Healing From the Ground Up: The Dangers of Eating Disorders and the Effectiveness of Integrated Treatment

Thrive • February 22, 2022

By Thrive Reno’s Chief Operating Officer Katie Stout-Ithurralde, MBA

UNDERSTANDING EATING DISORDERS 

Eating disorders are complicated behavioral health conditions that disrupt mental, physical, and emotional well-being and can even be fatal . Part of what makes them so complex is that they often co-occur with other psychological struggles , including anxiety, depression, and obsessive-compulsive disorder (OCD).

Individuals experiencing eating disorders typically engage in disordered eating behaviors , such as calorie restriction, binging, or purging, as ways to cope with their emotions. Over time these harmful coping strategies can become deeply ingrained, making it difficult to integrate healthy habits for processing emotions and allowing the eating disorder to establish dominance. Because of this, receiving outpatient or inpatient treatment for food and body-related struggles early on can make a person’s recovery smoother.

Often, individuals experiencing eating disorders feel embarrassed and ashamed, so they attempt to hide their condition which can prevent them from obtaining the help they need to recover. To mitigate the risk of a loved one struggling with an eating disorder in secret, it’s vital to be aware of the signs of an eating disorder.

WARNING SIGNS FOR EATING DISORDERS

Signs that a person may be experiencing an eating disorder include:

  • Preoccupation with body shape, size, or weight
  • Preoccupation with food or dieting
  • Creating rigid rules around food, eating, or physical activity 
  • Skipping meals or vomiting after eating
  • Feelings of discomfort when eating around others
  • Withdrawal from social situations involving eating
  • Fluctuations in weight
  • Gastrointestinal problems, including slowed digestion and constipation 
  • Menstrual irregularities
  • Difficulties concentrating
  • Anemia
  • Decrease of red or white blood cells
  • Underactive thyroid  
  • Decreased hormone levels
  • Low potassium levels
  • High cholesterol levels
  • Dizziness or fainting
  • Persistently feeling cold
  • Trouble sleeping
  • Dental problems, including enamel erosion, discoloration of teeth, cavities, and tooth sensitivity
  • Dry skin, hair loss, and brittle hair and nails
  • Growth of lanugo, which is hair that helps the body stay warm when facing starvation
  • Impaired immune functioning

For further insight into signs of eating disorders, you can assess disordered eating behaviors here .

COMMON TYPES OF EATING DISORDERS

Anorexia and bulimia typically come to mind when eating disorders are a topic of discussion, but many do not know the difference between them and there are other kinds of eating disorders that can inflict just as much suffering.

All statistics regarding the prevalence of eating disorders have been sourced from the National Eating Disorders Association’s (NEDA) Statistics & Research on Eating Disorders .

Anorexia Nervosa

Anorexia nervosa involves significant weight loss, calorie restriction, and distorted body image. It may also involve compulsive physical activity, purging behaviors such as self-induced vomiting or laxative abuse, and binge eating. Up to 2% of females and up to 0.3% of males will develop anorexia in their lifetimes.

Anorexia essentially starves the body by denying it the essential nutrients it needs to function. To conserve energy necessary for survival, the body slows down its processes which can result in serious and sometimes deadly consequences , including electrolyte imbalances and cardiac arrest. 

Avoidant Restrictive Food Intake Disorder (ARFID)

Avoidant restrictive food intake disorder (ARFID) is an eating disorder that most often affects youths . Individuals experiencing ARFID have difficulty eating due to a lack of interest, sensory aversions, or fear that they may experience pain and discomfort while eating. One study showed that adolescents with ARFID were more likely to be younger and male.

Binge Eating Disorder (BED) 

Binge eating disorder (BED) is characterized by frequently eating large quantities of food, feeling a loss of control while eating, and not regularly engaging in unhealthy compensatory behaviors such as purging. Individuals experiencing BED typically feel ashamed, distressed, or guilty following a binge. A study of Americans found that 3.5% of women and 2% of men had BED during their life, making it the most common type of eating disorder in the United States.

Bulimia Nervosa

Bulimia nervosa is expressed by frequently eating large quantities of food, feeling a loss of control while eating, and compensatory purging behaviors such as self-induced vomiting or abusing laxatives. One percent of young women and 0.1% of young men meet diagnostic criteria for bulimia.

Diabulimia

Although not an official medical diagnosis, diabulimia is recognized by the eating disorder treatment community and describes when insulin-dependent diabetes (typically type 1) co-occurs with an eating disorder. Behaviors associated with diabulimia typically include binge eating, purging, and insulin restriction. Individuals experiencing diabulimia face a significant risk of life-threatening medical complications. 

Other Specified Feeding or Eating Disorders (OSFED)

Other specified feeding or eating disorders (OSFED) are eating disorders that don’t fit the strict diagnostic criteria of any other eating disorders outlined by the ​​Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is used by clinicians to diagnose psychiatric illnesses. Although a somewhat general category of eating disorders, OSFED can be just as severe and life-threatening.

OSFED may describe:

  • Atypical anorexia : A condition that meets all the criteria for anorexia, except that the individual is not clinically underweight despite significant weight loss.
  • BED of low frequency and/or limited duration: A condition that meets all the criteria for BED, except at a lower frequency or for less than three months.
  • Bulimia of low frequency and/or limited duration: A condition that meets all the criteria for bulimia, except that the binge eating and unhealthy compensatory behavior occurs at a lower frequency and/or for less than three months.
  • Purging disorder: Frequent purging behavior to influence weight or shape without engaging in binge eating.
  • Night eating syndrome: Frequently engaging in night eating that causes significant distress or impairment and isn’t explained by another mental health condition, such as BED.

COMMON MISCONCEPTIONS ABOUT EATING DISORDERS

1. A person’s appearance reveals whether or not they’re experiencing an eating disorder.

While sometimes this is the case, more often than not, individuals experiencing eating disorders may be in bodies that appear to be within the “normal” range of size, shape, and weight.  

2. Only girls and women are at risk for developing eating disorders. 

Men also experience eating disorders, representing 25% of individuals with anorexia and 40% of those with BED. Men also face a higher risk of dying from eating disorders, partly due to the widely held assumption that men don’t struggle with eating disorders and therefore are underdiagnosed and undertreated. Some disordered eating behaviors such as binge eating, purging, and fasting are nearly as common among males as they are among females.

3. Eating disorders are lifetime conditions.

Full recovery from an eating disorder is entirely possible. While recovery takes time , through integrated treatment, a strong support system, and self-compassion , a person can heal their relationship with food and their body.

WHAT IS INTEGRATED TREATMENT?

An integrated approach to eating disorder treatment involves a team of primary care providers, therapists, psychiatrists, dietitians, body-positive counselors, and mindful movement specialists. Comprehensive treatment ensures that all the facets of an eating disorder, including its mental, emotional, behavioral, and physical implications, can be addressed for holistic healing and complete recovery.

HEAL AND GROW WITH THRIVE 

At Thrive, our eating disorder treatment programs provide individualized and integrated care. Implementing the latest evidence, Thrive’s multidisciplinary team of specialists collaborates to provide personal, well-rounded eating disorder treatment while respecting the complexity and severity of the disorders and guiding our clients to better health with compassion, encouragement, and nurturing care. You can learn more about our eating disorder treatment programs across the country by contacting us .

About the Author

Thrive Reno’s Chief Operating Officer Katie Stout-Ithurralde, MBA

Katie Stout joins Thrive with more than 17 years of experience in the behavioral health field, 13 years of which have been dedicated to eating disorder treatment. Katie has her master’s degree in business management along with an undergraduate degree in social work. As the previous chief executive officer of two behavioral health organizations, most recently serving as regional director of operations for Applegate Recovery, Katie has extensive experience in various settings including residential, partial hospitalization, intensive outpatient programs, and outpatient therapy centers.

With a passion that centers around treating the entire person, mind, body, and spirit, Katie provides a sense of trust that helps foster a safe environment for clients as they begin this path to a happier, healthier life.

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August 21, 2025
When Emma was 8, her parents noticed her food choices shrinking. At first, they assumed it was just picky eating — “She’ll outgrow it,” friends said. But by 10, Emma would only eat crackers, cheese, and chicken nuggets. Family dinners became nightly struggles, her growth slowed, and she skipped birthday parties to avoid “strange food.” Her parents felt powerless, her brother grew frustrated, and outings dwindled. What began as food avoidance soon reshaped the rhythm of the entire household. When children avoid food, most parents expect it’s a passing stage. But when restriction deepens, shrinks to only a few “safe foods,” and begins affecting growth or health, families suddenly find themselves in unfamiliar territory. This is often where Avoidant/Restrictive Food Intake Disorder (ARFID) emerges — with effects that extend far beyond the plate. As providers, we need to be attuned to these patterns. It’s tempting to dismiss them as “no big deal,” yet for many families, they are life-altering. Sadly, Emma’s story is not unusual. Mealtimes as Battlegrounds Families living with ARFID often describe mealtimes as emotionally charged, exhausting, and unpredictable. What should be a chance to connect around the table can feel more like a negotiation or even a standoff. Parents wrestle with whether to push their child to try a new food or give in to the same “safe foods” again and again to avoid tears, gagging, or complete meltdowns. This ongoing tension can make mealtimes dreaded rather than cherished. Siblings, too, are affected. Some may feel resentful when family meals are limited to what only one child will tolerate. Others may act out in response to the constant attention the child with ARFID receives. Over time, the dinner table shifts from a place of nourishment and bonding into a stage for conflict, anxiety, and guilt — a pattern that can erode family cohesion and resilience. Social Isolation and Missed Experiences ARFID impacts more than what happens at home; it influences how families engage with the world around them. Everyday events — birthday parties, school lunches, vacations, even extended family dinners — become sources of stress. Parents may pack special foods to avoid confrontation or, in many cases, decline invitations altogether to protect their child from embarrassment or overwhelm. This avoidance can lead to an unintended consequence: isolation. Families miss out on milestones, friendships, and traditions because of the unpredictability surrounding food. The child may feel left out or ashamed, while parents grieve the loss of “normal” family experiences. This social withdrawal can compound the anxiety already present in ARFID and deepen its impact across generations. Emotional Toll on Parents The emotional strain on parents navigating ARFID is significant. Many describe living in a constant state of worry — Will my child get enough nutrients? Will they ever grow out of this? Am I doing something wrong? This worry often spirals into guilt and self-blame, particularly when outside voices dismiss the disorder as mere “picky eating.” In addition, the pressure to “fix” mealtimes can strain marital relationships, creating disagreements over discipline, feeding strategies, or medical decisions. Parents may also feel emotionally depleted, pouring all their energy into managing one child’s needs while inadvertently neglecting themselves or their other children. Without support, this chronic stress can lead to burnout, depression, and disconnection within the family system. The Role of Providers For clinicians, ARFID must be viewed not only as an individual diagnosis but as a family-wide challenge. Effective care requires attention to both the clinical symptoms and the family dynamics that shape recovery. Parent Support: Educating caregivers that ARFID is not their fault, offering psychoeducation, and helping them reframe mealtime struggles as part of the disorder — not a parenting failure. Family-Based Interventions: Coaching families in structured meal support, communication strategies, and gradual exposure work so parents don’t feel powerless. Holistic Care: Involving therapists, dietitians, occupational therapists, and medical providers ensures that the family does not shoulder the weight of treatment alone. When families are validated, supported, and given practical tools, the entire household can begin to heal. Treatment is not only about expanding a child’s food repertoire but also about restoring peace, resilience, and connection at home. Moving Forward ARFID may begin with one individual, but its ripple effects are felt across the entire family system. By addressing both the psychological and relational dimensions, providers can help transform mealtimes from a source of conflict into an opportunity for healing and connection. For those who want to go deeper, we invite you to join our upcoming training on ARFID , where we will explore practical strategies for supporting both clients and their families.
July 30, 2025
How to Recognize Overlapping Behaviors + A Case Study and Screening Tools to Help
July 17, 2025
As a parent, noticing alarming behaviors around food or routines in your child can raise some important questions. You might be asking yourself, “Is this an eating disorder, obsessive-compulsive disorder (OCD), or something else entirely?” Understanding the signs and differences between these disorders is key to getting your child effective, timely treatment. In this blog, we’ll break down the overlap between OCD and eating disorders, what signs to watch for, and how to get professional help. If you're a parent wondering “Is my child’s eating disorder actually OCD?” or “OCD vs eating disorder in teens,” know that you’re not alone and you’re in the right place to find specialized care for your child. What Is OCD? Obsessive-Compulsive Disorder (OCD) is a mental health condition where unwanted thoughts (obsessions) cause anxiety, leading to repetitive behaviors (compulsions) intended to ease that anxiety. OCD can be focused on any subject. Common obsessions include contamination, perfectionism, scrupulosity, and harm, but sometimes, the content of obsessions can be focused on food, body image, or weight. What Is an Eating Disorder? Eating disorders , like anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder (ARFID) involve disturbed eating behaviors and intense concerns about body weight or shape. These conditions go beyond dieting or “picky eating” and can become life-threatening without professional intervention. The Overlap: Why It Can Be Confusing OCD and eating disorders often share similar symptoms : Ritualistic eating (e.g., needing to eat foods in a certain order or at a certain time) Rigid rules about food (like only eating certain food groups or certain amounts of food) Excessive checking (like weighing food or body or repeated checking of expiration dates or thorough cooking) Avoidance behaviors ( like avoiding carbs, fats, or other food groups or avoiding places or objects that can trigger obsessions) Distress when routines are disrupted (either around mealtimes or exercise routines) So, How Can You Tell the Difference? Use the following chart to compare and contrast symptoms of OCD and eating disorders.
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