Eating disorders are complex conditions that arise from a combination of genetic, biological, psychological, and environmental factors. Research shows that genetics play a significant role, and having a family member with an eating disorder or other mental health condition increases risk. Neurobiological differences in brain structure and function, particularly in areas related to reward, impulse control, and emotional regulation, may also contribute.

Psychological factors such as perfectionism, anxiety, difficulty tolerating distress, trauma history, and low self-esteem can increase vulnerability. Environmental and cultural influences—including diet culture, weight stigma, experiences of bullying or trauma, major life transitions, and exposure to appearance-focused messaging—can trigger or maintain eating disorder behaviors in susceptible individuals.

It's important to understand that eating disorders are never caused by a single factor, and they are not choices or the result of vanity or poor parenting. They are serious mental illnesses that develop through the interaction of multiple risk factors.

Eating disorders are diagnosed by qualified mental health professionals or physicians using criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). Diagnosis involves a comprehensive assessment that includes:

• Detailed history of eating behaviors, thoughts about food and body image, and any compensatory behaviors

• Evaluation of physical symptoms and medical complications

• Assessment of psychological symptoms including mood, anxiety, and trauma history

• Review of weight history and patterns of restriction, binge eating, or purging

• Evaluation of how symptoms impact daily functioning, relationships, and quality of life

At Nourished Minds, new clients always begin with a thorough assessment to understand the full picture of symptoms, co-occurring conditions, and individual circumstances. This assessment guides the development of your individualized treatment plan.

It's worth noting that you don't need to meet all diagnostic criteria to benefit from treatment. Many people struggle with clinically significant disordered eating that causes distress and impairment even if they don't meet full criteria for a specific diagnosis.

Effective eating disorder treatment typically involves a multidisciplinary team working together to address both the psychological and physical aspects of the illness. A comprehensive treatment team often includes:

• A therapist who provides evidence-based psychotherapy focused on eating disorder recovery

• A dietitian or nutritionist with specialized training in eating disorders who addresses nutrition rehabilitation, meal planning, and food-related fears

• A medical provider (physician, nurse practitioner, or physician assistant) who monitors physical health, lab work, vital signs, and medical complications

• When appropriate, a psychiatrist or psychiatric nurse practitioner who can evaluate and prescribe medication for the eating disorder or co-occurring conditions

At Nourished Minds, we provide the therapy and medication management components of this team. We work collaboratively with eating disorder dietitians and medical providers in the community, coordinating care to ensure all aspects of treatment are addressed. We can provide referrals to trusted specialists when needed.

Treatment addresses not just eating behaviors and physical health, but also underlying thoughts, emotions, trauma, relational patterns, and the cultural and systemic factors that contribute to both the development and healing of eating disorders.

Co-occurring mental health conditions are extremely common in people with eating disorders; in fact, they're often the rule rather than the exception. Research shows that the majority of individuals with eating disorders also experience at least one other psychiatric condition.

The most common co-occurring conditions include:

• Anxiety disorders (including generalized anxiety, social anxiety, panic disorder, and specific phobias)

• Obsessive-Compulsive Disorder (OCD)

• Depression and other mood disorders

• Post-Traumatic Stress Disorder (PTSD) and trauma-related symptoms

• ADHD

• Substance use disorders

• Personality disorders, particularly borderline personality disorder

These conditions can precede, develop alongside, or emerge as a result of the eating disorder. They can also complicate treatment and recovery, which is why comprehensive assessment and treatment that addresses all aspects of mental health is essential. At Nourished Minds, we specialize in treating both eating disorders and co-occurring conditions, particularly OCD, anxiety, and trauma.

While outpatient therapy is effective for many people with eating disorders, some individuals need more intensive support. Higher levels of care may be appropriate if you're experiencing:

• Medical instability or serious physical complications

• Severe malnutrition or rapid weight loss

• Psychiatric crisis including suicidal ideation or self-harm

• Inability to interrupt eating disorder behaviors despite outpatient treatment

• Lack of sufficient support or structure at home to maintain safety

Higher levels of care include:

Residential Treatment — 24/7 structured care in a treatment facility, typically for several weeks to months

Partial Hospitalization Program (PHP) — Full-day programming (typically 6-8 hours) five to seven days per week, with nights at home

Intensive Outpatient Program (IOP) — Several hours of programming multiple days per week, allowing for work or school participation

Enhanced Outpatient Treatment — More intensive than standard weekly therapy but less structured than IOP, with increased session frequency and specialized support

At Nourished Minds, we offer an Enhanced Outpatient Treatment Track for clients who need more structure and frequency than weekly sessions but don't require a formal program. This can be an appropriate step-down option for those transitioning from higher levels of care or for those who need additional support beyond standard outpatient treatment.

We can help assess your needs and coordinate referrals to higher levels of care when appropriate. We also provide ongoing outpatient support for clients who are stepping down from intensive programs.

No. This is one of the most harmful and persistent misconceptions about eating disorders. Eating disorders occur across all body sizes; people in larger bodies, mid-sized bodies, and smaller bodies can all have serious, life-threatening eating disorders.

You cannot determine whether someone has an eating disorder by looking at them. Weight is not a reliable indicator of illness severity, medical risk, or need for treatment. In fact, research shows that people with atypical anorexia (who meet all criteria for anorexia except low weight) experience similar medical complications, psychological distress, and mortality risk as those diagnosed with anorexia nervosa at lower weights.

Binge eating disorder, bulimia nervosa, ARFID, and many presentations of OSFED occur across the weight spectrum. Someone can be severely ill, medically compromised, and in urgent need of treatment regardless of their body size.

If you're struggling with disordered eating behaviors, distorted thoughts about food and body, or physical symptoms related to your eating patterns, you deserve assessment and treatment, regardless of what you weigh.

The terms are related but distinct. An eating disorder is a formal psychiatric diagnosis with specific criteria outlined in the DSM-5-TR. It involves persistent patterns of disturbed eating behaviors and related thoughts that cause significant distress, impairment in functioning, and often medical complications.

Disordered eating refers to a wide range of irregular eating behaviors and attitudes about food, weight, and body image that may not meet the full criteria for a diagnosis but still cause distress and can be harmful. Examples include chronic dieting, food anxiety, skipping meals, rigid food rules, occasional binge eating, or exercise driven primarily by appearance or calorie burning.

Disordered eating exists on a continuum and can escalate into a full eating disorder, particularly in vulnerable individuals. It's also harmful in its own right and often reflects the internalization of diet culture and weight stigma.

At Nourished Minds, we don't require a formal diagnosis to begin treatment. If your relationship with food, exercise, or your body is causing distress or interfering with your life, therapy can help whether or not you meet diagnostic criteria.

Yes. Research supports the effectiveness of virtual therapy for eating disorders, and many people benefit from the accessibility and flexibility of online treatment. Virtual therapy can be particularly helpful for those with limited access to specialized eating disorder providers in their area, those with scheduling constraints, or those who prefer the comfort of receiving care from home.

At Nourished Minds, we offer virtual therapy for clients in Rhode Island, Connecticut, Maine, and Florida, as well as in-person therapy in Massachusetts. Virtual sessions use secure, HIPAA-compliant video platforms and follow the same evidence-based treatment approaches as in-person care.

That said, virtual treatment may not be appropriate for everyone. If you're medically unstable, at high psychiatric risk, or require in-person support like meal supervision, a higher level of care or in-person treatment may be more suitable. We assess the appropriateness of virtual care during your initial consultation.

Not necessarily. Many people recover from eating disorders with psychotherapy alone. However, medication can be a helpful component of treatment for some individuals, particularly when:

• Co-occurring conditions like depression, anxiety, or OCD are present

• Symptoms are severe and interfering with the ability to engage in therapy

• Previous attempts at therapy alone have not been sufficient

• Obsessive thoughts or compulsive behaviors are especially persistent

Medication is not a cure for eating disorders and is most effective when combined with therapy. At Nourished Minds, our psychiatric nurse practitioner can evaluate whether medication may be beneficial for you, discuss options, and monitor your response over time. All medication decisions are collaborative and tailored to your individual needs and preferences.

Medication use in eating disorder treatment varies depending on the specific diagnosis and any co-occurring conditions. At Nourished Minds, our psychiatric nurse practitioner, Winnie Lee, PMHNP-BC, evaluates your specific symptoms, medical history, and treatment goals to determine whether medication may be helpful and which options are most appropriate.

Fluoxetine (Prozac) is approved for treatment of bulimia nervosa, and Lisdexamfetamine (Vyvanse) is approved to treat Binge Eating Disorder (BED). While there are no approved medications to treat anorexia nervosa, but oftentimes medications such as atypical antipsychotics can be used to help treat severe distress related to eating, fear of weight gain, and/or distorted body image/cognitions. Atypical antipsychotics such as Olanzapine (Zyprexa), Aripiprazole (Abilify), Quetiapine (Seroquel) can reduce obsessive thinking about food and weight, help with anxiety, and sometimes promote weight restoration by stimulating appetite cues.

Yes. While eating disorders are serious mental illnesses that can be chronic, many people achieve full recovery with appropriate treatment. Research shows that with evidence-based care, significant improvement occurs for the majority of individuals, and full recovery—meaning complete remission of eating disorder symptoms and restoration of physical and psychological health—is possible.

Recovery rates vary by diagnosis and individual factors, but studies suggest that roughly 60-70% of people with eating disorders achieve full or substantial recovery with treatment. Recovery is more likely with:

• Early intervention

• Sustained engagement in evidence-based treatment

• Treatment that addresses co-occurring conditions

• Support from family, friends, and treatment providers

• Attention to relational, cultural, and systemic factors that contribute to healing

It's important to understand that recovery is not always linear. Setbacks and challenges are normal parts of the process. What matters is staying connected to treatment and support, even when progress feels slow.

Recovery looks different for everyone. For some, it means complete freedom from eating disorder thoughts and behaviors. For others, it means managing symptoms effectively while living a full, meaningful life. Both are valid forms of recovery.

The length of eating disorder treatment varies widely depending on the severity of symptoms, how long the disorder has been present, co-occurring conditions, level of support, and individual response to treatment.

Some general timeframes:

• Many people begin seeing meaningful improvement within the first few months of consistent treatment

• Outpatient therapy typically lasts anywhere from several months to several years

• Those stepping down from higher levels of care often need ongoing outpatient support for six months to two years or longer

• Full recovery often takes one to several years of sustained treatment and practice

Treatment is not a straight line. Progress may be gradual, and there may be periods of faster improvement alternating with plateaus or setbacks. The goal is not to rush through treatment but to build sustainable skills and healing that last beyond therapy.

At Nourished Minds, we regularly review your progress and adjust treatment intensity and focus based on your needs. Some clients benefit from weekly therapy for an extended period, while others may transition to less frequent sessions as they stabilize or may need more intensive support through our Enhanced Outpatient Treatment Track during challenging phases.

The most important factor in recovery is staying engaged in treatment even when it feels difficult. Recovery is possible, and treatment length should be based on your individual needs rather than arbitrary timelines.