Eating Disorders
Anorexia Nervosa
Anorexia nervosa is an illness characterized by weight loss (or a lack of expected weight gain in children) leading to a low body weight, a fear of gaining weight or an inability to eat adequately despite being at a low weight, and a distorted perception of one’s body or an inability to grasp the severity of their state.
This illness typically develops around adolescence and can cause symptoms of anxiety and depression. Anorexia nervosa is a serious, sometimes life-threatening illness that can lead to medical complications.
Bulimia Nervosa
Bulimia nervosa involves episodes of feeling out of control when eating followed by compensatory behaviors (i.e. vomiting, laxative use, diuretics, etc) and a preoccupation with weight or body shape.
Binge-eating Disorder
Binge-eating disorder is characterized by episodes of feeling out of control when eating large amounts of food. The individual may eat in secret and feel guilty or ashamed about their eating.
Avoidant Restrictive Food Intake Disorder (ARFID)
ARFID occurs when an individual avoids certain foods to the point that they are not able to nourish themselves adequately or their avoidance of these foods causes issues in their social, professional or academic lives. Individuals may avoid foods because of sensory sensitivity, a fear of vomiting or choking, or for any reason aside from worries about their weight.
Treatment for Eating Disorders
Because eating disorders require comprehensive medical and psychological care, our providers work closely with your pediatrician or primary care physician and any other providers involved. We work with patients and families to develop treatment plans that are tailored to meet your individual needs.
Family-based Treatment (FBT or the Maudsley Method)
Family-based treatment is considered the gold standard therapy or first-line treatment for children and adolescents with anorexia nervosa. Between 50-70% of patients achieve recovery within one year, and parents and caregivers are equipped with relapse prevention tools.
FBT empowers parents and caregivers to support their child in overcoming the eating disorder with a firm and compassionate focus on renourishment. In the first phase of treatment, appointments are weekly. The second phase of treatment focuses on handing back control of eating and exercise to the adolescent in an effective and safe manner; meetings in this phase occur every other week. The last phase helps the individual return to their development.
Enhanced Cognitive Behavioral Therapy for Eating Disorders (CBT-E)
CBT-E is an individualized outpatient treatment with four stages. This treatment has been shown by research to be effective for all eating disorder diagnoses.
The first stage focuses on understanding the eating problem and creating a regular pattern of eating. The second stage reviews progress made and sets the frame for the remainder of treatment.
The third stage focuses on what is maintaining the eating problem which may include beliefs about shape or weight and dietary restriction. This stage also focuses on coping skills to manage everyday events and mood fluctuations.
Stage four emphasizes the future and relapse prevention.
Cognitive Behavioral Therapy for ARFID (CBT-AR)
CBT-AR supports individuals and their caregivers in addressing eating related problems which interfere with growth and development or social functioning. These issues may include sensory sensitivity, anxiety about eating, fear of choking or vomiting, or low appetite.
Feeling and Body Investigators for ARFID (FBI-ARFID)
FBI-ARFID is designed for children ages 4-10 years old and focuses on interoceptive activities to decrease avoidance of eating and body sensations. Children playfully engage with body sensations and food through cartoons and developmentally appropriate exposures.
Providers
NIKKI PAGANO, LCSW
nikki.pagano@carolinapsychotherapy.com
