Eating Disorder Treatment Scottsdale | Phoenix

Psychologists and psychiatrists at Shier Private Practice in Scottsdale, AZ specialize in the treatment of eating disorders such as anorexia, bulimia, and binge eating disorder. Our private outpatient clinic offers a comprehensive psychiatric/medical assessment and treatment plan. Treatment may include medications, behavioral therapies or a combination of treatments.

What is an Eating Disorder?

Eating disorders are mental health conditions that cause severe disturbances in eating, weight, and body image. These conditions may be severe and affect an individual’s health, emotions, and ability to function in important areas of life. The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder.

What is Anorexia Nervosa?

The symptoms of anorexia nervosa include abnormally low body weight, intense fears of weight gain, and distorted perception of body weight. The 12-month prevalence of anorexia nervosa among young females is approximately 0.4%. Clinical populations generally reflect a 10:1 female-to-male ratio.

DSM-5 criteria:
A. 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. Significantly low weight is defined as weight that is less than minimally normal or, for children and adolescents, less than the minimally expected. As are reference, a BMI of 18.5kg/m2 in adults has been employed by the Centers for Disease Control and prevention (CDC) and World Health Organization (WHO) as the lower limit of normal body weight.
B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
C. Disturbance in the way in which 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 the current low body weight.

What is Bulimia Nervosa?

Symptoms of Bulimia nervosa include recurrent binge eating and inappropriate compensatory behaviors ie. restriction, purging, excessive exercise, and misuse of laxatives. The 12-month prevalence of anorexia nervosa among young females is approximately 1%-1.5%. Clinical populations generally reflect a 10:1 female-to-male ratio.

DSM-5 criteria:
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
Eating, in a discrete period of time, an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
A sense of lack of control over eating during the episode.
B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.
C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of anorexia nervosa.

What is Binge Eating Disorder?

Symptoms of Binge eating disorder include recurrent binge eating, common in bulimia nervosa, without recurrent inappropriate compensatory behaviors. The 12-month prevalence of anorexia nervosa among young females is approximately 1.6%. Clinical populations generally reflect a 2:1 female-to-male ratio.

DSM-5 criteria:
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
Eating, in a discrete period of time, an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
A sense of lack of control over eating during the episode.
B. 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.
C. Marked distress regarding binge eating is present.
D. The binge eating occurs, on average, at least once a week for 3 months.
E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

What Causes Eating Disorders?

The specific cause of eating disorders is unknown. The risk and prognostic factors are highly variable and influenced by temperamental, environmental, genetic, and physiological factors. Comorbidity with mood and anxiety disorders are common.

What Happens with Untreated Eating Disorders?

Eating disorders may result in a wide range of physical and metabolic disturbances. Anorexia is also known to result in  metabolic abnormalities including leukopenia, anemia, thromobocytopenia, electrolyte abnormalities, and thyroid hormone imbalances. Arrhythmias and low bone density may also be present.

There is a significantly elevated risk of death from all causes (medical complications and suicide). The crude mortality rate (CMR) for anorexia nervosa is 5% per decade; the CMR for bulimia nervosa is 2% per decade.

How are Eating Disorders Diagnosed?

The diagnosis of an eating disorder requires a thorough biopsychosocial psychiatric and medical assessment to confirm the diagnosis and rule out other psychological or medical conditions.

Eating Disorder Treatment

The treatment of depression may include medications and or psychotherapy (talk therapy). First-line medications used in the treatment of eating disorders include Serotonin Reuptake Inhibitors (SSRIS). Evidence-based psychotherapies such as Cognitive Behavioral Therapy (CBT) have been proven to be effective. Despite availability of effective treatments for eating disorders many people do not actively seek or receive the proper treatment.

How to Cope

1. Self-care and basic needs – Make sure you are taking care of yourself and getting plenty of rest.
2. Eat well and get exercise – Maintain a healthy physical status. Good diet and exercise provides significant psychological benefit. Avoid excessive weight checking as this may trigger unhealthy habits.
3. Relaxation and meditation – Learn how to control your breathing and ease your muscle tension when you are feeling depressed or anxious.
4. Avoid drugs and alcohol – Avoid self-medicating as this may worsen depressive symptoms and increase your risk for physical health issues.
5. Seek support from friends and family- Avoid long periods of social isolation as this may worsen symptoms of depression and anxiety.
6. Join a support group – Support groups will help you meet others with similar experiences, share coping strategies, and gain a sense empowerment and connection.

Last update: February 22, 2019

The content on this website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.