What We Treat

Eating disorders describe illnesses that may be portrayed by obsessive thoughts and behaviors related to food intake, weight, appearance and/or exercise. The severities of eating disorders often go unrecognized, which may lead to even greater health issues. The signs and symptoms vary among each eating disorder, however, there are also many with similarities. Loved ones need to understand an eating disorder is not a lifestyle choice. The individual suffering needs to realize recovery is possible. Eating disorders are extremely dangerous and if gone unrecognized will worsen. Three Trees Center for Disordered Eating treats the individual and the eating disorder, their emotional and behavioral challenges and all other unhealthy problems an individual may struggle with. We have provided a comprehensive list of the eating disorders we treat along with ways to identify if you or your loved one have an eating disorder.

ANOREXIA

A study by the National Associate of Anorexia Nervosa and Associated Disorders reported that approximately 15% of those suffering from anorexia die within ten years after contracting the disorder, 20% will die after 20 years due to premature complications related to their eating disorder, and up to 40% have full recovery. These startling statistics shows the need to provide appropriate treatment in order to battling this disease. Eating disorders are deadly diseases and identifying warning signs can mean the difference between life and death for you or your loved one.

Anorexia is characterized by behaviors including self-induced starvation, restricting calorie intake, restricting/fearing certain types of food, and having a distorted body image accompanied by excessive weight loss. Individuals with anorexia have difficulty maintaining an appropriate weight due to the tremendously debilitating fear of weight gain or becoming fat, even when in actuality they are underweight.

Physical Symptoms

  • Significant Weight loss
  • Brittle nails
  • Thinning hair or hair loss,
  • Lanugo (the growth of soft, fine body and facial hair)
  • Dizziness and possible fainting
  • Amenorrhea (Irregular or loss of menstrual cycle)
  • Cold Intolerance
  • Poor circulation (hands & feet)
  • Feeling extremely full from a small amount of food
  • Chronic constipation
  • Fatigue/Fainting
  • Difficult concentrating
  • Poor memory
  • Stomach distended
  • Swelling
  • Low blood pressure
  • Anemia
  • Pale Skin

Behavior Symptoms

  • Perfectionism
  • Restriction in daily caloric intake
  • Intense fear of weight gain
  • Feelings of guilt from eating
  • Food rituals
  • Distorted Body Image
  • Excuses constantly to not eat (individual will say he/she already ate when they did not)
  • Preoccupation with food, weight, calories, body image
  • Engages in preparing elaborate meals for others to eat but not themselves
  • Poor self-esteem
  • Withdrawn from friends and family
  • Denies reality of weight loss

Anorexia may often include the following behaviors as well:

  • Purging through vomiting/laxative/diuretics
  • Compulsive exercising
  • Binge eating with or without purging episodes

Individuals often do not understand the true dangers associated with bulimia. Perhaps because extreme weight loss is not evident and physical symptoms may go unnoticed, however health complications are extremely high with individuals engaging in bingeing/purging episodes.

Common Health Concerns

  • Electrolyte imbalance
  • Cardiac arrest
  • Gastrointestinal complications (chronic diarrhea, constipated, IBS)
  • Amenorrhea (Irregular or loss of menstrual cycle)
  • Stomach pain
  • Bloating
  • Bacterial Infections
  • Chronic Kidney issues/Failure
  • Neurological issues

Coexisting disorders may be present in a diagnosis of Anorexia. To in sure a complete evaluation for the eating disorder, comorbid disorders may occur.

Psychiatric conditions commonly co-occurring with anorexia may be combined with:

  • Bipolar disorder
  • Borderline Personality Disorder
  • Depression
  • Obsessive Compulsive Disorder (OCD)
  • Obsessive Compulsive Personality Disorder (OCPD)
  • Panic/Anxiety disorders
  • Post-Traumatic Stress Disorder (PTSD)
  • Substance Abuse

Although these are typical symptoms please note, not all must be present to exhibit the severity of the eating disorder.

BINGE EATING DISORDER

Binge eating disorder (BED) is one of the newest eating disorders recognized by the American Psychiatric Association. BED is the most common eating disorder in the United States. It is characterized by recurrent, uncontrolled episodes of consuming significantly more food in a short period of time than most individuals would eat under similar circumstances. a very serious eating disorder with similar characteristics to bulimia, except without the behavior of purging. It occurs at least once a week, on average for over three months. During these episodes an individual may engage in the following:

Behavior Symptoms

  • Eating large amount of food without purging behaviors when not hungry
  • Sense of lack of control with eating and around food
  • Self medicating with food
  • Hoarding/Hiding food
  • Thoughts of shame and guilt after a binge episode
  • Food ritual
  • Prefer to eat alone & sometimes a fear of eating in public
  • Frequently dieting
  • Poor Self esteem

Physical Symptoms

  • Eating until uncomfortable, may even feel sick
  • Weight gain/fluctuations
  • Stomach cramps
  • Difficulty concentrating

Common Health Concerns

  • Overweight or obese
  • Sleep apnea
  • Type II Diabetes
  • Heart Disease
  • Increased Blood Pressure
  • Increased lipid levels (including cholesterol)
  • Osteoarthritis
  • Joint/Muscle pain
  • Gallbladder disease
  • Gastrointestinal complications

Coexisting disorders may be present in a diagnosis of BED. To in sure a complete evaluation for the eating disorder, comorbid disorders may occur.

Psychiatric conditions commonly co-occurring with may be combined with:

  • Bipolar disorder
  • Depression
  • Panic/Anxiety disorders
  • Personality Disorder
  • Post-Traumatic Stress Disorder (PTSD)
  • Substance abuse disorder

Although overeating is a struggle many Americans face, recurring binge eating is less common, much more severe, and correlated with extreme physical and psychological concerns. Approximately 40% of individuals pursuing weight loss treatment can be clinically diagnosed with BED. Unfortunately, since the underlying issues in the majority of these pursuits are not treated, the cycle of bingeing will continue.

Although these are typical symptoms please note, not all must be present to exhibit the severity of the eating disorder.

BULIMIA

Bulimia is characterized by excessive or compulsive consumption of food (bingeing) accompanied by the act of getting rid of the food consumed (purging). Individuals suffering from bulimia often describe their struggle as feeling a complete loss of control when eating. This feeling leads to a regular intake of an excessive amount of food in a short period of time, ending with the ridding of the food through purging. The compensatory behaviors of purging include self-induced vomiting, laxative or diuretic abuse, periods of fasting, and/or excessive or compulsive exercise episodes.

Physical Symptoms

  • Chronic sore throat
  • Heartburn/reflux
  • Swollen cheeks and neck
  • Bloating
  • Fatigue/Faint
  • Dry skin
  • Muscle cramping
  • Gum disease/bleeding
  • Broken blood vessels in the eyes and/or face
  • Discoloration of teeth
  • Calluses on knuckles and/or back of hands (from self-induced vomiting)
  • Fluctuation in weight

Behavior Symptoms

  • Bingeing and Purging
  • Consuming a large amount of food in a short period of time
  • Preoccupation with food & body weight,
  • Hoarding food/Hiding food
  • Frequent visits to the bathroom (especially after eating)
  • Secretive eating (finding food wrappers in bedroom/bathroom)
  • Abuse of laxatives, diuretics, and/or diet pills
  • Excessive exercising
  • Isolation from friends and family
  • Shame & Guilt related around eating behaviors
  • Poor self esteem

Coexisting disorders may be present in a diagnosis of Bulimia. To in sure a complete evaluation for the eating disorder, comorbid disorders may occur.

Psychiatric conditions commonly co-occurring with bulimia may be combined with:

  • Bipolar Disorder
  • Borderline Personality Disorder
  • Depression
  • Obsessive Compulsive Personality Disorder (OCPD)
  • Panic/Anxiety disorders
  • Post-Traumatic Stress Disorder (PTSD)
  • Substance Abuse Disorder

Individuals too often do not understand the true dangers associated with bulimia. Perhaps because extreme weight loss is not evident and physical symptoms may go unnoticed, however, health complications are extremely high with individuals engaging in bingeing/purging episodes.

Common Health Concerns

  • Dehydration
  • May lead to Type 2 Diabetes/Pancreatitis
  • Electrolyte Imbalance
  • Lining of stomach torn
  • Chronic Irritable Bowel Syndrome (IBS)
  • Gastrointestinal complications
  • Esophagus inflammation and perhaps rupture
  • Chronic Kidney problems
  • Seizures

Although these are typical symptoms please note, not all must be present to exhibit the severity of the eating disorder.

ORTHOREXIA

Orthorexia is characterized by an obsession with following a “healthy diet”.  Individuals believe they are engaging in the best approach for their body by eating healthy, however, the accompanied behaviors often lead to something more severe. Sufferers are fixated with maintaining the “perfect diet” rather than focused on body weight. An individual with orthorexia exhibits signs and symptoms similar to those of anxiety disorders along with anorexia and/or bulimia behaviors.

Physical Symptoms

  • May be similar to anorexia and/or bulimia symptoms, dependent on the severity of those behaviors correlating with the following Orthorexia behavior symptoms.
  • Individual believes they feel physically ill if food they do not believe is healthy has been consumed.

Behavior Symptoms

  • Preoccupied with food
  • Fear of eating food not prepared by the individual
  • Will only eat organic foods
  • Fear of eating out because they are not aware of the origin and ingredients of meal
  • Obsessed with avoiding the following:
    • Animal products
    • Artificial colors, flavors or preservatives
    • Carbohydrates
    • Dairy products
    • Pesticides and genetically modified foods
    • Other ingredients the individual believes to be unhealthy

Similar to anorexia, orthorexia is characterized by restricting food intake and poor variety of foods eaten, creating malnutrition. Therefore, both disorders have similar health issues.

Common Health Concerns

  • Electrolyte imbalance
  • Cardiovascular concerns
  • Gastrointestinal complications (chronic diarrhea, constipated, IBS)
  • Amenorrhea (Irregular or loss of menstrual cycle)
  • Stomach pain
  • Bloating
  • Chronic Kidney issues
  • Neurological issues

Coexisting disorders may be present in a diagnosis of Orthorexia. To in sure a complete evaluation for the eating disorder, comorbid disorders may occur.

Psychiatric conditions commonly co-occurring with bulimia may be combined with:

  • Bipolar Disorder
  • Borderline Personality Disorder
  • Depression
  • Obsessive Compulsive Disorder (OCD)
  • Obsessive Compulsive Personality Disorder (OCPD)
  • Panic/Anxiety disorders

Although these are typical symptoms please note, not all must be present to exhibit the severity of the eating disorder. Orthorexia may be accompanied with other eating disorders, which will determine the increased health risks. Reference the other eating disorders to identify key behaviors.

OTHER SPECIFIED FEEDING and EATING DISORDERS (OSFED)

Other Specified Feeding and Eating Disorders (OSFED) is characterized by maladaptive behaviors correlated to eating, food and body image, yet does not meet all diagnostic criteria for another specific diagnosis such as anorexia, bulimia, binge eating disorder. The following is a list of physical and behavior symptoms, however not all may be present, dependent on the accompanied eating disorder.

Physical Symptoms

  • Weight fluctuation
  • Difficulty concentrating
  • Dizziness
  • Gastrointestinal discomfort (cramping)
  • Menstrual irregularities
  • Dry skin
  • Lanugo (the growth of soft, fine body and facial hair)
  • Weakened immune system
  • Discoloration of teeth (if vomiting present)
  • Thinning hair on head
  • Fainting
  • Feeling constantly cold
  • Fatigue
  • Muscle weakness
  • Difficulty concentrating on anything besides food

Behavior Symptoms

  • Atypical Anorexia: The diagnosis criteria for anorexia are present, except the individuals weight is within or above the normal range.
  • Bulimia: The diagnosis criteria for bulimia are present, except the binge/purge episodes occur less than once a week on average for less than 3 months.
  • Binge Eating Disorder: The diagnosis criteria for BED are present, except the binge eating episodes occur less than once a week on average for less than 3 months.

Common Health Concerns

  • Anemia
  • Abnormal labs (electrolytes, thyroid & hormonal levels, low blood cell counts)
  • Dependent on accompanied eating disorder; refer to the other disorders.

Psychiatric conditions commonly co-occurring with OSFED may be combined with:

  • Bipolar Disorder
  • Borderline Personality Disorder
  • Depression
  • Obsessive Compulsive Disorder (OCD)
  • Obsessive Compulsive Personality Disorder (OCPD)
  • Panic/Anxiety disorders

This disorder is often accompanied with other eating disorders, which will determine the increased health risks. Reference the other eating disorders to identify key behaviors.

Post-Bariatric Surgery Disorder (PBSD)

Bariatric surgery is an increasingly common approach to promote weight loss in severely obese individuals. Psychological health conditions are common among these individuals and if the eating disorder behaviors are not treated, they could lead too much greater problems. A significant amount of post-bariatric patient struggle with eating disorder symptoms, therefore learning to adapt to necessary changes is fundamental for success. A common statement from PBSD clients is, “I couldn’t eat my emotions, so I had to find new coping skills when I was stressed or anxious”. This is a powerful and debilitating feeling. If someone is not proactive in identifying healthy coping skills the root to their distorted behaviors towards food and eating will continue to be exhibited, just in different forms.

Physical Symptoms

  • Eat until feel sick or become sick
  • Loss of control around food
  • Purging could be present (laxatives, diet pills, diuretics, over-exercising)

Behavior Symptoms

  • Restriction in daily caloric intake
  • Intense fear of weight gain
  • Feelings of guilt from eating
  • Food rituals
  • Distorted Body Image
  • Preoccupation with food, weight, calories, body image
  • Engages in preparing elaborate meals for others to eat but not themselves
  • Poor self-esteem
  • Withdrawn from friends and family

Common Health Concerns

  • Type II Diabetes
  • High blood pressure
  • Gastrointestinal damage
  • Surgery side effects

Psychiatric conditions commonly co-occurring with ARFID may be combined with:

  • Depression
  • Panic/Anxiety disorders
  • Personality Disorder
  • Post-Traumatic Stress Disorder (PTSD)
  • Substance abuse disorder

This disorder is often accompanied with other eating disorders, which will determine behaviors and physical symptoms the increased health risks.

Eating Disorders In Athletes

Athletes often struggle with eating disorders because many sports place an extreme emphasis on body weight and/or shape. Denial is often the hardest struggle with these individuals because they consider their disordered eating as a significant component to excel in their sport. In addition, individuals that support these athletes such as their coaches, parents, and teachers often do not recognize there is a problem. Not being aware of certain warning signs could lead to encouragement of negative behaviors without realizing the associated risks. Athletes are often perfectionists in their sport, and this characteristic may drive the eating disorder in several avenues. High-risk sports associated with an increased susceptibility to develop an eating disorder include figure skating, ballet/dancing, gymnastics, swimming, track and field, cheerleading, wrestling, and football. The physical and behavior symptoms could be similar to anorexia and bulimia and therefore create comparable health concerns. As in all eating disorders, awareness of a healthy drive to succeed in one’s sport compared to behaviors that may lead to severe health problems could mean the difference between life and death.

1. Avoidant-Restrictive Food Intake Disorder

Avoidant-Restrictive Food Intake Disorder (ARFID) is the persistent pattern of disordered eating categorized by the following symptoms. Unlike some of the other eating disorders, ARFID is not focused on body image issues nor the fear of weight gain, rather these individuals exhibit severe picky eating behaviors accompanied with somatic complaints due to eating most foods. This is characterized as a picky eater, to the extreme resulting in malnutrition and extremely low body weight.

Physical Symptoms

  • Lack of appetite
  • Complaints of bodily symptoms leading to greater restriction of food
  • Significant weight loss
  • Difficulty concentrating
  • Fatigue
  • Brittle Nails
  • Dry/loss of hair
  • Osteoarthritis
  • Amenorrhea (Irregular or loss of menstrual cycle)

Behavior Symptoms

  • Lack of interest in food
  • Fear of choking or vomiting resulting in reduced intake/refusal to eat
  • Inability to eat in front of others
  • Extremely limited range of preferred food that progressively worsens
  • Dependent on nutritional supplements

Common Health Concerns

  • Malnutrition leading to several concerns similar to anorexia
  • Anemia
  • Stunted growth in children
  • Severely underweight
  • Electrolyte imbalance
  • Cardiac arrest
  • Gastrointestinal complications (chronic diarrhea, constipated, IBS)
  • Amenorrhea (Irregular or loss of menstrual cycle)
  • Neurological issues

Coexisting disorders may be present in a diagnosis of ARFID. To in sure a complete evaluation for the eating disorder, comorbid disorders may occur.

Psychiatric conditions commonly co-occurring with ARFID may be combined with:

  • Anxiety Disorders
  • Depression

Although these are typical symptoms please note, not all must be present to exhibit the severity of the eating disorder. 

2. Rumination Disorder

Rumination Disorder is characterized by regular regurgitation of food that occurs for a minimum of one month.

Physical & Behaviors Symptoms

  • Regurgitated food may be spite out, re-chewed, or re-swallowed.
  • Repetitive regurgitation behavior of food for at least one month
  • Behaviors do not occur exclusively in the course of anorexia, bulimia, BED, or avoidant-restrictive food intake disorder
  • Negative thoughts

Common Health Concerns

  • Cardiovascular concerns
  • Increased psychological issues

Psychiatric conditions commonly co-occurring with ARFID may be combined with:

  • Depression
  • Panic/Anxiety disorders
  • Personality Disorder

Treatment for this disorder is specific to learning to adapt techniques that will help break the cycle. This disorder is often accompanied with other eating disorders, which will determine the increased health risks. Reference the other eating disorders to identify key behaviors.

3. Night Eating Syndrome

Night eating syndrome (NES) is characterized as a persistent pattern of late night binge eating. Individuals may or may not be aware of the time, what they are eating and what they are eating. Almost 30% of these individuals having a gastric bypass surgery are afflicted with NES.

Physical & Behavior Symptoms

  • Trouble falling asleep and/or staying asleep
  • More than half of daily food consumption is during and after dinner
  • Skips breakfast and delays first meal for several hours after awakening
  • Sleepwalking
  • Guilt/anxious while eating
  • Depressed
  • Suffers from anxiety

Similar to Binge Eating Disorder, Night Eating Syndrome is characterized by eating most food intake in the evening, which leads to similar symptoms to BED. Therefore, both disorders have similar health issues.

Common Health Concerns

  • Overweight or obese
  • Sleep apnea
  • Type II Diabetes
  • Heart Disease
  • Increased Blood Pressure
  • Increased lipid levels (including cholesterol)
  • Joint/Muscle pain
  • Gallbladder disease
  • Gastrointestinal complications

Psychiatric conditions commonly co-occurring with ARFID may be combined with:

  • Depression
  • Panic/Anxiety disorders
  • Post-Traumatic Stress Disorder (PTSD)
  • Substance abuse disorder

4. Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is an obsession with a flaw in one’s appearance, whether it is an imagined one or an actual slight imperfection.

Physical & Behaviors Symptoms

  • Poor self esteem
  • Extreme fears of rejection due to their perceived notion of how they look
  • Distorted body image
  • An uncontrollable impulse to obsess over distorted perception

Common Health Concerns

This disorder is often accompanied with other eating disorders, which will determine the increased health risks. Reference the other eating disorders to identify key behaviors.

Psychiatric conditions commonly co-occurring with ARFID may be combined with:

  • Depression
  • Panic/Anxiety disorders
  • Obsessive Compulsive Disorder (OCD)
  • Obsessive Compulsive Personality Disorder (OCPD)
  • Post-Traumatic Stress Disorder (PTSD)
  • Substance abuse disorder

5. Compulsive Over-Exercising

Contrary to what many people believe, it is possible to exercise too much. Compulsive Over-Exercising is a behavior commonly accompanying anorexia, bulimia, and body dysmorphic disorder, but could also be present in the other eating disorders. The main drive for an individual suffering from this compulsion may be to burn calories, relieve guilt associated from eating or bingeing, or even the feeling of allowing oneself to eat. Considered another form of purging, the behavior of over-exercising may give a feeling of power, sense of control and even self-respect.

Physical Symptoms

  • Amenorrhea (Irregular or loss of menstrual cycle)
  • Bone Fractures
  • Fatigue
  • Insomnia

Behavioral Symptoms

  • The individual feels extreme guilt if he/she cannot exercise
  • Rigid exercise schedule; will find time to workout no matter what
  • Social isolation
  • Working out for hours at a time (beyond what is considered safe)
  • Working out with an injury
  • Working out if physically sick
  • Worsening eating disorder symptoms

Although these are typical symptoms please note, not all must be present to exhibit the severity of the eating disorder.

Common Health Concerns

  • Bone Fractures
  • Arthritis
  • Damage to ligaments and/or cartilage
  • Muscular Atrophy
  • This disorder is often accompanied with other eating disorders, which will determine the increased health risks. Reference the other eating disorders to identify similarities in your or your loved ones behavior.

Psychiatric conditions commonly co-occurring with Compulsive Over Exercising combined with:

  • Depression
  • Panic/Anxiety disorders
  • Obsessive Compulsive Disorder (OCD)
  • Obsessive Compulsive Personality Disorder (OCPD)
  • Post-Traumatic Stress Disorder (PTSD)

Substance abuse disorder (especially in body altering forms: Testosterone & Androgenic-Anabolic Steroids (AAS), HGH, Synthol, Insulin-Like Growth Factor-1 (IGF), Clenbuterol, Thyroxin (T4), and any other physical body altering substance.

This disorder is often accompanied with other eating disorders, which will determine behaviors and physical symptoms the increased health risks.

LEVELS OF CARE

Three Trees Center for Disordered Eating offers a full spectrum, comprehensive level of care system. Each level represents the clients’ recovery process. We provides a continuum of care through all phases in the transition from actively being in the eating disorder to permitting oneself to letting go. Upon admission, each client receives the following services:

First Two Weeks

The first two weeks at Three Trees will include the following but are not limited to:

  • Initial Psychological Evaluation
  • Detailed Nursing assessment
  • Full Set of Labs
  • 2 Sessions with the Dietitian weekly
  • 2 individualized therapeutic sessions weekly
  • 2 Family sessions (If approved by the treatment team)
  • 2 medical service follow-ups weekly
  • Daily group therapy sessions weekly
  • Case Management

Partial Hospitalization Program (Day/Night Treatment)

  • Daily group therapy (Monday thru Saturday)
  • 1 individual session with primary therapist weekly
  • 1 family session weekly
  • 1 medical follow-up weekly or as needed
  • 1 Dietitian follow-up weekly or as needed
  • Case Management

Intensive Outpatient

(2 tracks available Day/Night) (speak to your admissions counselor regarding the program options)

  • Group therapy
  • 1 individual session with primary therapist weekly
  • 1 family session weekly (as needed)
  • Medical follow-up as needed
  • 1 Dietitian follow-up weekly or as needed
  • Case management

Outpatient

  • 1 group therapy session weekly
  • Individual sessions as needed
  • Medical follow-up as needed for medication management
  • Dietitian follow-up as needed

Three Trees is Here to Help

We know the importance in a smooth progression to restoring one’s belief and relationship with food. The Three Trees team identifies each client’s needs to help empower one’s self-acceptance through a healthier relationship with food. Our program is designed to advocate recovery in a supportive, challenging, and rewarding environment at every step in all levels. No matter where you are in recovery from your eating disorder, we assure our team to help identify with you the best level of care needed at this time.