RESTRICTING:
Restricting food can look like: limiting food intake to control weight or body shape. This can include calorie counting, macro counting, limiting and/or avoiding certain food groups. It is common to start feeling anxious, guilty or shameful when breaking restrictive “food rules”. Often, people restricting themselves are still eating something which can make it hard for people on the outside to detect. Rarely does someone with an eating disorder eat absolutely nothing. These behaviors often serve the purpose not only of changing body size, but also to numb out from difficult emotions and communicate unmet needs. People of all shapes and sizes can have restrictive eating disorders such as Anorexia Nervosa. Not all bodies drastically change and become “underweight” with restriction. Those with higher weight anorexia (also called atypical anorexia) can experience the same medical consequences that someone in a smaller body can. We take this very seriously and utilize a health at every size perspective when working with any eating disorder, at any body size.

PURGING:

Purging is any use of compensatory behaviors after eating such as vomiting, excessive exercise, or misuse of laxatives. These behaviors are often not a one time thing, the cycle can feel addicting, compulsive and hard to untangle from. To classify as bulimia nervosa, must happen at least three times a week for a few months. That being said, purging (specifically self induced vomiting) is one of the most dangerous eating disorder behaviors and any amount of purging deserves psychological attention so that we can prevent it from spiraling. You can actually die from cardiac issues with just one purge. Purging typically involves a cycle of thoughts, emotions and behaviors. We utilize a wide variety of treatment options to help you break the cycle of purging and understand the complexity of letting go of this behavior. We believe harm reduction approaches are incredibly valuable and life saving here.

BINGE EATING
Binge eating looks like: consuming large amounts of food in a short period despite nutritional needs otherwise being met, feeling ashamed of food behaviors, often binging in secret, feeling a loss of control around food and eating well beyond fullness to the point of discomfort and pain.

Binge eating often involves some amount of physical or emotional restriction leading up to the binge. Like all eating disorder behaviors, we need to look below the surface to determine the appropriate interventions for treatment. Binge eating disorder is the most common eating disorder, but also the most stigmatized. It is often left out of discussions when society talks about eating disorders. This is due to how pervasive diet culture is- we live in a world that praises restraint and control around food. Binge eating often feels ego-dystonic to the person and fuels shame. Please know we believe anyone struggling with binge eating deserves compassion, attunement, and just as much care as someone struggling with a restrictive eating disorder.

OSFED:

OSFED or ‘Otherwise Specified Feeding and Eating Disorder’ is the most commonly diagnosed form of an eating disorder. It is used when someone does not fit neatly into diagnostic criteria- i.e. they have some of the symptoms, but not all. Or, they have a handful of symptoms in multiple categories of eating disorders. Humans are multifaceted and complex- we don’t often fit perfectly into checklist boxes of diagnostic criteria. And, diagnostic criteria is often exclusionary of inclusive identities. So, it makes sense that the most common eating disorder is actually OSFED.

It is important to know that OSFED does not mean “less severe.” Research shows that OSFED can be just as deadly and have just as many health consequences. It is important to get help as soon as possible and it is just as valid. Don’t let anyone tell you that you aren’t sick enough because you have OSFED and not Anorexia.

ARFID:
Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by food avoidance or restriction that leads to nutritional deficiencies, malnourishment, or difficulty meeting daily energy needs. While body image concerns can absolutely co-occur, it isn’t typically the driving force for the food aversion and is not always present. ARFID is often misunderstood as “picky eating,” but it is far more complex and is often rooted in sensory sensitivities, fear of eating due to a feared consequence such as vomiting, choking or getting sick. ARFID commonly co-occurs with various forms of neurodivergence such as autism or ADHD. Our approach to treating ARFID is neurodiversity affirming, meaning we honor the client’s sensory needs and food preferences rather than pathologize them or “fixing” them. We focus on creating individualized accommodations that make eating safer, more accessible, and less distressing. While many providers in the eating disorder field believe that treating ARFID means exposure to aversive food and habituating to the distress, we know that this can actually be traumatizing to the client and out of alignment with their goals. Therefore, we aim to get creative with our ARFID clients and look at ways to expand/adapt existing safe foods- and only engage in gradual exposure if that is what the client is wanting.