Eating Disorders Psychiatrists: Treatment Online & In-Person

What are Eating Disorders (EDs)?

Eating Disorders (EDs) are mental health conditions defined by abnormal eating behaviors that have a negative impact on one’s physical and/or mental wellbeing. They are serious health conditions that affect how one thinks about food, eating, and physical appearance. Eating Disorders can lead to significant health risks, including cardiac, digestive, neurological, dental and others. Individuals who struggle with eating disorders have high co-occurring rates of other psychiatric disorders, including anxiety, depression, substance use disorders, self-harm and suicidal thoughts and behaviors. The Eating Disorders psychiatrists and eating disorder therapists at Rittenhouse are experienced in treating not only the underlying ED, but in the evaluation, diagnosis and treatment of co-occurring mental illness as well.

Types of Eating Disorders

Anorexia Nervosa

Anorexia Nervosa (AN) is a serious medical condition where someone has an unhealthy low body weight and an intense fear of gaining weight. People with anorexia nervosa often go through extreme efforts to control their body weight and shape, which may not only take up a large percentage of their time but can also lead to serious health consequences. Behaviors may include limiting the intake of calories, cutting out certain types of food from one’s diet (or severely limiting food repertoire), excessive exercise, laxative or diet aid use, and/or vomiting after meals. Anorexia Nervosa (AN) is more common in women than men, and affects approximately 0.5% of women over their lifetime. Eating Disorder treatment for AN may include a medical workup (and treatment of abnormalities), medication management for co-occurring psychiatric conditions, in-office or online eating disorder therapy from a specialist, collaboration with a nutritionalist and others.

Bulimia Nervosa

Bulimia Nervosa (BN) is a serious medical condition where someone has episodes of bingeing (eating extremely large quantities of food over a short period), often followed by episodes of purging (which may include vomiting, excessive exercise, severe calorie restriction and/or laxative use). Periods of bingeing typically involve a sense of loss of control over one’s eating, and periods of purging typically involve a sense of shame, guilt or severe self-criticism regarding the bingeing episode. People with Bulimia Nervosa (BN) are often preoccupied with appearance and weight, and suffer with low self-esteem and high judgment regarding their physical appearance. In-office and virtual eating disorder treatment for bulimia nervosa may include medication management (there are medication options that treat bulimia), medication management of co-occurring mental health diagnoses (such as OCD, anxiety and depression) and psychotherapy.

Binge Eating Disorder

Binge Eating Disorder is a mental health condition where individuals binge eat (eating large quantities of food over short periods), which can lead to psychological and medical consequences. Unlike Bulimia Nervosa (above), these episodes are not followed by purging. Binges may occur even when individuals do not feel hungry, or long past a feeling of fullness. Binge Eating Disorder can result in feelings of guilt, shame and disgust. Individuals often isolate to hide their eating disorder, and there are high co-occurring rates of anxiety, depression and other mental health disorders, among people with binge eating disorder. Patients with this condition may benefit from seeing an eating disorder psychiatrist or online eating disorder therapist who can treat not only the ED but other mental health disorders as well.

Avoidant/ Restrictive Food Intake Disorder (ARFID)

Avoidant/ Restrictive Food Intake Disorder (ARFID) is a mental health condition where someone severely limits their eating, or the types of foods that they eat. Total calories typically are below daily requirements, which can lead to significant health consequences, such as slowed/ stunted growth, hormonal abnormalities, vitamin and/or electrolyte imbalances, digestive problems, cardiac abnormalities and others. People with Avoidant/ Restrictive Food Intake Disorder (ARFID) do not have fears of gaining weight or preoccupations with their body (unlike those with Anorexia or Bulimia). Reasons for avoiding or restricting foods may include preferences for tastes, smells, colors or textures of foods. Other reasons may include fears of GI upset, nausea, vomiting or choking (leading them to avoid foods that they believe could cause these problems).

Virtual eating disorder treatment from an eating disorder psychiatrist or therapist who understands the nuances of this condition and co-occurring diagnosis treatment is in the patient’s best interest.

Rumination Disorder

Rumination disorder is a condition where someone repeatedly regurgitates undigested food from the stomach. The regurgitated food is then re-chewed and swallowed, or spit out. The regurgitation of food occurs without effort (people are not purposefully regurgitating the food), and it often occurs after all meals. Since the food has not yet been digested, it does not taste like acid or vomit. Treatment for rumination disorder may include medication management and/or behavioral therapy. Therapy may involve teaching patients certain ways of breathing to reduce the regurgitation of food. Patients with Rumination Disorder would benefit from seeing an eating disorder psychiatrist or having virtual eating disorder therapy with a provider who is experienced in treating this condition.

Eating Disorder Treatment at Rittenhouse Psychiatric Associates

Your First Visit for Eating Disorders

We recommend that patients schedule with one of our Eating Disorder Psychiatrists or Psychiatric Nurse Practitioners, who can fully evaluate not only the underlying eating disorder, but any co-occurring mental health difficulties (such as anxiety, depression, OCD, personality vulnerabilities and/or substance use disorders) as well. Your provider will also perform a thorough medical history, which may include labs and/or additional medical workup. They will often collaborate with a patient’s eating disorder therapist (or recommend one), nutritionist, primary care provider and/or cardiologist, to improve the quality of a patient’s care and their overall health outcome(s).

Therapy for Eating Disorders

Online eating disorder therapy is available to most US states, and may include Cognitive Behavioral Therapy (CBT), motivational interviewing, EMDR, supportive therapy and/or other modalities. Therapy will work to address not only the eating disorder itself, but also co-occurring psychiatric diagnoses and struggles, such as anxiety, depression, OCD, personality disorders and others.

Medication Management

Eating Disorder Psychiatrists and other mental health professionals at Rittenhouse Psychiatric Associates can utilize psychiatric medication management to help patients who struggle with EDs. Working with a provider who is educated about the nuances of medication management for this population is recommended, as well as working with a specialist who can diagnose and treat co-occurring mental health difficulties, such as anxiety, depression and OCD.

Treatment (for the appropriate patient) may include selective serotonin reuptake inhibitors (SSRIs), Selective Serotonin Norepinephrine Reuptake Inhibitors (SNRIs), long-acting stimulants (for binge eating disorder) and others. Of note, several psychiatric medications can be dangerous to use within this population or may require specific dosing, which is another reason why we recommend working with a mental health professional with expertise in this area of psychiatry.

Eating Disorder Medication Management Available in these States:

• California
• Delaware
• Florida
• Massachusetts
• Maryland
• New Jersey
• New York
• Pennsylvania
• USVI

Eating Disorder Resources

• Discover the Rittenhouse Psychiatric Associates YouTube channel! Discover over 100 videos on mental health topics, including eating disorders, with our providers.
• Our National Mental Health Resources provide you with quick access to information on many mental health topics and emergency hotlines.