Psychiatrists for Eating Disorders: Disordered Eating Treatment Online & In-Person

What are Eating Disorders (EDs)?

Eating disorders are mental health conditions defined by persistent patterns of disordered eating that impact both physical health and emotional well-being.

These conditions influence how a person thinks about food, eating behaviors, weight, and body image, and can lead to significant medical complications involving the heart, digestive system, brain, teeth, and other organs.

Eating disorders frequently occur alongside other psychiatric conditions such as anxiety, depression, substance use disorders, self-harm, and suicidal thoughts.

At Rittenhouse Psychiatric Associates, our psychiatrists for eating disorders provide comprehensive, outpatient disordered eating treatment that addresses both the eating disorder itself and any co-occurring mental health conditions, drawing from an interdisciplinary, evidence-based approach similar to leading academic medical programs.

Dr. Tracy Kuniega-Pietrzak, Director of Eating Disorder Services, offers in-office visits in Baltimore and virtually throughout CA, DE, DC, FL, MD, NJ, NY and PA.

Types of Eating Disorders

Anorexia Nervosa

Anorexia Nervosa (AN) is a serious medical condition in which someone has an unhealthy low body weight and an intense fear of gaining weight. People with anorexia nervosa often engage in extreme efforts to control their weight and shape, which can dominate their time and lead to serious health consequences. Behaviors may include limiting calorie intake, cutting out entire food groups, excessive exercise, laxative or diet aid use, and/or vomiting after meals.

Anorexia Nervosa is more common in women than men and affects approximately 0.5% of women over their lifetime. Disordered eating treatment for AN may include a medical workup (and treatment of any abnormalities), medication management for co-occurring psychiatric conditions, in-office or online therapy with an eating disorder psychiatrist or therapist, and collaboration with a dietitian and other medical providers.

Bulimia Nervosa

Bulimia Nervosa (BN) is a serious medical condition marked by episodes of bingeing (eating large quantities of food over a short period), followed by purging behaviors (such as vomiting, excessive exercise, severe calorie restriction, and/or laxative use). Binge episodes often involve a sense of loss of control, and purging is frequently followed by shame, guilt, or harsh self-criticism.

People with Bulimia Nervosa are often preoccupied with appearance and weight and may struggle with low self-esteem. In-office and virtual disordered eating treatment for Bulimia Nervosa may include medication management (including medications that specifically treat Bulimia), treatment of co-occurring conditions such as OCD, anxiety, and depression, and psychotherapy.

Binge Eating Disorder

Binge Eating Disorder is a mental health condition in which individuals binge eat (consume large quantities of food over short periods), leading to psychological and medical consequences. Unlike Bulimia Nervosa, these episodes are not followed by purging. Binges may occur when individuals are not physically hungry, or continue long past a feeling of fullness.

Binge Eating Disorder can result in guilt, shame, and disgust, and people may isolate to hide their symptoms. There are high rates of co-occurring anxiety, depression, and other mental health disorders. Patients with this condition often benefit from working with a psychiatrist for eating disorders or an online eating disorder therapist who can address both the binge eating and co-occurring mental health concerns.

Avoidant/ Restrictive Food Intake Disorder (ARFID)

Avoidant/Restrictive Food Intake Disorder (ARFID) is a serious eating disorder characterized by persistent restriction of food intake or avoidance of certain foods, often resulting in inadequate nutrition. Individuals with ARFID may eat very limited amounts or restrict foods based on sensory sensitivities (taste, texture, smell, or appearance) or fears of adverse consequences such as choking, nausea, or gastrointestinal distress. Unlike Anorexia Nervosa or Bulimia Nervosa, ARFID is not driven by concerns about weight, shape, or body image. Without appropriate care, ARFID can lead to significant medical complications, including nutritional deficiencies, vitamin and electrolyte imbalances, gastrointestinal issues, and cardiac concerns. Disordered eating treatment for ARFID typically involves coordinated care with a psychiatrist for eating disorders and therapy focused on medical stability, increasing nutritional adequacy, and gradually expanding the range of tolerated foods, consistent with approaches used at academic medical centers.

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 an eating disorder in which someone repeatedly regurgitates undigested food from the stomach. The regurgitated food is then re-chewed and swallowed or spit out. This regurgitation occurs without effort (people are not purposefully bringing up the food) and often happens after most meals. Because 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, including strategies such as specialized breathing techniques to reduce regurgitation. Patients with Rumination Disorder benefit from working with a psychiatrist for eating disorders or a virtual eating disorder therapist experienced in treating this condition.

Eating Disorder Treatment at Rittenhouse Psychiatric Associates

Your First Visit with a Psychiatrist for Eating Disorders

We recommend that patients schedule with one of our psychiatrists for eating disorders or psychiatric nurse practitioners, who can fully evaluate the underlying eating disorder as well as any co-occurring mental health conditions (such as anxiety, depression, OCD, personality vulnerabilities, and/or substance use disorders). Your provider will also complete a thorough medical history, which may include labs and/or additional medical workup. They often collaborate with a patient’s eating disorder therapist (or can recommend one), dietitian, primary care provider, and/or cardiologist to support safe, coordinated disordered eating treatment and overall health outcomes.

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 for Eating Disorders

Eating Disorder Psychiatrists and other mental health professionals at Rittenhouse Psychiatric Associates can provide psychiatric medication management to help patients who struggle with EDs. Working with a psychiatrist for eating disorders, who understands the nuances of prescribing for this population, is recommended, along with a specialist who can diagnose and treat co-occurring conditions such as anxiety, depression, and OCD.

Treatment (for the appropriate patient) may include Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), long-acting stimulants (for binge eating disorder), and other medications. Several psychiatric medications can be risky in this population or may require specific dosing, which is another reason comprehensive disordered eating treatment should be guided by a mental health professional with expertise in eating disorders psychiatry.

Eating Disorder Medication Management Available in these States:

• California
• Delaware
• Florida
• Massachusetts
• Maryland
• New Jersey
• New York
• Pennsylvania
• Washington DC
• 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.