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Signs Your College Student Has an Eating Disorder: A Boston Therapist’s Guide
Eating disorders are among the most serious and most missed mental health conditions affecting college students. They’re also among the most treatable — when caught early.

The challenge is that many parents don’t recognize what they’re seeing. Eating disorders in college students are rarely dramatic in early stages. They look like discipline, health consciousness, or the normal changes that come with being away from home for the first time. By the time the signs are unmistakable, the disorder has often been entrenched for months.

This guide is written for parents. It covers the warning signs that matter, the ones that are commonly misread, and what to do if you’re concerned.

Why College Is Such a High-Risk Period

Eating disorders don’t develop randomly. They develop in specific conditions — and college recreates many of them:

New independence around food. For the first time, your student is making all their own food decisions without parental oversight. For someone with a predisposition toward disordered eating, this autonomy can accelerate patterns that were already quietly forming.

Body comparison and social pressure. Dorm life, social media, Greek culture, and the general visibility of college social environments create intense body comparison pressure — particularly, but not exclusively, for women. The “freshman fifteen” narrative alone generates anxiety about weight gain that drives restriction in many students.

Identity stress. College is a major identity transition. For students who are uncertain of who they are outside of achievement, appearance and body control can become organizing principles — a way of feeling competent when everything else feels uncertain.

Stress and loss of coping mechanisms. The structure, routines, and relationships that helped a student manage stress at home are gone. Eating behavior — restriction, binging, purging — becomes a coping mechanism that provides a feeling of control.

High-achieving students are not exempt. In fact, perfectionism and high achievement are risk factors. The same drive that produces academic excellence can produce rigidity around food, exercise, and body image that tips into disorder.

The Warning Signs Parents Often Miss

Changes in eating behavior that look like “healthy eating”

One of the most important things to understand: early eating disorder behavior often looks virtuous. Cutting out “processed food.” Going vegan or gluten-free without a medical reason. Intermittent fasting. Meticulous attention to macros or calories. These can all be signs of disordered eating — especially when accompanied by anxiety around food, rigidity about rules, or distress when the rules are broken.

Exercise that has become compulsive

Exercise is another area where disordered behavior looks like health. Watch for: exercise that continues through illness or injury, extreme anxiety or guilt when a workout is missed, exercise that consistently takes priority over social events, academics, or sleep, and a significant increase in exercise volume that isn’t explained by a sport or fitness goal.

Avoidance of food-related social situations

Eating disorders thrive on isolation. If your student is consistently declining family meals, avoiding restaurants, making excuses to not eat at home during breaks, or showing anxiety when eating in front of others — pay attention.

Physical signs
- Significant weight loss or weight fluctuation
- Feeling cold all the time (a sign of inadequate caloric intake)
- Hair loss or thinning
- Loss of menstrual periods
- Fainting or dizziness
- Swollen jaw or cheeks (a sign of purging)
- Calluses on knuckles (a sign of purging)
- Erosion of tooth enamel
Behavioral and emotional signs
- Increased preoccupation with food, weight, body, or appearance
- Wearing baggy clothes to hide the body
- Disappearing to the bathroom after meals
- Changes in mood that correlate with eating — anxiety before meals, guilt after, relief after restriction or purging
- Denial that there’s a problem despite obvious concern from others
- Withdrawal from friends and activities they used to enjoy
Signs Specific to Different Types of Eating Disorders

Anorexia nervosa

Anorexia involves severe restriction of food intake, intense fear of weight gain, and distorted body image. Physically: significant weight loss, loss of menstrual periods, feeling cold, fatigue. Behaviorally: food rituals (cutting food into tiny pieces, eating very slowly), denial of hunger, excessive exercise, avoidance of eating with others.

Important: Anorexia has the highest mortality rate of any psychiatric disorder. It is a medical emergency at lower weights. If your student has lost significant weight and is showing other signs, do not wait.

Bulimia nervosa

Bulimia involves cycles of bingeing (eating large amounts rapidly) and purging (self-induced vomiting, laxative use, excessive exercise, fasting). Weight may appear normal or even high, which is why it’s often missed. Signs: frequent bathroom trips after meals, dental problems, swollen cheeks, unexplained food disappearance, and emotional patterns around eating (shame, secrecy, relief after purging).

Binge eating disorder

Binge eating disorder involves recurrent episodes of eating large amounts rapidly, often in secret, with a sense of loss of control and significant shame — but without compensatory purging. It’s the most common eating disorder in the United States. Signs: eating past fullness regularly, eating in secret or hiding food, intense shame around eating, distress about eating behavior without meeting criteria for anorexia or bulimia.

ARFID (Avoidant/Restrictive Food Intake Disorder)

ARFID involves restriction based on the sensory properties of food, fear of aversive consequences (choking, vomiting, allergic reaction), or lack of interest in food — not driven by body image concerns. Less commonly discussed but significant in college populations, especially among students with anxiety or neurodevelopmental differences.

What to Do If You’re Concerned

Have the conversation — carefully

Approach it from a place of concern, not accusation. “I’ve noticed you seem stressed around food lately, and I love you and want to make sure you’re okay” opens a very different door than “I think you have an eating disorder.” Lead with relationship, not diagnosis.

Be prepared for denial. Denial is a core feature of eating disorders, not a sign that you’re wrong. A student who says “I’m fine, I’ve just been eating healthier” in response to signs of significant restriction is showing you a typical early-stage presentation.

Contact a specialist

Eating disorder treatment requires a therapist with specific training in eating disorders — not a general counselor who “also does some eating disorder work.” The evidence-based treatments for eating disorders (CBT-E, FBT for younger patients, DBT-informed approaches) are distinct from general therapy and require specific training.

Consider the university counseling center — but know its limits

Most university counseling centers have wait times of weeks to months for initial appointments, and limited ongoing session availability. They’re often not equipped for students with more than mild eating disorder presentations. For anything beyond mild, a community-based specialist is typically a better option.

Know when it’s a medical emergency

If your student is significantly underweight, fainting, has irregular heartbeat, or is refusing to eat, the first step is a medical evaluation — not a therapy referral. Eating disorders at lower weights are a medical emergency. Start with a physician or emergency care if you’re concerned about physical safety.

Working With Miriam Iken Goodman, LICSW

I’m a licensed clinical social worker in Boston specializing in eating disorder therapy for college students and young adults ages 17–30. I work with students from BU, Northeastern, BC, Harvard, MIT, Tufts, Emerson, Simmons, and other Boston-area universities.

I work with anorexia, bulimia, binge eating disorder, and ARFID, using evidence-based approaches including CBT, DBT, and ACT. I also coordinate with treatment teams including dietitians, physicians, and higher-level-of-care programs when needed.

I offer a free 15-minute consultation for parents and prospective clients. Sessions are via telehealth.

Schedule a Free Consultation or reach me at contact form.

Miriam Iken Goodman, LICSW is a Boston eating disorder therapist specializing in treatment for college students and young adults. She completed her MSW at the University of Pennsylvania and has a clinical affiliation with Walden Behavioral Care.
June 24, 2026
Eating Disorder Misrepresentation

In the world of entertainment, Eating Disorders are a topic that have been sidelined for years. Many showrunners and writers do not understand how to portray Eating Disorders accurately and responsibly. Eating Disorders are one of the most misrepresented illnesses in television today; often used as comedic fodder rather than a severe mental illness.
This is damaging to those who suffer from Eating Disorders and the general public viewing these portrayals. Eating Disorders are becoming more prevalent in our society, and all the isolation in 2020 and 2021 has increased the prevalence of these disorders according to the Chief Executive Officer of the National Eating Disorders Association (NEDA) Clair Mysko, “Eating disorders thrive in isolation.” The isolation we as a society have experienced over the last two years has allowed people to continue this cycle and avoid getting help.
Eating Disorders are mental illnesses with serious consequences. Eating Disorders are going to affect 1 in 5 people. Eating Disorders may begin as a coping mechanism for uncomfortable emotions or used as a form of control. It is crucial to have accurate and responsible portrayals of Eating Disorders in the media to break their stigma.
While Eating Disorders are more prevalent in teenage girls, they can affect anyone. Eating Disorders should never be taken lightly; they are mental illnesses that carry severe consequences. Eating Disorders are not just about food or weight but are a way to cope with difficult emotions. Eating Disorders may begin to lose weight, but they often become a way of life. The pressure put on people with the new influencer culture and the societal pressures to look a specific way impacts many people. We need to start having an honest conversation about eating disorders.

Support

If you or someone you know is suffering from an Eating Disorder, please seek professional help. There is no shame in seeking help; Eating Disorders are serious mental illnesses that require treatment. Recovery is possible, and those who suffer from Eating Disorders deserve support and understanding. Spur Counseling offers individualized treatment in a safe space. Contact us to set up your first appointment.

December 14, 2021
The Differences Between Bulimia and Binge Eating
Binge Eating Disorder and Bulimia Nervosa are two very serious types of eating disorders. There are overlapping criteria for the disorders, and the main difference is the presence of purging, which occurs in Bulimia. Individuals with Bulimia Nervosa will engage in periods of binge-eating followed by purging while people with binge eating disorders do not purge after a period of bingeing. There are also other differences between the two disorders to be aware of.
Binge eating disorder and Bulimia nervosa affect 2-3% of women in the US, according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD). In addition, ANAD reports that over half of Bulimia nervosa patients have at least one mood or anxiety disorder which they need to address with the help of a professional. One in ten Bulimia nervosa and Binge eating disorder clients suffer from an addiction to drugs or alcohol.
Binge Eating Disorder Signs
Often times people will “emotionally eat” due to feeling upset or lonely. People with Binge Eating Disorder (BED) struggle to control their eating habits and can’t stop themselves from repeatedly overeating, even though they don’t enjoy the process of over-eating and feel ashamed about the behavior afterward. Potential signs of BED are:
Eating quickly or without being aware of what you are eating;
Consumption of large quantities of food, even though you are not hungry;
Eating in private due to embarrassment;
Experience suicidal thoughts, feelings of depression and guilt after an episode.
The American Psychiatric Association (APA) says that people with BED having binge episodes for at least once each week for three consecutive months. BED sufferers may be overweight and self-conscious about the changes in their bodies; there is not always a body image component to the disorder as there may be with other eating disorders. Since the binge episodes often occur in secret, friends and family members may not be aware that individual is struggling, which can make it hard to diagnose. An official diagnosis should only be made by a mental health professional.
Bulimia Nervosa Signs
As opposed to Binge eating disorder, people with Bulimia nervosa (BN) may engage in harmful compensatory behaviors such as purging, fasting, or over-exercise. These behaviors keep their body weight at an unhealthy level and prevent them from establishing an effective healthy relationship with food. Common signs of Bulimia Nervosa include, but are not limited to, exercising for several hours a day, use or abuse of diuretics and laxatives, and use or abuse of stimulants in order to increase metabolism. A distorted views of one’s body is also an indication that someone may have bulimia nervosa. Individuals with bulimia nervosa generally see themselves as overweight despite the fact that they me be significantly underweight.
Binge eating disorder and bulimia nervosa are similar in that an individual may feel uncomfortable around others when eating, or refuse to eat with people. However, this is not always the case. Bulimia nervosa can also compel someone to develop food rituals, such as chewing excessively, hoard food, or only eat certain foods.
People with bulimia nervosa may purge after eating, drink large amounts of fluids to control weight and frequently avoid food in public. The behavior is also often done in secret, yet there may be signs, such as swollen jaws or cheeks, callouses on the knuckles, teeth stains, bloated appearances and various ailments stemming from a weak immune system. People suffering from bulimia nervosa may worry excessively about their appearance, and might examine themselves for flaws in the mirror.
The Health Risks of Binge Eating Disorder and Bulimia Nervosa
Though the health risks of bulimia nervosa and binge eating disorder differ slightly, both disorders are characterized by major medical complications. These complications may leave you with lifelong consequences.
The biggest risk for someone who is binge eating is obesity. One of the more serious health conditions associated with obesity is heart disease. The connection exists because an individual’s weight, blood sugar levels, levels of high cholesterol and triglycerides can all be related to risk for cardiovascular disease.
People with bulimia nervosa often experience medical issues such as a compromised immune system. Some of the health problems that may arise from this eating disorder include:
Heartburn and acid reflux
Nausea
Constipation
Passing out
Heart arrhythmia
Muscle weakness
Gum disease, gingivitis or decay of teeth
Brittle and breaking nails
Dry, flaky skin
Hair thinning/hair loss/bald spots
Abnormal hair growth on the body
Slow healing of open wounds
Mental health issues have long been associated with bulimia and binge eating disorder. Both involve major depression, panic disorder, self-injury behaviors, substance abuse, and lack of impulse control.
People diagnosed with type I diabetes may also have a disorder called diabulimia nervosa which is caused by a person with bulimia deliberately restricting their insulin to lose weight. Diabulimia nervosa is different from bulimia or binge eating disorder because it comes about as a result of the individual having type I diabetes, pair with the fear that insulin will lead to weight gain. They may also withhold their intake of certain foods to decrease insulin levels, and withdraw from family and friends to avoid being confronted about not treating their diabetes.
How Do You Treat Binge Eating Disorder and Bulimia Nervosa?
A binge eating disorder or bulimia nervosa treatment plan includes corresponding psychotherapies and requisite medication regimens crafted by specialists in treating such conditions. These specialists may include therapists, primary care physicians, psychiatrists and dietitians.
Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are two types of psychotherapies that can help those with bulimia nervosa or binge eating disorder. Both therapies help teach skills around emotional regulation and halting negative thoughts. Clients can also learn how insomnia, food binges, self-induced vomiting and the abuse of drugs may impact their physical and mental health. When counseling clients with eating disorder, therapists recommend focusing on work-life balance and self-care, and teach steps for how to consciously incorporate these into their lives.
Common skills learned through CBT and DBT include:
Reducing negative thoughts and controlling emotions
Understanding and recognizing triggers and barriers that stop you from controlling your thoughts
Teaching yourself how to recognize and dismiss unhelpful and illogical thoughts
Using mindfulness to observe seemingly random emotions and distress

What is Radical Acceptance and How Does It Help?
Radical acceptance in psychotherapy means accepting something for what it is fully and wholly. As a result of therapy, people with bulimia nervosa or binge eating disorder are taught not to jump to conclusions about something they perceive as detrimental or negative. Radical acceptance is the ability to accept reality as it truly is rather than making assumptions about what things should be. However, it does not encourage passive behavior, but instead encourages clients to think differently and make decisions in a rational way. By doing so, people with bulimia nervosa and binge eating disorder can start taking control of their thoughts, emotions and behaviors.
A history of trauma can influence how one can use skill and cope effectively. Trauma can lead to eating disorders, and CBT and DBT can help to manage the reactions and thoughts that are connected to the trauma.
Distress Tolerance
Methods of distress tolerance through cognitive behavioral therapy and dialectical behavior therapy allow for bulimia nervosa and binge eating disorder clients to experience a difficult moment without the situation getting worse. People with eating disorders, in particular, need to master distress tolerance techniques since self-destructive behavior often results from ineffective coping skills. Through the use of mindful alternatives, clients can modify hurtful, unproductive ways of coping with their eating disorder. In therapy we remind clients that you will have moments of distress that you can get through without the aid of an eating disorder behavior.
Coping Skills
Learning to cope with the events that trigger a sense of panic and fear for an individual with these eating disorders is key in any treatment program. Many clients feel lost when it comes to managing conflict because they do not know any healthy ways of dealing with stress. For someone with bulimia nervosa or BED, situations that are not challenging for other people may sometimes be considered too difficult. With the help of a therapist, decision-making skills, sense of self-worth and self-esteem can all improve.
Spur Counseling helps those with bulimia nervosa and binge eating disorder learn how to cope through teaching them different sets of skills and strategies.
We know that going from the grips of binge eating disorder, bulimia nervosa or other life-altering issues to wellness can be challenging. We offer compassionate treatment for individuals with anorexia nervosa, bulimia nervosa, and binge eating disorder.
If you are searching for an “eating disorder therapist near me,” reach out today to set up online counseling.
August 1, 2021
The Nutritional Effects of an Eating Disorder

Eating disorders are extremely difficult to live with, but they also have a very serious effect on your body. Eating disorders such as Bulimia Nervosa and Binge Eating Disorder can lead to loss of muscle mass while Anorexia can lead to malnutrition and other health problems if left untreated. It is important for those who suffer from these illnesses to understand the risks in order to maintain their own health. In this post, I will discuss what eating disorders can do to your body both physically and mentally.
The physical effects of an eating disorder
The nutrition of someone with an eating disorder can vary depending on the type of eating disorder and their symptoms. Anorexia is a very serious condition in which people struggle to eat, or will have small amounts. The lack of nourishment can lead to health problems like low blood pressure, hair loss, muscle loss, and brittle bones if it goes untreated for too long.
Bulimia nervosa is another form of eating disorder where sufferers engage in bingeing behavior followed by purging behaviors, such as vomiting, laxative use or over-exercise. Some individuals will restrict their food intake between use of behaviors to avoid weight gain from overeating.
When someone has an eating disorder and experiences malnourishment, their body goes into starvation mode and begins holding onto any food it receives in order to survive. Metabolism can also slow from frequent fasting, altering the processing of food due to the inconsistent nourishment.
Both binge eating disorder and anorexia will have serious physical health consequences. The behaviors can start with a change in eating habits over time, desire to lose weight, and can even be brought on by mental illness such as depression or anxiety.
What nutritional deficiencies do eating disorder patients have?
People suffering from disordered eating like anorexia nervosa will often experience deficiencies in nutrition due to the fact that they’re not eating enough calories. The most common symptoms of anorexia are a lack of menstruation in women, extreme thinness, and low body weight (usually less than 85% ideal weight). This is because when someone limits their diet so much it can lead to hormonal imbalances which can slow down the metabolism.
Anorexia sufferers will generally have lower levels of iron, magnesium, and zinc, since these minerals are found in foods high in carbohydrates like cereal grains or meat, while lower-carbohydrate diets have fewer micronutrients or nutrients from food sources. This can occur with people with bulimia since the nutrients may be lost during purging episodes.
The human brain requires glucose for fuel; if someone does not have enough carbohydrates. blood sugar may drop below optimal levels, which can lead to mood swings, depression or anxiety.
Are there calorie requirements for those with eating disorders?
Part of nutrition therapy or nutrition counseling may be the introduction of more calories for someone with an eating disorder. This can also help the body to heal.
Anorexia is a serious eating disorder that may result in death if not treated properly and timely. The condition mostly affects young girls between 12-25 years old, but it’s possible for anyone of any age or gender identity to experience the struggle. The nutritional needs vary depending on each person’s needs, and I would recommend looking to your providers for guidance if necessary.
How does nutrition affect bulimia?
Bulimia also can have a significant effect on your nutrition. Bulimia is typically characterized by binge eating (eating excessive amounts of food, typically alone) followed by purging (self-induced vomiting, laxative use, or over-exercise, for example) often to influence shape of weight. The continual cycle of binging and purging can have a negative effect on your mental health as well as your nutrition, because you will not be processing the necessary nutrients needed in one day.
Studies have found that people who have bulimia or anorexia are more likely than typical weight peers to experience depression, anxiety disorders, substance abuse disorders which could point towards low self-esteem from being overweight or underweight respectively. People with chronic BED also show greater signs of depressive symptoms such as feeling worthless and hopelessness when compared to those without eating disorders.
Why do people with bulimia crave sugar?
Individuals with Bulimia Nervosa often crave sugar because it helps them feel full, satisfied, and in control of their weight. Sucrose is a carbohydrate found in many types of food including fruits, vegetables, milk products and grain products like pasta or cereal, and the recommended amount of sucrose intake per day is 40-50 grams. The concern for the person who binges on these foods is that they are eating too much sugar which can lead to tooth decay, high acidity levels from purging, as well as an increased risk of heart disease due to high blood pressure.
Sucrose can also lead to hypoglycemia which is when blood glucose levels are too low; this condition can be life-threatening in some cases. Hypoglycemia happens as your body moves quickly through its carbohydrate storage; this may lead to feeling shaky, anxious, or irritable if you don’t eat soon enough.
Bulimia sufferers who binge on sugary foods often find that they have an increased appetite for more food afterward. This can make them gain weight and also lead to a cycle of eating high-sugar foods that can contribute to many different health problems.
A diet plan should be established with the help of their doctor, dietitian or therapist in order to balance out caloric intake, vitamins, minerals, and proteins.
What does bulimia do to your electrolytes?
Bulimia can also affect your electrolyte balance. Common electrolytes that are involved in the body’s function include sodium, potassium and calcium levels.
Sodium is needed for nerve conduction, water balance and digestion of food; when a person with bulimia consumes excessive amounts of sugar without balancing it out with adequate fluids, their blood may become too acidic or dilute which can lead to low sodium levels, therefore causing weakness and fatigue.
Potassium plays an important role in muscle contractions as well as regulating fluid balances throughout our bodies; eating disorders such as bulimia can cause lower than normal potassium levels due to vomiting-induced diuresis (increased frequency/volume of urination) along with other factors like diarrhea from laxative abuse. This can lead to nausea, muscle cramps, irritability, and confusion.
Calcium is needed for strong bones and teeth; eating disorders like anorexia can lead to weak muscles which cause issues with maintaining calcium levels as well as other vitamin deficiencies that may result in osteopenia (thinning of the bones). Anemia from low iron intake can also contribute to this issue
Does bulimia cause muscle weakness?
Bulimia can also cause medical complications like muscle weakness. Diarrhea from laxative abuse and vomiting-induced diuresis can lead to a lower than normal potassium level. This, coupled with other vitamin deficiencies like calcium deficiency that cause osteopenia (thinning of the bones), can result in muscle weakness.
Can your esophagus heal after bulimia?
Many wonder whether the esophagus can heal after bulimia. The answer is yes, but if the damage has caused a narrowed food passage, it may be difficult for one to swallow.
Difficulty swallowing increases the risk for aspiration of food or liquids, which can lead to pneumonia.
Some people will also experience difficulty swallowing after eating certain foods like nuts due to swollen esophagus tissues (esophagitis). Dysphagia may be caused by inflammation around the valve at the top of your stomach known as gastroesophageal reflux disease (GERD)
This condition causes irritation when acid from your stomach backs up into your throat. Finally, some individuals with bulimia will suffer from dysphagia because of a lower production of saliva caused by excessive gum chewing.
The Mental Effects of an Eating Disorder
What happens to your brain with anorexia?
Anorexia can lead to an increased risk for other mental health conditions, which has shown to impact the brain. Research shows that when someone is severely underweight with a body mass index (BMI) less than 17kg/m², their risk for developing certain mental disorders increases significantly. These include depression, anxiety disorder, and substance abuse disorders which could be linked to low self-esteem from weight loss; all of these can include cognitive distortions.
In addition, a brain scan of anorexic patients has found decreased grey matter, changes in the circuitry that connects different regions of the brain and also lower activity levels.
Does anorexia make you forgetful?
Anorexia could make you forgetful. A study found that people who are underweight have a more difficult time retrieving words from their memory; this is because they don’t have enough glucose in the brain. A lack of glucose in your brain can make you hungry and forgetful.
Mental fog is common among people with eating disorders because of the physical changes that are happening to their brains. An inability to locate words, difficulty concentrating and lack of motivation are all commonly associated with eating disorders.
Recovery from an eating disorder is possible.
If you are suffering from these or other eating disorder symptoms, it is important to get help. The sooner you find the right treatment, the better. The right team, including a mental health therapist and nutrition counselor, is the best way to get back on track.
Eating disorders can have a profound impact on physical health. The consequences of an eating disorder are not limited to the individual but often affect family members and friends as well. If you or someone you know has been struggling with an eating disorder, it is time for a change! Reach out to me at Spur Counseling today so we can get started helping you recover from your eating disorder. Together we will develop coping skills that help during difficult times when urges arise; work through negative thoughts about food or weight; find healthy ways to deal with stress such as exercise and relaxation techniques; and create a healthier relationship with your body by appreciating all its amazing capabilities.

June 14, 2021
6 Tips To Stop The Binge Eating Cycle

It’s hard to escape the binge cycle. This cyclical pattern often proves challenging for many of us, and it can be difficult to escape from. Life is stressful as it is; we often turn to food for comfort when things are particularly tough going, but this pattern just leads to more problems. When you find yourself bingeing, again and again, try the six tips below:
First, it’s important to know what Binge Eating Disorder is. Binge Eating Disorder is a condition that is characterized by recurrent binge eating episodes without the regular use of compensatory measures such as purging. Binges commonly occur when an individual is alone and when they eat more than a typical serving of food. Second, it’s important to know what causes binge eating disorder. The most common cause is thoughts about food and body image; for others, it may be related to stress or emotional difficulties like depression or anxiety. A focus on body type, body weight or food is not always the cause.
Bingeing is common among adolescent girls and women, but men also suffer from this condition. It is also important to note that bingeing is a different eating disorder than anorexia nervosa or bulimia nervosa.
1. Identify the Triggers That Lead to Binge Eating
The first step to reducing bingeing is identifying all the triggers that lead up to it. It can be difficult but writing them down will help you identify what situations or feelings make you want to overeat, whether they are emotional (stress), social (loneliness), or physical (fatigue). Once we identify what triggers our binge, we can come up with strategies to deal with these issues in alternate ways. Individual therapy or family therapy can help with identifying triggers or gaining an education on different treatment methods.
Identifying our triggers and having strategies for coping helps us feel more in control of the situation as opposed to just feeling out of control when it happens again. Preparation is key and learning about your own emotional experience can help you know what is going on inside of your body and why.
2. Find a Healthy Alternative
If you feel like you are going to binge eat, try to find a healthy alternative. If you feel like the binge is inevitable, try:
– Reaching out for help through counseling or seeking help from friends/family members who care about you.
– Trying new activities to occupy your time such as going for a walk on the Boston Commons or the Arboretum, taking up knitting with TV on in the background or just baking something.
If we know that our binge cycle starts for the same reason every time (stress), then it would be helpful if we could come up with a plan ahead of time about what we’re going to do when that situation arises. I have found that one way my patients have successfully managed their stress and improved their well being has been through journaling – whether they write in detail about their feelings and thoughts, jot down some ideas for positive self-talk, draw pictures reflecting how they feel inside themselves…whatever works best for you!
Reflecting on your story through journaling can be very helpful on the road to recovery. While journaling, it may be helpful to focus on mindfulness (paying attention to the present) as a way to assist yourself in building self-awareness and developing strategies for carrying out your goals.
We want to create a plan that includes coping skills for when we’re feeling stressed so that our binge habits don’t take over again. One way to do this would be by writing out examples of what things we might say or do if it happens (e.g., “I will call my friend,” “I’ll go for walk outside”).
3. Try Not to Isolate Yourself
Connection can be very important for those who are struggling with bingeing. Isolating yourself can make it harder for you to connect with others, which may in turn lead to more binging issues. It can be helpful to talk with someone who understands what you’re going through
Connecting with other individuals who are in the same boat as you can be a great way to get help and encouragement. One of the best ways to do this is by joining support groups or through group therapy.
There are many benefits of group therapy, especially when it comes to mental health. In a supportive environment with others who understand what you’re going through, you’ll find that your binges will decrease and self-esteem can grow into a strength. There’s also the benefit of having therapists around during tough moments who know how to support your recovery in healthy ways – not enabling or indulging in unhealthy habits like bingeing but rather being available as an outlet for these feelings without acting on them. Finally, there is the opportunity for new perspectives which may be different than your own – fresh thoughts and ideas about things that could help change for the better.
If you are looking for these resources in the Boston area, there are several treatment programs that could lead you in the right direction. These include Walden Behavioral Care, Renfrew Center, Monte Nido, Cambridge Eating Disorder Center, Harvard Medical School and others. You could also reach out to the National Eating Disorders Association to see if they know of any resources.
4. Sleep and Exercise Regularly
Both sleep and exercise have been shown to help reduce the urge to binge eat. This is because we are all less hungry when these things happen and our thoughts about food will be more clear.
Sleep deprivation can lead to increased food intake, which might trigger a relapse into binging. If you’re going without sleep it’s important that you don’t let yourself get too hungry before you eat nutritious food or take a nap so your body stays energized.
Exercise has also been linked with reduced Binge Eating Disorder. It reduces stress levels, distracts us from unhealthy impulses like taking drugs or drinking alcohol, and boosts self-esteem. Exercise can be anything like taking a walk outside, getting fresh air, or doing a chair exercise at your desk. Just make sure you are exercising without an unhealthy focus on your body or weight gain.
Diet is also key. If you’re not getting enough food with protein and fiber then it’s likely that you’ll feel deprived during times of hunger or frustration and subsequently resort back to binging for relief. Binges usually come from hunger or an emotional state of stress. Being nourished is crucial to lowering your chances of a binge occurring.
5.Practice Mindful Eating
Mindful eating is a meditative practice that can help you to slow down, be in touch with your body and senses, eat more consciously and slowly, and enjoy your food more.
Mindful eating is also a way of being aware of how much food you are actually eating–a step toward reducing overeating. A person who eats mindfully will usually feel satisfied after finishing the meal or at least recognize when they have had enough. This means less chance for bingeing.
Mindful eating has been proven to be an effective way of combatting overeating, and it’s also associated with improved mental health and greater levels of self-awareness. The goal for mindful eating should not be weight loss but instead achieving emotional balance by focusing on the present moment while being aware of their body’s physical needs such as hunger or fullness.
Mindfulness can be challenging to introduce into your daily routine, but there are some simple ways to slowly integrate it.
Start by asking yourself what you were feeling before or when the urge struck? Did you feel stressed and overwhelmed with work? Or maybe bored at home on a rainy day? If so, then make sure next time that you’re not just sitting around without anything to do because boredom can be a leading cause of overeating. Give yourself something productive to do like clean up your apartment or organize your closet.
Or did something happen in the past few hours that triggered this binge cycle for example being told “no” by someone who matters to me while I was trying hard not to take offense? This is an important moment where mindfulness practice could come in handy.
6. Work with a Professional
If you are struggling with bingeing or a different eating disorder, it is important to see a therapist. A mental health professional will be able to help you identify the patterns that may contribute to your behavior and teach skills on how to cope when these feelings come up.
For many people who struggle with bingeing, overeating can feel like a way of coping with difficult emotions such as stress or loneliness. Eating feels good during those moments–it numbs out bad feelings temporarily. But at some point, usually, after an hour or two has passed (but sometimes sooner), the food high wears off and then they’ll want more food again because their cravings have returned stronger than before!
It is also possible you have other undiagnosed mental health problems that are contributing to your eating disorder. Depending on the level of care you need, there are different options for treatment plans. Outpatient care is the most common and lowest level of care. Mental health professionals recommend weekly sessions in order to address your eating disorder symptoms and learn more about the condition’s impact on you.
The next level of care would be an intensive outpatient program. This means you would come in for a few hours or so every day, but still have time to go home and lead a more normal life. During that time you would participate in individual, family, or group therapy with eating disorder professionals. Intensive outpatient therapy may not be covered by your insurance so it’s important to check!
Day treatment is the third level of care. This program would mean coming in every day but only during the daytime hours – usually seven hours or so. These programs are often outpatient. Day treatment is more intense than an intensive outpatient program (you’ll go more days per week) and can be helpful if you want extra help around your eating disorder recovery, but don’t feel ready to totally give up your outside life just yet!
A residential facility is one of the highest levels of care. In Boston, there are many good options for these programs. In this type of setting you live on campus with other people who struggle with their body image, anorexia, bulimia or another food intake disorder; it may not sound very fun, but there’s no denying the value of living in a community with people who understand what you’re going through.
Bingeing is a serious condition that can lead to health problems, but it does not have to become something you live with for the rest of your life. These six tips will help you control your urges and put bingeing in its place. At Spur Counseling, we offer online outpatient services to clients on an individual basis – email us today if you are struggling with binge eating, anorexia, bulimia, or other eating disorders.

May 14, 2021
The Ultimate Guide to Eating Disorder Therapy in Boston (and Beyond) for 2021

Eating disorders are one of the most deadly mental illnesses in the world. Some experts say that one in five deaths due to mental illness is from an eating disorder, and one out of every eight people with Anorexia Nervosa dies by suicide. Despite the prevalence of eating disorders, they are still widely misunderstood and underdiagnosed. This blog post will cover how to find a therapist specializing in eating disorders, and what you should know, if you or someone you know is looking for support.

Who Gets Eating Disorders?

An eating disorder is a serious disease that includes having maladaptive cooping skills to manage habits and thoughts. Approximately 30 million Americans are currently living with an eating disorder; while women are twice as likely to suffer from an eating disorder than men, men are more likely to die from the illness due to late diagnosis. Young women on the autism spectrum have a higher likelihood of experiencing an eating disorder than their neurotypical peers. The average age of onset for Anorexia Nervosa and Bulimia Nervosa is 18, while the average age of onset for Binge Eating Disorder is 21. Several studies suggest that there is an inherited predisposition to disordered eating, however no one is immune to these disorders.

What Are The Different Types Of Treatment For Eating Disorders?

Treatment for eating disorders often adopts a team approach. Typically, mental health therapy is offered alongside nutrition education, medical monitoring, and sometimes medication. The most successful approach is one where the therapist, nutritionist, and prescriber collaborate in working towards the same goals, while the client takes in active role in their own recovery.

Dialectical Behavioral Therapy (DBT) is one of the most commonly used approaches to treat eating disorders. DBT encourages individuals to practice regulating intense emotions, as well as managing relationships. Clients using DBT are encouraged to acknowledge that distressing situations and emotions exist, and they can practice skills to tolerate them.

Cognitive Behavioral Therapy (CBT) is another common form of treatment, as it explores the link among thoughts, feelings, and behaviors that as associated with triggers for the behavior use. This therapeutic method can be helpful in offering the client a sense of control over their environment without resorting to harmful eating behaviors.

Other types of therapy that may be helpful are family therapy and group therapy. Family therapy is highly recommended, as an understanding support system correlates with more positive treatment outcomes. Additionally, eating disorders often occur in family situations where another dysfunction is present. Helping the family identify their unhealthy patterns and behaviors can encourage a shift in the family dynamics and have a positive impact on the person struggling with the eating disorder. Group therapy can be beneficial for those struggling with eating disorders. Eating disorders are typically isolating, and the group connection can provide support to clients, as well as challenge the isolation of the eating disorder. Group therapy led by a skilled professional allows people to connect with like-minded individuals who are working towards similar goals.

There are eating disorder treatment centers that can provide treatment to individuals who are recommended to have a higher level of care than outpatient therapy. This includes inpatient and residential treatment, down Partial and Intensive Outpatient Programs. These programs are widely available at various facilities that specialize in the treatment of eating disorders.

How Long Does It Take To Cure An Eating Disorder?

Since eating disorders take time to develop, they also take time to treat. Treatment at higher levels of care can be recommended for weeks or months at a time; there will always be a recommended after-care treatment plan in place prior to discharge from one of these programs.

Since eating disorders can be complex in nature, there is no specific timeframe for which a person will be “healed.” The best approach for those with eating disorders involves many different care providers, such as doctors, psychiatrists and therapists. People who need immediate health threats resolved can get this done quickly, but people working through the psychology of an eating disorder may require more time and ongoing work.

You can expect to experience tremendous healing as you establish new and healthier habits, and notice that with time the distressing thoughts and urges from an eating disorder can subside. It is recommended to have ongoing support after the symptoms are decreased in order to manage the eating disorder in the long-term.

How Will I Know I’m Working With The Right Therapist?

Therapists come from different educational backgrounds, including but not limited to Marriage and Family Therapists (MFT), Licensed Professional Counselors (LPC), Licensed Independent Clinical Social Workers (LICSW), and Psychologists (PhDs and PsyDs). Any of these clinicians are legally able to treat eating disorders, however not all therapists specialize in eating disorder treatment methods. It is most important to find a therapist that you can connect to and trust, and are willing to meet with over time. The therapist should make you feel at ease and be comforting so that you are able to express your feelings. The individual clinician should be licensed to provide therapy by Massachusetts or your state.

When searching for a therapist, consider popular directories such as Psychology Today, Zencare, and Good Therapy. These are great resources to refer to when searching online, as they often include a therapists’ specialties on their sites. You can also refer to your insurance plan to find providers who may be in your network.

How Will I Know If My Eating Disorder Therapy Is Working?

The therapeutic process is not linear, and therefore it can be difficult to know if you’re making progress. As you participate in therapy, you should begin to see opportunities to implement new coping strategies, or you might have moments of hindsight where you see you could have used new coping methods. Even the act of using an eating disorder behavior, followed by increased insight can demonstrate progress in the therapeutic process. If you are concerned about your progress in therapy, you should address this openly with your therapist so you can work together to set specific goals for your growth and healing.

What Does Therapy Cost And How Do I Pay For It?

There are many factors that go into determining the cost of therapy, including where you live and what type of treatment is needed. The average full-fee cost of a 50-minute therapy session in the Boston area can range anywhere from $150-$200, but rates vary depending on your therapist’s experience or specific geographical location, as well as their specific qualifications and training.

If you are able to use your health insurance, you will either be responsible for co-payments or the entire cost depending on your insurance plan and whether you have a high deductible or not. Most therapists will allow you to pay for your session costs with Health Savings or Flexible Spending Accounts. If you want to see a therapist who is not in-network with your insurance plan, you may be able to get the majority of the cost of each session reimbursed by your insurer. These are known as out-of-network benefits and you can call your insurer to find out if these benefits are included in your health plan.

Many insurance plans will cover more intensive treatment programs for eating disorders, as well as necessary medications and other medical interventions. A consultation with a representative from your insurance company will be helpful in organizing the most efficient and economical treatment approach.

How Do I Prepare For My First Session?

For the first therapy session, the best preparation is to try and keep an open mind, since therapy can be intimidating! It is normal to feel some anxiety as you go into your first session, and it is common to want to make a good impression. However, honesty is always the best way for a therapist to get to know you and your specific struggles. Approaching therapy with an open mind and willingness to heal makes it much more likely that positive change will happen. You could also reflect on your journey with eating disorders prior to the meeting, as this will likely come up.

How Do I Know When To Stop Going To Therapy?

If you have been in therapy for some time and feel you have met all of your original goals, you should consider discussing an end to your treatment. It’s recommended that you and your therapist check-in with your original goals frequently to make sure you’re both tracking your therapeutic progress. A 3-month check-in allows the therapist to do their best work with you, and gives you ample time to adjust your goals in the healing process.

If you are sure that the fit with the therapist is not a good one, you should also end therapy and find a different provider. Finally, you should always end therapy if your therapist does something you consider to be inappropriate or unethical.

How Can You Help?

I am a Licensed Independent Clinical Social Worker (LICSW) in the Boston area with almost 10 years of experience treating individuals who struggle with eating disorders. Prior to becoming a clinician, I worked as a mental health worker at an eating disorder treatment center. After getting my Master’s degree, I returned to the same treatment center where I worked as a clinician and supervised meals, ran groups, conducted evaluations and provided individual and group counseling. Now, I conduct evaluations at the eating disorder treatment center, as well as have a private practice where I conduct therapy for individuals and their families. If you are interested in learning more about Spur Counseling, me, or my approach, please reach out!

April 24, 2021
The Myth of Self-Care

For the better part of the 20th century, it wasn’t common knowledge to take care of oneself. It was only recently that we start hearing about self-care on TV and in magazines as a way to stay healthy and strong in challenging times. Nowadays, self-care has transformed into something with many meanings which can vary person by person.

While this is true in many cases, it’s a very narrow understanding of the concept when it comes to our mental health. Self-care may very well mean a massage or a day of golf. It might mean going out with friends or taking a day to enjoy some extra rest. Who doesn’t love taking time away from the stress of daily life to do something with the sole purpose of giving yourself an emotional boost?

In actuality, self-care goes much deeper than a day at the spa, and the sooner you can embrace it in its full meaning, the healthier you will become. Good self-care doesn’t always mean doing something enjoyable. Honestly, it might mean doing things you actively dislike.

When it comes to taking care of ourselves, we’re quick to embrace the activities that feel nice. Those massages and manicured nails aren’t much of a struggle. We enjoy them, and yes, we should make time for those things. But, freshly painted nails aren’t life-changing, and sometimes we need the kind of care that cuts to our core. Sometimes, self-care looks more like self-parenting. Stop eating the cookies after one or two. Go to bed at a decent hour. No, you can’t go play with friends until the house is clean. Every now and then, what we really need isn’t relaxation. It’s discipline.

Here are some other examples of self care:

*Regular exercise.

*Good nutrition

*Setting healthy boundaries

*Meditation/Prayer

*Having vulnerable conversations

*Going to therapy

*Quitting smoking/drinking

*Journaling

*Goal setting

*Relinquishing control of others

*Embracing positivity

Self-care is vitally important to being our best selves. We need time to recharge, and engaging in relaxing and fun activities is part of living our best life. But true self-care also includes the hard things that don’t always seem easy at the moment, yet pack a big payoff. Challenge yourself to add some tough love into your self-care routine. Let me know if I can help!

February 26, 2021