Results-Driven Therapy for Eating Disorders

Eating disorders are serious but treatable mental and physical illnesses that can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights. In the United States, 28.8 million Americans will suffer from an eating disorder at some point in their lives.

There is no single cause of an eating disorder. Rather, it is a complex combination of biological, psychological, and sociocultural factors.

Types Of Eating Disorders

  • Anorexia nervosa is an eating disorder characterized by weight loss (or lack of appropriate weight gain in growing children); difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image. People with anorexia nervosa generally restrict the number of calories and the types of food they eat. Some people with the disorder also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.

  • Bulimia nervosa (BN) is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting or compulsive exercise designed to undo or compensate for the effects of binge eating.

  • Binge eating disorder is characterized by recurrent episodes of binge eating and eating larger amounts of food in a period of time than most people would in the same situation. Other associated behaviors include eating very rapidly, eating past the point of being full, eating when not hungry, and eating alone. This behavior is coupled with intense feelings of “loss of control” overeating, shame and guilt.

  • Individuals with ARFID limit the volume and/or variety of foods they consume, but unlike the other eating disorders, food avoidance or restriction is not related to fears of fatness or distress about body shape, size or weight. Instead, in ARFID, selective eating is motivated by a lack of interest in eating or food, sensory sensitivity (e.g., strong reactions to taste, texture, smell of foods), and/or a fear of aversive consequences (e.g., of choking or vomiting).2

    A person with ARFID has a diet that is so limited it leads to medical, nutritional, and/or psychosocial problems. This may mean weight loss, or stalled growth; significant nutritional deficiencies that will vary based on diet; and interference in relationships or engagement in school or work due to difficulties eating.

  • OSFED is a category that was developed to encompass those individuals who did not meet strict diagnostic criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder but still had a significant eating disorder. Recent research has found that OSFED is the most common eating disorder with approximately 3.8% of women and 1.6% of men being diagnosed with the disorder at some point in their lives.

  • Atypical anorexia nervosa is an eating disorder that presents with the same symptoms as anorexia nervosa, except that the person is within a “normal” or higher weight range after losing a significant amount of weight. Despite being labeled as “atypical,” some studies have found that atypical anorexia is equally if not more common than anorexia with 0.2% – 4.9% of people experiencing the disorder at some point in their lifetimes, a rate two or three times higher than that of anorexia. Furthermore, in the last decade research has found that the number of patients seeking treatment for atypical anorexia has increased substantially and led to a greater proportion of patients seeking hospitalization for complications due to the disorder.

    Unfortunately, despite the increasing prevalence, individuals with atypical anorexia are less likely to be diagnosed and receive eating disorder treatment than those with anorexia due to weight bias among providers and the stereotype that a person must be underweight to have an eating disorder. The reality, however, is that anyone regardless of their shape and size can have a serious and life-threatening eating disorder that requires treatment. 

  • Orthorexia is an obsession with ‘healthful’ eating. Although being aware of and concerned with the nutritional quality of the food you eat isn’t a problem in and of itself, people with orthorexia become so fixated on so-called ‘healthy eating’ that they damage their own well-being and experience health consequences such as malnutrition and/or impairment of psychosocial functioning.

  • Diabulimia is a serious eating disorder which is defined by the deliberate misuse of insulin (limiting their insulin) among individuals with type 1 diabetes in order to lose weight and control their blood sugar levels. Unfortunately, this very dangerous behavior can lead to serious health risks and even death. 

Therapy for Eating Disorders in Ann Arbor

I use a combination of cognitive-behavioral therapy (CBT) for eating disorders, dialectical behavioral therapy (DBT) to treat eating disorders, acceptance and commitment therapy for eating disorders, and psychodynamic therapy to treat eating disorders. All of these have strong research backing and are evidence-based. 

What are the Different Types of Psychotherapy for Eating Disorders?

 There are many types of evidence-based therapy for eating disorders. All of them address the underlying issues, thoughts, feelings, behaviors, and relationship factors that are influencing the eating disorder symptoms. Therapy will address food behaviors, what purpose is the eating disorder serving (i.e. it’s something they can control, a way to seek independence, the eating disorder prevents awareness of a deeper issue, and many more), family and social factors, and the influence of other medical or psychiatric symptoms such as depression or anxiety. 

  • DBT therapy for eating disorders works on developing skills to replace eating disorder behaviors. Skills focus on building mindfulness, becoming more effective in interpersonal relationships, emotion regulation, and distress tolerance. 

    Radically Open DBT (R/O DBT) is a newer adaptation of DBT that addresses factors such as social anxiety, perfectionism, and emotional restriction. It may be particularly helpful for people with anorexia nervosa.


  • The goals of psychodynamic therapy for eating disorders are client self-awareness of the underlying issues or motives driving the eating disorder behavior and understanding of the influence of the past on present behavior. The psychodynamic approach helps clients gain insight into how eating disorder symptoms and behaviors help the individual manage psychological development, internal conflict, relationships and emotions. 

  • A big concern in the field of eating disorders is that therapists today frequently advertise that they have experience working with eating disorders but in reality, many have only taken a class or worked with a few people with more mild eating issues. Eating disorders have one of the highest fatality rates of any psychiatric disorder, and choosing a provider without that experience can be dangerous. I did a 2-year post-doctoral residency at the Renfrew Center in Philadelphia, the first and most-renowned eating disorder residential treatment center in the World. This experience provided me with a world class education and tons of experience working with every type of eating disorder, with children, adolescents and adults and with many severe and more mild cases. She also gained experience working with clients with eating disorders in many other clinical settings. Since 2011, I have been in private practice specializing in eating disorders and seeking out supervision and lots of continuing education along the way to make sure I’m aware and educated about all the newest research and treatment modalities.

    Without having had experience working in a residential or inpatient treatment center or an outpatient/partial structured program, it’s really hard to gain the experience and perspective to treat eating disorders in regular therapy. Without this experience, it is really hard to differentiate between eating disorders and disordered eating, figure out what combination of therapies will work best for a certain client, and understand the range of severity and what each level of severity requires treatment wise, and understand the importance of having a therapist communicate regularly with medical/nutrition/and psychiatric providers for the most effective treatment.