Early Intervention, Multi-Modal Treatment Key to Long-Term Recovery of Eating Disorders

Eating disorders (EDs) are occurring at an alarming rate in the United States. In fact, the National Association of Anorexia Nervosa and Associated Disorders (ANAD) indicates up to 24 million people of all ages – both male and female – suffer from an ED. Often manifesting in adolescence, EDs may go untreated for years until a life-threatening episode occurs. That’s why Dr. Tracey Cornella-Carlson, a board-certified child and adolescent psychiatrist at Rogers Memorial Hospital, says the earlier the treatment, the better.

“If we can see patients early on in their illness,” Dr. Cornella-Carlson said, “then we can help them recover more successfully. Plus, the more intensive the treatment, the more effective and successful the outcome will be.” As the medical director of Rogers’ child and adolescent eating disorder services, Dr. Cornella-Carlson (or Dr. CC, as patients call her), sees that importance firsthand.

EDs currently have the highest mortality rate of any mental illness, yet only 1 in 10 receives treatment. In addition, less than half receive care by a specialized facility equipped to provide effective treatment. That’s critical because death from anorexia is 12 times higher than the rate associated with all causes of death for females 15-24 years old. What’s more, boys are at risk too. In fact, a recent post by Technorati indicated that EDs among the male population are on the rise. Since they are complex diseases that can result from many contributing factors, EDs cannot be cured by willpower alone. That’s why a specialized treatment program that utilizes many kinds of therapy is so important.

“We often see co-existing disorders,” Dr. CC explained. “Intensive treatment provides the opportunity to identify other factors such as depression and anxiety that may have triggered or perpetuated the ED, which helps to provide proper, effective treatment. A residential program, like what we offer in Rogers’ Eating Disorder Center, can often provide the best treatment for all the disorders, helping to resolve the ED.” She added that those who suffer from EDs develop irrational thinking. That’s why it’s important to treat children and adolescents before those thoughts become too entrenched, affecting behavior and creating unhealthy habits.

Quality, Intensive Treatment Leads to Recovery
Christina Grasso, a 23-year-old survivor and former patient, can attest to the importance of seeking the right treatment early in the disease. “I started battling an ED when I was 12, but kept silent for almost 10 years,” she said. “As an eighth grader, I began experimenting with eating less. This seemingly innocuous diet soon developed into a full-blown ED. When I moved away for college, my illness worsened significantly. It was easy to hide until my junior year when my friends and school officials intervened. They implored me to seek treatment although I had no idea how ill I’d truly become. My hair was falling out, my skin had turned yellow, I was covered in bruises and my heart slowed to a deadly pace. Anorexia fully consumed my life.”

Grasso was admitted to a partial hospitalization program for several months and began seeing an ED specialist in Cleveland. She was so medically compromised that her physician and treatment providers literally saved her life. “I made great progress,” she said, “but after almost 10 years of battling anorexia, it was not enough.” She returned to school and relapsed almost immediately, then found herself back in that program for another few months. When she returned to school, she was unable to sustain her recovery. At the urging of her treatment providers, she was admitted to Rogers, where she stayed from June to August at 22 years of age.

“After several previously unsuccessful treatments, I was admitted to Rogers’ Eating Disorder Center,” she said. “It was a sobering experience, seeing in other patients what I was unable to see in myself. It made the disease very real and helped me to realize the true horror of an ED. By the time I got to Rogers, I had battled anorexia for almost a decade and prior treatments had only briefly interrupted my symptoms. I felt hopeless and honestly believed the disease was bound to kill me. Different treatment approaches work for different people, but I know the work I did at Rogers was lifesaving.”

A Means for Control
For many, EDs seem to offer control. That was definitely the case for Meagan Lavey. A 22-year-old student at Carthage College in Kenosha, Wis., she is also a survivor and former patient. “I had signs as early as eighth grade through high school, starting with binge eating and turning into anorexia. I had problems obsessing over things, and I didn’t like change. I often felt the need to compare myself to those who seemed happier than I was. Other people seemed to accept change. I wondered why I was so different. I didn’t understand what to do to be like other girls and weight became a competition. I made excuses in high school and lied to hide my problem.”

During high school, changes occurred quickly and she felt completely out of control. “I decided that one thing I could control was me. With each pound I lost, I would feel more power and more in control.” Lavey was starving herself and didn’t know it, but others suspected. She, too, began hearing the rumors.

“I just felt that wasn’t who I was,” Lavey said. “I couldn’t have anorexia!” As a senior, though, she finally admitted it and went to Rogers for the first time. She was in inpatient hospitalization and felt she knew all the answers and what they wanted, so she performed accordingly. When she convinced others she should be in partial treatment, she made efforts to offset the weight she thought she was gaining.

“The voice in my head was insidious,” she said. “I was afraid anything would make me fat.” So she would wear layers and layers of clothes to bed to sweat off the extra weight. She would chew and spit out her food, obsessively exercise and manipulate the outcome however she could. Around Halloween that year, she was released at 100 pounds but went down to 73 pounds by Thanksgiving. Before meetings with her dietitian, she drank 80 ounces of water so she could gain five pounds and wear soda bottles filled with water and weights under her clothes so she would appear heavier. Finally, at the start of December, she realized she needed help. She was admitted in a local hospital’s oncology ward to get medically stabilized before participating in Rogers’ program. Once stable, she was admitted to Rogers’ inpatient eating disorder hospitalization for about a month, then was stepped down to the residential program in the Eating Disorder Center where she stayed for two months.

“I was really upset and angry about that at first,” she said, “but looking back, I know it was the right choice. It was there I was able to learn more of the coping skills I needed to monitor my disease and stay on track. Now, I’m grateful my physician was insistent on the residential treatment. Once I started to open up and became honest, it was much easier physically and mentally. Treatment gives you the skills you need, but you still have to apply them.”

Hope for Recovery
Both Grasso and Lavey came from good homes, with supportive families, and they are doing well today, monitoring their disease and trying to give back in some way. Grasso lives in New York and says she would be lying if she said the illness was something of the past. “After battling it for 10 years, sustaining a full recovery will be a lifelong process… but I take it day by day.” She is currently pursuing her dream of working in the fashion industry. Due to her illness and hospitalization, she was forced to give up an internship with Teen Vogue a few summers ago. Since then, she has been featured on the magazine’s website for her volunteer work with the National Eating Disorders Association (NEDA).

Lavey now realizes there wasn’t a single cause for her disease, but a series of events she could not cope with. She even gave a presentation on learning to accept yourself for an Active Minds’ Speak Out-Reach Out program intended to build awareness of mental illness among college students. “Now, I know the only person I need to please is me,” she said, “and I’m accountable. People who know me recognize when I’m not doing well. As much as you want to believe you’re in control of the disease, it controls you if you don’t have the right skills to cut it off. People deserve a real shot at life, and treatment gives you that shot. Rogers gave me the tools.”

Both stress the importance of seeking treatment and building awareness of the disease. “Mental illness can affect anyone,” Lavey said, “but having an ED doesn’t necessarily mean you’re totally incapacitated or crazy. You can actually appear to be carrying on with life.”

Grasso agreed. “There are so many stereotypes that perpetuate the struggles for those who suffer,” she said. “EDs manifest in all shapes and sizes and are far from chic. Premature aging, hair loss, infertility, feeding tubes… they are destructive, maddening and deeply painful, both emotionally and physically. There is no lonelier place than an ED.”

Specialized Treatment for Children and Adolescents
A nationally respected leader in the treatment of eating disorders, Rogers Memorial Hospital is one of very few facilities in the United States that treats children and adolescents on a specialized inpatient ED unit. Children are monitored by a medical physician who has an extensive background in managing medical complications of EDs. The program uses evidence-based treatment components, including family education, nutrition, experiential therapy, cognitive-behavioral therapy and a newly proven approach to ED treatment – dialectical behavior therapy. The staff works with each patient to achieve nutritional stability, identify and correct errors in thinking, and address obstacles to recovery. Specialized programs are aimed at getting to the core issue through custom, hands-on therapy by some of the country’s leading ED specialists. All ED programs are overseen by three full-time board-certified psychiatrists who specialize in treating EDs (Dr. Theodore Weltzin, Dr. Tracey Cornella-Carlson and Dr. Brad Smith) and focus on addressing each patient nutritionally and psychologically, as well as managing the medical issues common to EDs.

To learn more about treatment for eating disorders at Rogers Memorial Hospital, call 800-767-4411 or visit RogersHospital.org.