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Eating disorders like anorexia nervosa are more complex than they might seem on the surface. Indeed, even though the sentiment concerning the best treatment options is changing to a more inclusive attitude, there are still many families and loved ones of individuals with an eating disorder that feel it may be a phase. Of course, nothing is further from the truth and that is where treatment at a center for eating disorders comes in.

What Is an Eating Disorder?

On the surface, an eating disorder looks like a simple problem that can be addressed by definitive action on the part of the individual involved. Depending on which particular eating disorder the person has, this could look as if they only need to stop eating so much or start eating more and the problem is effectively addressed and managed.

The reality of the situation is that addressing eating disorders in adolescence simply isn’t that easy. This is because there are often underlying issues that go way deeper than just eating. There is a reason why the individual is overeating and then using laxatives to rid their body of the excess calories, for example. A person who looks in the mirror and bemoans that fact that they are carrying excess weight does not realize that they, in fact, look quite the opposite. It is these beliefs — and the reasons that fuel them — that are at the heart of engaging in eating disorder counseling as part of treatment.

Eating Disorders Are Only One Piece of the Puzzle

For many people — sometimes even the individuals involved themselves — hearing that the eating disorder is one symptom and not the only issue at stake is at once eye-opening and a statement that is also met with skepticism. After all, the results of the eating disorder are what is visible so it makes sense that if that particular issue is treated, then all will be well.

Unfortunately, the world today is filled with pressures and stress that can skew a person’s thinking and reality regarding food.

Telling a person who has an eating disorder to eat more so they won’t be so skinny or that they should not eat so much food at one time does not fix the issue at hand. Both of these statements can fill the individual involved with shame or sadness without addressing the underlying issues that lead to the eating disorder in the first place. It is this complexity that warrants the need for eating disorder counseling.

Benefits of Eating Disorder Treatment

At the heart of all eating disorders are psychological issues that must be learned about, brought out into the open and addressed in a healthy manner. This does not necessarily mean that the individual with the eating disorder is also struggling with a mental health disorder such as depression, anxiety, bipolar disorder or the like. However, there are often mental health issues that are also occurring and that must be addressed effectively in order for the individual to recover effectively and completely from eating disorders like anorexia nervosa.

Eating Disorder Counseling: An Overview

Mental health counseling is not a new field so most people are aware of its existence as well as the many benefits that arise from engaging with the service. What is fairly new within the industry, though, are the specializations that have become more well known within recent years. By choosing a particular counselor that has proven expertise in a specific area, an individual can be assured of getting the type of specific care and services that best meet their needs.

For example, by engaging in eating disorder counseling, an individual can feel confident that the counselor they are working with can guide them more effectively toward solutions that have been proven effective in other instances and with people in similar situations. While the eating disorder counselor understands that not everyone will respond in the same manner to a particular treatment, this experience does provide a starting point for treatment so that progress can be made early on. Instead of going through the background of an eating disorder that might need to take place with a counselor without such experience, the focus can be more on specific strategies.

Which Came First: The Eating Disorder or the Mental Health Condition?

Many mental health conditions occur alongside an eating disorder like anorexia nervosa. Addressing this aspect of recovery is vital to the recovery of the individual involved. Anxiety, depression, substance abuse and/or use and obsessive-compulsive disorder (OCD) are some of the more common disorders that co-occur, especially when eating disorders in adolescence are experienced.

The complexity arises because these disorders are so intertwined that they cannot be effectively separated without the help and guidance of a trained professional. Only with the skilled care of an eating disorder counselor can it be determined if the individual’s eating disorder is fueling anxiety and depression. Knowing that the person was depressed or anxious prior to having an eating disorder requires a different approach.

A person with an eating disorder like anorexia nervosa, for example, might feel anxious that her weight is becoming a deterrent to her goal of getting a spot on an elite gymnastics team. That anxiety – either consciously or unconsciously – leads to her restricting the amount of food she eats, when she eats it and how she eats it. She loses weight and gains the attention of her loved ones for it. More anxiety could occur as she tries to balance this unwanted attention on her body with the fact that she is trying to set herself up for success on the gymnastics team.

In a world that is focused on weight and being skinny, an adolescent or young woman who does not fit into the narrow parameters of what is considered to be normal can struggle with depression. This depression can lead to an eating disorder such as binge eating disorder. While a person who is obese, overweight or a healthy weight can have binge eating disorder, many of those with the eating disorder are overweight or obese. This cycle of overeating and weight gain can also lead to depression or make depression that already exists worse.

OCD and eating disorders share many of the same components with a focus on the individual’s attempts to control their environment. Determining whether the eating disorder of an individual who must exercise for an exact number of minutes after binge eating in order to control the overload of calories on their body is just one example of how the two disorders can become intertwined. Another scenario is that the individual feels so very little control within their own life that they control their eating with complex rituals and rules that help them feel better about their situation.

Not Just Any Counselor Will Do

During adolescence and extending into young adulthood, many young women feel that no one else understands what they are going through. This is one of the challenges that parents face when trying to help their children weather the emotional ups and downs that occur in their lives.

An outside perspective is often necessary in order to help facilitate communication between the individual who has the eating disorder and her loved ones and closest supporters. Here is where eating disorder counseling can provide a vital element within her recovery plan. Speaking with a trained professional who has the expertise and experience to navigate the challenges faced by the young woman or teen can help her unravel the feelings and issues that are under the surface.

This eating disorder counselor can also provide the connection that the individual needs to communicate more effectively with her family, loved ones and friends. Not only will doing so help her recovery go more smoothly, but it can also give her support system crucial insight into what their loved one is going through.

A trained professional who has real-life experience with eating disorders – either by personally struggling with them in the past or from the struggles of a close loved one – provides the understanding that individuals crave. Making a positive connection between the individual and the eating disorder counselor is crucial to her recovery.

Part of the Professional Team

Obtaining care from a center for eating disorders means that eating disorder counseling is only one component of the individual’s treatment plan. This aspect, though, is of great importance as the counselor’s guidance will be sought when it comes to determining the level and type of treatment needed.

Not only is eating disorder counseling adept at helping the young woman or teen girl delve into the reasons behind her eating disorder, but they can also help guide treatment options that meet the individual where they are in their treatment. For example, one component of treatment might be successfully navigating an outing in which the individual must order food at a restaurant. This event – which might look simple and natural to someone without an eating disorder – can be fraught with a number of anxiety-producing elements that go beyond the food itself.

Many individuals with an eating disorder feel anxiety when it comes to eating around others, even those who are closest to them such as family or friends. Ordering an amount and type of food that is considered to be reasonable and acceptable by the standards of society is just one element. Being able to eat that food while chatting with others and in front of people in a restaurant is something completely different. Determining when the individual is ready for this step, role-playing the scenario before it helps and processing the event afterward are just a few of the many ways that eating disorder counseling helps treat eating disorders in adolescence.

Counselors who focus on treating eating disorders are also updated on the latest treatment techniques and research within the field. They can help determine whether inpatient or outpatient treatment at a center for eating disorders is the best for a particular individual.

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Houston, TX | South Miami, FL | Malibu Lake, CA | Naperville, IL | Portland, OR | Briarcliff Manor, NY | Twin Lakes, VA


Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.