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Articles tagged with: Eating Disorders

The Broad Response to Evidence Based Treatment

April 09, 2013. Written by Mark Warren, M.D.
  • Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

    By Dr. Mark Warren

    Harriet Brown, well known to readers of this blog and to the eating disorder community for her book Brave Girl Eating, recently published an article in the New York Times on why evidence based care is so rarely used in the field of mental health and psychology. Her article is the latest in what has become a very important conversation about the translation of evidence based research into the treatment of mental illness. This topic was also discussed at great length at the recent eating disorder conference in London, organized by Drs Bryan Lask and Rachel Bryant-Waugh. The keynote of this conference, which echos Harriet's article, shows that the number of practitioners in the community using evidence based care is shockingly low.

    Unsurprisingly the response to this article, the presentation in London, and other articles of this nature has been twofold. Many people and clinicians are excited and hopeful that there is effective treatment for historically difficult to treat illnesses. On the other hand, some practitioners are responding by challenging the notion that evidence based care should be the standard of care. The reasons for this vary from the notion that the evidence is weak (possibly, but it is the best we have), to the assumption that the evidence doesn't apply to every practice (unclear why not), to the criticism that the evidence doesn't acknowledge cultural and clinical realities (it does). Many criticisms are based on the anecdotal experience of the provider. One provider referred to the evidence as "weak tea."

    It is very difficult when scientific evidence challenges our own personal experiences and beliefs. However, if you happen to have an eating disorder, or a loved one has an eating disorder, and if you're aware of the last 20 years of eating disorder treatment, you would want to know that since the advent of evidence based care we have started to get better outcomes. If I, or a loved one, had an eating disorder, I would far prefer a glass of weak tea to no tea at all.

    For more information: Looking for Evidence That Therapy Works

    Contributions by Sarah Emerman

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Community Event: Exploring Eating Disorder & Recovery Addiction

April 02, 2013.
  • Eating Disorder and Addiction RecoveryMark your calendars for June 20th at 7 PM. Cindy Solberg, MA, LPC, LADC is a therapist at The Emily Program. She will discuss the topic: Eating Disorder and Recovery Addiction at The Recovery Church.

    Date: Thursday, June 20
    Time: 7:00 PM
    Location: The Recovery Church, 253 State Street, St. Paul, MN 55107

    Most people are usually very surprised to learn that eating disorders have little to do with food. Especially when one considers that many people who suffer from eating disorders actually have an unhealthy obsession with food. Eating disorders and addiction often come hand in hand as well. This session will provide a basic level of understanding of the multidimensional nature of eating disorder and addiction recovery. It will also discuss how someone might learn to have a non-addictive relationship with food.

    Thank you to The Recovery Church and Minnesota Recovery Connection for hosting this event.

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Dr. Mark Warren Voted “Best Doc” by Cleveland Magazine!

March 26, 2013.
  • Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

    We are very proud to announce our very own Mark Warren MD was voted a "2013 Best Doctor" by Cleveland Magazine! He was named by a national board of his peers. Pick up a print version to see the full listing, or read about the featured physicians.

    "I'm so honored and thrilled to be acknowledged by my peers and community as a Best Doc," says Dr. Warren. "It's gratifying to know that all of our hard work at the Cleveland Center for Eating Disorders and our profound and unrelenting commitment to eating disorder treatment is getting noticed and making a difference in this field."

    With this monumental achievement, we sat down with Dr. Warren to reflect on his career and accomplishments, where his passion for eating disorder treatment comes from, and what's next for him. Read on to learn more about Dr. Warren and why he continues to inspire us every day.

    CCED: What is your area of expertise within the subject of eating disorders?

    Dr. Warren: There are several areas that I have gained expertise in. The three that are my greatest focus are men and eating disorders, professionals with a history of eating disorders, and evidence-based therapies.

    CCED: At what point in your training did you decide to specialize in the study of eating disorders, and why?

    Dr. Warren: I went into the treatment of eating disorders after about 12 years of practice. I have a history of anorexia, which started in my teenage years. I was lucky to fall in love with (and for her to have been equally smitten) with a woman who successfully re-fed me. As there was no eating disorder treatment at the time, my own recovery was haphazard and spread out over many years.

    Only after full recovery — not only being re-fed and stopping behaviors, but also feeling whole and having a good relationship with my body and with food — did I enter the field of eating disorder treatment. I then retrained in dialectical behavioral therapy, learned Maudsley Family Based Therapy, and began my full-time eating disorder work with Lucene Wisniewski, PhD — my partner here at CCED.

    CCED: What is the most interesting or surprising thing you have learned about eating disorders over your years of research and practice?

    Dr. Warren: I suppose it is how much sense they make when you are suffering from an eating disorder and how little sense they make to everyone else. Our new understanding of the biology of eating disorders and the brain has helped to make this separation so much clearer. I have great hopes that our further biological understanding will make eating disorders sensible to everyone and make clear how foolish and wrong it is to see eating disorders as a conscious choice.

    CCED: If money were no object, what aspect of eating disorders would you most like to explore in research, or what resource/treatment would you most like to develop?

    Dr. Warren: I would most like to explore in research how to develop treatments that help to stop the painful thoughts and feelings that accompany the disorder. We are getting better at re-feeding. We need to figure out how to help everyone with an eating disorder to experience a life worth living.

    CCED: When you reflect on how far CCED has come since opening in 2006, what are you most proud of?

    Dr. Warren: Before CCED, there was no way to get the most advanced, evidence-based care for eating disorders in Northeast Ohio. Patients either saw practitioners who were not using proven treatments or had to travel long distances to get the necessary care. We are still in a treatment environment where many providers either don't know what evidence-based care is or don't do the training needed to become an expert.

    Now, for many patients, they can get the care they need, while staying at home. Eating disorders are deadly illnesses. Patients deserve the best practice of care from providers who have done the work to learn what has the highest likelihood of success. I am proud that CCED continuously strives to provide the best practice for all our patients.

    CCED: What's next on your list?

    Dr. Warren: We have three main goals:

    Under the lead of Dr. Wisniewski, we have developed and implemented new therapies based on the best evidence and will continue to expand in this way.

    Second, we need to continue to research our outcomes so we know how well we are doing and what we can do to make ourselves better. This work is already ongoing and we are publishing and presenting our outcome data, which both improves the work we do and helps the eating disorder field as a whole.

    Third, we need to get the word out that there is real therapy, therapy based on a scientific model, for eating disorders. Pediatricians, therapists, family doctors, internists, Emergency Room doctors and, especially patients and their families, need to know that there is true help for those who suffer with eating disorders. When patients, providers and families work together, there is hope for recovery.

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Intensive Treatment Lodging at Hillside

March 19, 2013.
  • In January we introduced Hillside Lodging, a 4 bedroom lodging option located in St. Paul, MN for female clients in Intensive Day Program or Intensive Outpatient Programs. We are thrilled to be able to offer a convenient and peaceful lodging option for out-of-area clients.

    Take a photo tour of the warm and welcoming interior of the house.

    Hillside tvroom smlRelax and unwind in this sunny room.
    Hillside livingroom smlCome home to a bright welcoming living room and dining room.
    Hillside fireplaceroom sml Curl up to your favorite book in this cozy corner of the house.
    Hillside bedroom smlOur single bedrooms allow you to have privacy and a place to relax and reflect.

    If you are interested in Intensive Programs and Hillside Lodging, or have any questions please contact our Lodging Manager, Erin at (651) 315-3302.   

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Eating Disorder Awareness Week: What you may have missed at “Body Beautiful”

March 01, 2013.
  • Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

    Our expert panel answers your questions about body image disorder and eating disorders.

    Thanks to those of you who joined us on Monday at "Body Beautiful," presented by Cleveland Center for Eating Disorders and John Carroll University. We had a great turnout! Students, professors, eating disorder professionals and families came out to increase awareness and promote hope around body image disorder and eating disorders.

    The event, which ran in conjunction with National Eating Disorders Awareness Week, featured a student interactive art show, "Mirror Images" and a screening of the popular documentary, "America the Beautiful." Immediately following, our expert panel was there to answer questions from the audience.

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What might Family Based Treatment suggest about treatment for adults with eating disorders?

February 19, 2013. Written by Mark Warren, M.D.
  • Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

    By Dr. Mark Warren

    In the field of eating disorders, multiple studies have shown that Family Based Treatment (FBT) is the most effective method available to achieve successful weight restoration and maintenance after treatment is completed. Unfortunately, specific treatments for adults have not been shown to have the same long term benefits as FBT. Clearly there are many variables involved in this data, however there are elements to FBT that may point us to a better understanding of what happens for adults.

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Recent Maudsley FBT Research

January 15, 2013. Written by Mark Warren, M.D.
  • Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

    By Dr. Mark Warren

    A recent article in the International Journal of Eating Disorders by Couturier, Kimber, and Szatmari (2013) adds to the literature on the effectiveness of Maudsley Family Based Therapy (FBT). Their conclusion is that while FBT does not show superiority to other therapies during treatment, there are significant benefits at the 6 -12 month follow up. These benefits reach a level of significance that would cause one to recommend FBT for the treatment of eating disorders in adolescents instead of individual therapy. As they discuss in their article, there are multiple limitations to this study, however research literature has long pointed to the superiority of FBT over individual therapy. This article therefore adds to a growing body of data.

    From a CCED perspective, we are particularly interested in what happens in those first 6 months and if there is a way to improve the outcome of FBT more rapidly for adolescents. Our clinical experience is that by adding higher levels of care, in particularly partial hospitalization in conjunction with FBT, that we can improve orientation, adherence, and effectiveness of FBT, while still staying in line with the FBT model. Our clinical experience does not meet the criteria of the research considered in this particular article, since it is not a randomized control trial or have a control group associated with it. However, given the data that we have, we hope to find that the utilization of FBT within a higher level of care may be a more rapid way to help our clients move from anorexia to recovery. We hope to publish in the next year on the results of our research into this question.

    Couturier, J., Kimber, M. and Szatmari, P. (2013), Efficacy of family-based treatment for adolescents with eating disorders: A systematic review and meta-analysis. Int. J. Eat. Disord., 46: 3–11. doi: 10.1002/eat.22042

    Contributions by Sarah Emerman

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Top 5 Eating Disorder Recovery Tips for the New Year

January 10, 2013.
  • By: Kate Kaczor, Dietetic Intern

    1. Think of where you want to be next year and recognize the progress that has been made from the year before. The New Year is a good time for reflection. Thinking about where you’d like your life to be can help you make active steps for achieving it. Don’t forget to praise yourself for all you have accomplished in the last year! This can help motivate you with your current goals.
    2. Ignore diet resolutions. Some of the most prominent New Year’s resolutions deal with dieting and weight loss—they are also some of the most abandoned. Don’t let all of the post-holiday diet talk negatively impact your recovery. Remember that the over-whelming majority of diets fail and that with the help of your dietitian and the rest of your treatment team you are on the right path to a healthy body.
    3. Don’t postpone. It is easy to say you will start tomorrow. Your ED may tell you that it’s okay to follow your disordered eating behaviors today—you’ll begin your recovery meal plan tomorrow. Too often, however, this leads to more and more days with ED in control. Decide to take the control back today. Making small, realistic goals can help you stay focused.
    4. Don’t expect a miracle. With all the fireworks, confetti, and balloons, the New Year gives off a false impression that something magical is happening. Just because 2013 has arrived doesn’t mean things will suddenly be different. Only your continued efforts will help you reach your goals.
    5. Continue with your team. The New Year can bring about a great deal of change. Change can be just what is needed to get your recovery headed in the right direction, but it can also be an opportunity for ED to sneak in. By staying in continuous communication with your team and attending all appointments you can help ensure that your recovery path is headed in a positive direction.
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Introducing Hillside: Intensive Treatment Lodging

January 03, 2013.
  • The Emily Program Hillside LodgingAt The Emily Program we believe that treatment should be accessible and that recovery happens when individuals are able to practice recovery skills in real-life situations. Beginning in January, Hillside Lodging will open for adult female clients who come to our Minneapolis-St. Paul locations for outpatient intensive eating disorder treatment.

    Nestled in a safe neighborhood, Hillside Lodging is a fully furnished, four bedroom home located within minutes of our offices, public transportation, restaurants, and retail shops. This non-clinical lodging option offers intensive program clients private space with all the conveniences of home.

    For more information or to refer a client, please contact our Lodging Manager, Erin at (651) 315-3302.

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To Tell or Not To Tell – By Dr. Sarah Ravin

December 14, 2012.
  • Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

    We are happy to announce that today's post is written by psychologist Dr. Sarah Ravin. Dr. Ravin utilizes DBT, CBT and ACT to treat adolescents and young adults with eating disorders, body dissatisfaction, anxiety, depression, OCD, and self-injury. We have often linked to and are inspired by the posts on her blog. A big thank you to Dr. Ravin for her contribution to our blog!

    If you have an eating disorder, you have probably struggled with the question of whether to reveal your diagnosis to others.

    Teenagers and young adults with eating disorders run the gamut of self-disclosure: some of them never tell a single soul about their illness, while others write about it on Facebook or tweet about it daily to hundreds of followers. In my practice, I advise patients to think carefully before revealing their illness to anyone. In this age of tell-all books, tabloid magazines, and Jerry Springer, it is easy to forget that the concept of revealing deeply personal information to large numbers of people is relatively new and quite controversial. There are consequences – both positive and negative – to telling people about your eating disorder.

    In considering whom to tell, it is important to balance the desire for privacy with the need for social support. On the one hand, having an illness is a personal matter and is not typically something you would share with a large number of people. Think about whom you would tell if you had asthma or a learning disability. Most people would share this information with their close friends, relatives, and doctors. Most people would not share this information on a first date, or on a job interview, or on their Facebook page.

    On the other hand, someone going through an eating disorder needs a tremendous amount of support in order to get well. Friends and loved ones can only support you if they are aware that you are struggling and that you need their help. Suffering from an eating disorder can be a lonely and isolating experience, particularly if you keep your illness a secret from everyone.

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Updates on Men and Eating Disorders

December 10, 2012. Written by Mark Warren, M.D.
  • Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

    Males are historically underrepresented throughout the eating disorder field- as patients, treatment professionals, by diagnosis and prevalence, in research studies and in stories of recovery. 30 years ago men with eating disorders were virtually invisible and options for treatment were mostly non-existent. Fortunately, we are at a tipping point in our understanding of males and eating disorders. While major gaps still exist in our understanding, we are continuously learning more about males with ED.

    According to the National Comorbidity Study (Hudson, 2007), lifetime prevalence in ED in men is:

    Anorexia Nervosa- 0.3%

    Bulimia Nervosa- 0.5%

    Binge Eating Disorder- 2%

    In this study, over 50% of men also had co-morbidities.

    In a study by Striegel-Moore, et al in 2009, over 26% of men in the community had ED symptomatology.

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This Winter Brings More Groups for COE/BED Clients

December 04, 2012.
  • Have you checked out the latest group catalog? We are now offering more outpatient groups specifically for clients working toward recovery from COE/BED. Here are just a few:

    Overcoming Barriers to Movement

    Wednesdays, 8:00-9:30 AM in St. Louis Park (5354 Parkdale Dr.)
    Led by: Jennie Laskow, MA, LPCC & Jocey Mathern, RD, LD
    This group will offer psychoeducation, process therapy and an exercise component. The group will provide a safe place to identify, explore, and overcome barriers (emotional, physical, logistical) to exercise. It will be co-facilitated by a therapist and a personal trainer/dietitian. Group members will be encouraged to explore/receive support around thoughts and feelings that arise in the process of bringing movement into their eating disorder recovery process. The physical movement will include the three components of exercise: cardiovascular, flexibility, and resistance.

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Tips for the Holidays

November 21, 2012.
  • Winter ImageThe holidays often involve family rituals and traditions where food has a central role. The holidays also may be one of the few times that a family comes together each year. Planning ahead can help people with eating disorders (and their loved ones) manage these challenges and enjoy conversation and good times with friends and family during the holidays.

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