Virtue Recovery Center focuses on freedom with food, empowering individuals with coping skills and tools to explore the origins of the eating disorder while repairing their relationship with the self. Eating disorders aren’t about the food – food is a mechanism of control, especially during times of distress and in response to traumatic experiences that damage how we view and experience the world around us. The eating disorder treatment clinical team provides evidence-based groups and experiential modalities to assist with mind and body connection.

Here at Virtue Recovery Center, our expert team is prepared to provide quality care for all eating disorders, including:

  • Anorexia Nervosa
  • Bulimia Nervosa
  • Binge Eating Disorder
  • OSFED
  • Avoidant Food Restrictive Intake Disorder (ARFID)

Our eating disorder program focuses on healing the mind-body disconnection through compassion, education, shame reduction, and understanding. Exploring the root causes such as:

  • Family dynamics
  • Societal influences
  • Traumatic experiences
  • Genetic predispositions

And other origins unique to the individual’s personal experience.

Virtue Recovery Center’s nutritional philosophy of “all foods fit” is the foundation of our dietary program that helps patients repair their relationship with food and their bodies. Our program supports and guides patients of all shapes and sizes through our weigh-inclusive approach. The goals of our nutritional rehabilitation program include the following:

  • Stabilizing eating patterns
  • Listening to their body’s cues and signals that have been silenced Honoring their bodies’ wants and needs
  • Ability to follow their meal plan outside of the structure of a residential setting Decreasing distress related to food and their body through exposure exercises
  • Increasing education to support the teaching of recovery and dispute cognitive distortions

Individualized care is our specialty!

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Types of Eating Disorders

There are several types of eating disorders that we typically encounter and are prepared to treat. Some you may be familiar with and others that the general public may not be familiar with. Below are descriptions of all the major eating disorders along with some more colloquial information about how we have seen them present.

Anorexia Nervosa

According to the DSM-5, there are three primary symptoms of Anorexia Nervosa (AN), which are described below:

  • Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.

In other words, individuals restrict their food intake, resulting in a lower-than-normal body mass. Often individuals will irrationally decide how much or how little food they can consume each day. This restriction can result in a gaunt or emaciated appearance, although not always. The restriction will often leave individuals struggling with poor motivation/energy, increased focus on food, and difficulty concentrating.

  • Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.

For individuals with this disorder, the fears of weight gain are intense. Some individuals will go to the extremes of refusing medications because of concerns about caloric content. This can also be accompanied by compulsive behaviors of checking weight anywhere from one to twenty times in a single day. Compulsions can also be seen in what kind of food individuals are willing to eat. Some individuals will compulsively check the caloric and nutritional content of food, other individuals will rule out entire food groups because they may result in weight gain or the perception of weight gain. Compulsions of extreme exercise can also be observed where individuals may rarely be comfortable sitting down, may be on the move almost constantly throughout the day, or may be spending several hours in the gym each day.

  • Disturbance in how one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of low body weight.

We often call this trait body dysmorphia. Essentially, individuals that struggle with this trait do not have a realistic or objective view of their bodies. They will perceive their bodies to be bigger than they may actually appear. They may talk about the continued need to lose weight or feeling “fat” despite appearing thin or even gaunt to more objective observers.

Often individuals will judge their entire sense of self-worth on the appearance of their body. They are under the impression that the only way to measure their own worth as a person is through how little they weigh or whether or not they are “skinny.”

Additionally, these individuals often do not recognize or will downplay the medical information that they receive about their condition. They can be unfazed about serious heart conditions, menopause in their early 20s, or other concerning lab results that often indicate their life is in danger.

AN can also occur with episodes of binging. Extended restriction can lead to intense cravings for food, which can then result in eating significant amounts of food in a single sitting. However, individuals that struggle with AN can have a skewed idea of how much food is “normal.” These individuals will sometimes report binges when they have eaten an amount of food that is deemed appropriate for a single meal or even less.

Bulimia Nervosa

According to the DSM-5, the criteria for Bulimia Nervosa (BN) are as follows:

  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.
    • A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).

There are times in all of our lives where we may engage in what could be qualified as a binge. Holidays, like Thanksgiving, are prime examples of this, however, these are normative cultural events. For individuals that struggle with BN, they are engaging in this behavior anywhere from several times per day to once per week. Typically these events are followed by intense feelings of shame. Individuals that struggle with binging behaviors will often try to hide evidence of their binge or binge in secret.

  • Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuses of laxatives, diuretics, or other medications; fasting; or excessive exercise

All of the above are what we call purge behaviors. Purge behaviors can serve many functions for individuals that struggle with eating disorders. Although the intention may be to avoid weight gain, often these behaviors serve as a means of emotion regulation. These binge behaviors can often be followed by a sense of relief or release by those who engage in them.

  • The binge eating and inappropriate compensatory behaviors both occur, on average at least once per week

Again, these behaviors do not occur in isolation. The binging and purging are a pattern of behaviors that will typically increase in frequency over time.

  • Self-evaluation is unduly influenced by body shape and weight

Much like with Anorexia, there is intense focus on body size and shape with individuals that struggle with BN. Individuals often believe that their worth as a human being is mostly or entirely based on their bodies.

Binge Eating Disorder

According to the DSM-5, Binge Eating Disorder (BED) can be characterized by the following symptoms:

  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.
    • A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
  • The binge-eating episodes are associated with three (or more) of the following:
    • Eating much more rapidly than normal
    • Eating until feeling uncomfortably full
    • Eating large amounts of food when not feeling physically hungry
    • Eating alone because of feeling embarrassed by how much one is eating
    • Feeling disgusted with oneself, depressed, or very guilty afterward

Often these binge episodes can feel mysterious to the individual engaging in them. They may not be sure why they have started eating or continue eating. They are also uncomfortable in a variety of ways. Individuals who engage in binges will often feel physically uncomfortable due to the amount of food they have eaten and emotionally uncomfortable due to feelings of shame that follow binge behaviors.

  • Marked distress regarding binge eating is present.

As stated above, individuals who struggle with binge eating can feel any number of emotions including feelings of shame, fear, anger, sadness, and guilt, just to name a few

  • Binge eating occurs, on average, at least once a week for 3 months

Much like Anorexia and Bulima, BED is a pattern of behaviors. It occurs repeatedly and may increase in frequency over time or due to stress.

  • The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa

Avoidant/Restrictive Food Intake Disorder

According to the DSM-5, the following are symptoms of Avoidant/Restrictive Food Intake Disorder, or ARFID:

  • An eating of feeding disturbance (e.g. apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
    • Significant weight loss (or failure to achieve expected weight gain or faltering growth in children)
    • Significant nutritional deficiency
    • Dependence on enteral feeding or oral nutrition supplements
    • Marked interference with psychosocial functioning

ARFID is primarily characterized by avoiding particular foods or food groups for sensory reasons. Some individuals struggle with particular textures of food. Others struggle with taste or taste inconsistency (for example, one carrot may taste differently than another carrot, but all potato chips in a bag tend to taste the same). Others still may struggle with colors of foods or liquids.

Individuals that struggle with ARFID tend to experience significant impact to their daily nutritional intake. They may not be getting enough of certain nutrients which can result in significant health concerns. Other individuals may be nutritionally deficient with calorie intake because they are unwilling to eat foods that are available to them.

  • The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice

Individuals with ARFID will typically have a good variety of foods available to them. However, because of the sensory sensitivity described above, they will limit their intake to safe foods or to no food at all. Additionally cultural practices, like eating kosher or halal, would not characterize someone as meeting criteria for ARFID.

  • The disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced

The body dysmorphia inherent in anorexia and bulimia is absent in individuals that struggle with ARFID. Individuals that struggle with anorexia and bulimia may cut out foods or refuse to eat entire food groups, however, the motivation tends to be related to body shape or weight. In fact, there can even be times when individuals with ARFID want to gain weight, but struggle to do so with limited foods that they feel comfortable eating.

Rumination Disorder

According to the DSM-5, the following are the criteria for Rumination Disorder:

  • Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed, or spit out

In other words, individuals that struggle with Rumination Disorder will begin the digestive process of chewing their food. There are a number of presentations of Rumination Disorder which include spitting out food after chewing or vomiting within the mouth and then swallowing the food back down.

  • The repeated regurgitation is not attributable to an associated gastrointestinal or other medical condition (e.g., gastroesophageal reflux, pyloric stenosis)
  • The eating disturbance does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, binge-eating disorder, or avoidant/restrictive food intake disorder

Other Specified Feeding or Eating Disorder

According to the DSM-5, “this category applies to presentation in which symptoms characteristic of a feeding and eating disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the feeding and eating disorders diagnostic class.”

The following are presentations that are identified in the DSM-5 which would qualify under the Other Specified Feeding or Eating Disorder, or OSFED, category:

  • Atypical anorexia nervosa: All of the criteria for anorexia nervosa are met, except that despite significant weight loss, the individual’s weight is within or above the normal range

This can also be the case with significant restriction and attempts to lose weight. The staff at Virtue Recovery have had experience with individuals restricting diets to 500 or even 300 calories per day and remain within a normal weight range

  • Bulimia Nervosa (of low frequency and/or limited duration): all of the criteria for bulimia nervosa are met, except that the binge eating and inappropriate compensatory behaviors occur, on average, less than once a week and/or for less than 3 months
  • Binge-eating disorder (of low frequency and/or limited duration): all of the criteria for binge-eating disorder are met, except that the binge eating occurs, on average, less than once a week and/or for less than 3 months
  • Purging disorder: Recurrent purging behavior to influence weight or shape (e.g., self-induced vomiting; misuse of laxatives, diuretics, or other medications) in the absence of binge eating
  • Night eating syndrome: Recurrent episodes of night eating, as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal. There is awareness and recall of the eating. The night eating is not better explained by external influences such as changes in the individual’s sleep-wake cycle or by local social norms. The night eating causes significant distress and/or impairment in functioning. The disordered pattern of eating is not better explained by binge-eating disorder or another mental disorder, including substance use, and is not attributable to another medical disorder or to an effect of medication.

It is important to note that although these presentations are technically “sub-clinical,” they can still be dangerous for an individual’s health and cause significant distress in an individual’s life. We still highly encourage anyone identifying with the above descriptions to seek treatment.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental

disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Individual Counseling

When an individual finally seeks professional help for an eating disorder, it is often in the form of individual counseling with a generalized therapist. These professionals can offer the individual suffering and their family members a greater understanding of the nature of their disease. However, individual counseling on an outpatient one-on-one basis alone is not the answer. Eating disorders are complex bio-psycho-social diseases that require a great degree of expertise and experience to treat successfully. Virtue Recovery Center for Eating Disorders in Arizona is here to help.

Residential Treatment

This is the beauty of residential care. Many facilities throughout the United States offer eating disorder treatment for those suffering from this problem. Some offer a ranch-style setting. Others are simply a spacious homelike environment. Some resemble an institution-like setting, but the more the environment resembles “normal” life, the less the patient will resist rehabilitation. The staff at Virtue Recovery is predictable and welcoming and feels like a healing family member with their supportive care and knowledge about navigating the difficulties of early recovery. Many staff have walked a similar path and can be a comfort during a difficult time of surrender.

Family Style

Let’s talk about the kind of therapy an individual would receive once accepted into a facility. Most facilities require that the patients living at the “home” live together “family style.” They share rooms, take their meals together, have social time, and even participate in outside events. All of this is intended to begin to break through the isolation barrier that those with this disorder tend to develop and often cling to with great determination. One of the best aspects of residential care that leads to rehabilitation is the group atmosphere. Groups are formed around everything from simply talking about the issues surrounding this to processing the pain, fear, and anger that precipitates an eating disorder.

Residential Treatment Center program

As part of a residential program, clients can access on-site personnel 24 hours a day. A medical doctor meets with each client individually weekly or as needed. Some therapists meet both individually and with larger groups for discussion.

During the recovery process, family members are invited to join them for several therapy sessions with permission from the client. This is a crucial part of rehabilitation. There is no such thing as an “eating-disordered individual.” There are “eating-disordered families.” That is not to say that everyone in the family has eating disorders, but that the family of origin has informed the individual’s life choices to a greater degree than initially might be apparent. It is difficult for families and clients to deal with the issues caused and cultivated by this problem. A trained therapist in the right setting can facilitate this painful process to bring healing and release.

The Best Step Toward Recovery

While time and cost are major factors that keep a person or family from seeking help at a residential facility, it is truly the best step toward recovery. Nobody wants anybody else digging through their family’s best-kept secrets (usually some issues go back, sometimes, generations), but recovery for the individual can often mean recovery for a family. Seeking professional help in a residential setting has huge dividends for all involved. Being willing to step out of the shadow of this severe obsession and onto the road of enlightened recovery.  Families tend to want to send their loved ones to a facility and say, “fix them.” It took a family to create this dynamic; it will take a family to recreate a different one. Twenty or thirty years ago, the term eating disorders was barely used in everyday conversation. Now, there is hardly anyone who doesn’t know someone who struggles with this debilitating and life-threatening disease. Eating disorder facts show that this doesn’t have to be a life sentence. The right residential facility can certainly set those with these disorders on the road to a healthy, brighter future. Let Virtue Recovery Center help start your journey toward recovery.