about eating disorders, anorexia (self-starving) and bulimia (excessive overeating and purging) generally come to mind. But the most common one, says Erin I. Kleifield Ph.D., director of the Eating Disorders Program at Silver Hill Hospital in New Canaan (www.silverhillhospital.org or 866-542-4455), is binge eating disorder, binging without purging. “Binge disorder is eating for emotional reasons, not hunger, usually accompanied by feelings of guilt and self-loathing — and the worse they feel, the more they eat,” Kleifield explains.
An eating disorder is defined by the degree and severity of preoccupation with food and body image, she continues. “For anorexics, what may start out as an effort to lose weight and get healthier takes on a life of its own. A person losing weight doesn’t know when to stop … becomes fearful of certain foods, or foods are designated good or bad. They develop rituals and preoccupation with certain foods and get to a point of going to great lengths to lose weight.
“On the other side,” she says, “are people who cope with life’s problems with food. Behind both are rigid beliefs about food, and foods are seen as black and white. And many have co-occurring disorders — depression, anxiety, substance abuse, personality disorders, etc. As a psychiatric hospital, Silver Hill is especially able to treat such patients, which is essential for successful and lasting recovery.”
The treatment of eating disorders has changed, Kleifield notes. “Where initially the emphasis was on changing beliefs, it is now more about acceptance … you may still believe your body isn’t perfect — whatever that means to you — but you learn to accept that that is OK. Through exposure and acceptance, taking a holistic mind-body-spirit approach, the neural pathways get retrained and your beliefs change, which changes your life.”
Maria Tripodi RD was chief dietitian at Renfrew Center in Old Greenwich from 2002 to 2011, along with building a private practice in Westport ([email protected], 203-515-6311). She specializes in body dysmorphic issues (an obsessive preoccupation that some aspect of one’s appearance needs to be “fixed”), which affects males and females equally.
Both Tripodi and Kleifield believe social media have made eating disorders worse, creating new ways for people to compare and judge themselves. “Apps and websites can affect state of mind; what might be a place of motivation takes an ominous turn,” Kleifield says. “Sadly, these disorders are occurring in younger people, as their bodies start to change. Parents need to be careful about the world of images their children encounter, how they define self-worth.”
Tripodi concurs: “When I started at Renfrew, we served only females and our youngest patients were 14; I would see an occasional male in my private practice. Anorexia can be very hard to treat, as the lack of nutrients affects the brain as well as the body, and younger people can be more heavily impacted.
“The best way to treat eating disorders is with a nutritionist, therapist and psychiatrist working as a team. The eating disorder community in Fairfield County is small, and we know each other, which is helpful to the clients.”
Overcoming eating disorders is a work in progress, she stresses. “Both patients and families need to expect relapses. The key is to be self-aware, know your triggers and ask for help and support when life events such as weddings, pregnancy, graduation, retirement occur.”
A longtime mind-body-spirit practitioner, Renee Simon MS, CNS, CDN, RYT took her passions to a profession, becoming a clinical nutritionist in 1999 and later a certified yoga instructor. She now has private practices in Ridgefield, South Salem and Katonah. Her eating disorder clients tend to be overeaters rather than anorexics (totalwellnessnutrition.com, [email protected] or 914-763-9107).
“There are a number of different types of overeaters,” she says. “I see a lot of binge eaters, who often have physical, metabolic sensitivities, such as wheat, gluten, yeast, that can cause cravings, so I test for sensitivities. Mineral deficiencies can also cause problems that affect appetite and mood.
“Typically, someone will come in wanting to lose weight, eat healthier, get more energy … there might be mood swings or digestive disorders. The goal is to get to an understanding of what is underlying the symptoms; once understood, programs are customized to work on the interconnections of food, supplements and body movement.
“I found I can best connect with some clients through yoga and Reiki … breathing and mindfulness, so I got certified to teach yoga. I found I could do much more with emotional and stress management by incorporating yoga and Reiki with nutrition,” says Simon, who is also a Reiki master.
For those concerned that a friend or family member may have crossed into disordered eating habits, Kleifield advises, “It is best to use a direct but nonjudgmental approach. Express your concern honestly — don’t condemn or blame, offer support and compassion. Understand that eating disorders are mental illnesses that create anxiety, self-loathing and true suffering. They involve changes in the brain and body that lead to malnourishment, which affects physical and mental capabilities.”