Eating disorders are complex problems with psychological, emotional, nutritional, and biochemical components.
At ‘Ai Pono Eating Disorder Program, your eating disorder will always be the primary focus of your treatment and looking at your relationship to food and specific eating behaviors are necessary starting points. In order to effectively and sustainably treat eating disorders, however, we must use a multimodal and holistic approach in order to uncover and address the roots of the eating disorder that are underneath the eating and food-related behaviors that appear on the surface. Only when we are able to address these core issues is full recovery from an eating disorder possible.
100% recovery from an eating disorder is possible.
specializations
eating disorders treated
Anorexia Nervosa
Inadequate food intake leading to a weight that is clearly too low.
Intense fear of weight gain, obsession with weight, and persistent behavior to prevent weight gain.
Self-esteem overly related to body image.
Inability to appreciate the severity of the situation.
Binge-Eating/Purging Type involves binge eating and/or purging behaviors during the last three months.
Restricting Type does not involve binge eating or purging.
Binge Eating Disorder
Frequent episodes of consuming very large amounts of food but without behaviors to prevent weight gain, such as self-induced vomiting.
A feeling of being out of control during the binge eating episodes.
Feelings of strong shame or guilt regarding the binge eating.
Indications that the binge eating is out of control, such as eating when not hungry, eating to the point of discomfort, or eating alone because of shame about the behavior.
Bulimia Nervosa
Frequent episodes of consuming very large amount of food followed by behaviors to prevent weight gain, such self-induced vomiting and/or excessive exercise.
A feeling of being out of control during the binge-eating episodes.
Self-esteem overly related to body image.
Avoidant Restrictive Food Intake Disorder (ARFID)
A lack of interest in eating or food or avoidance of food based on the specific characteristics of it. An individual is typically overly or inappropriately concerned about the consequences of eating, resulting in a failure to meet nutritional and/or energy needs.
Common behavior changes or signs of developing Orthorexia include:
Significant weight loss (or failure to achieve expected weight gain or faltering growth in children)
Significant nutritional deficiency
Dependence on enteral feeding or oral nutritional supplements
Marked interference with psychosocial functioning
Additional Feeding or Eating Disorders
A feeding or eating disorder that causes significant distress or impairment, but does not meet the criteria for another feeding or eating disorder.
Examples include:
Atypical anorexia nervosa (weight is not below normal)
Bulimia nervosa (with less frequent behaviors)
Binge-eating disorder (with less frequent occurrences)
Purging disorder (purging without binge eating)
Night eating syndrome (excessive nighttime food consumption)
Avoidant/Restrictive Food Intake Disorder
Pica
Orthorexia
*It is important to note that Orthorexia, or Orthorexia Nervosa, has not yet been identified as a primary, diagnosable eating disorder in the most recent version of the Diagnostics and Statistics Manual. If you identify as having symptoms of Orthorexia, please refer here for more information.
Orthorexia describes a condition that entails an obsession with what have been identified with “healthy” or “clean” foods. Orthorexia sufferers often display signs and symptoms of anxiety disorders that frequently co-occur with anorexia nervosa or other eating disorders.
Common behavior changes or signs of developing Orthorexia include:
Compulsive checking of ingredient lists and nutritional labels and an increased concern about the nutritional content of foods
Ceasing consumption of entire food groups (all sugar, all carbs, all dairy, all meat, all animal products)
An inability to eat anything but a selective group of foods that are determined to be ‘healthy’ or ‘pure’
Unusual interest in the nutritional content of what others are eating
Spending excessive time thinking about what food might be available at upcoming events
Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available
Obsessive following of food and ‘healthy lifestyle’ blogs on social media
Body image concerns may or may not be present
More information for those struggling with symptoms of Orthorexia can be found here.
treating co-occurring issues
When treating an eating disorder, it is essential to address any co-occurring issues or disorders that may impact the eating disorder. Without addressing these underlying or co-occurring issues, complete recovery from the eating disorder will not be possible.
Depression
Major Depressive Disorder or clinical depression is a relatively common mood disorder, particularly for those with eating disorders. Depression does not just affect mood and emotional state, however, it can also result in pronounced physical symptoms.
Depressed mood most of the day, nearly every day.
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
Diminished ability to think or concentrate, or indecisiveness, nearly every day.
Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Anxiety
Anxiety and eating disorders often go hand-in-hand. According to the National Eating Disorder Association, 48-51% of people with Anorexia Nervosa, 54-81% of people with Bulimia Nervosa, and 55-65% of people with Binge Eating Disorder are also diagnosed with anxiety disorder. Symptoms of an anxiety disorder may include:
Excessive worry that is difficult to control and has caused significant distress or impairment in social occupational, or other important areas of functioning.
Restlessness or feeling keyed up or on edge.
Being easily fatigued.
Difficulty concentrating or mind going blank.
Irritability.
Muscle tension
Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep)
PTSD
PTSD stands for Post Traumatic Stress Disorder. PSTD can occur as the result of witnessing a single traumatic event or after exposure to a series or traumatic events or circumstances.
PTSD and eating disorder behavior is quite common and they share some similarities. For one, they both involve dissociation. Eating disorder behaviors may be a way to distract or distance a person from their disturbing thoughts, emotions, or memories associated with trauma. PSTD can look like:
Reoccurring, involuntary, and intrusive upsetting memories
Upsetting dreams that may disturb sleep
Flashbacks
Distress upon exposure to triggers that remind you of a particular event or time
Avoidance of thoughts, feelings, physical sensations, people, places, conversations, activities, objects, or situations that bring up memories of the trauma
inability to remember parts of your experience around a particular trauma or in general
Thinking negatively of yourself, others, or the world and inability to feel or express positive emotions
Loss of interest in people or activities and feeling detached from those around you
Body Dysmorphia
Like many of the other co-occurring disorders mentioned, body dysmorphia, or Body Dysmorphic Disorder, commonly co-occurs with eating disorders and can be a huge barrier to recovery if it is not identified, understood, and dealt with as part of the overall treatment plan.
- Preoccupation with perceived flaws in appearance that others don’t see
- Believing that you are ugly, deformed, or less than due to defects in your appearance
- Belief that others view your appearance in a negative way or mock you
- Frequently checking the mirror, grooming or skin picking
- Over-attention to makeup, or clothes to attempt to hide perceived flaws
- Constantly comparing yourself to others
- Frequently asking for reassurance about your appearance
- Having perfectionist tendencies
- Seeking cosmetic procedures with little satisfaction
- Avoiding social situations due to your negative perception of your appearance
Not sure if ‘Ai Pono is the right fit for you?
Call us today for a free phone assessment.
During your assessment you will be introduced to a member of our Admissions Team who will ask you some questions about your struggles with food and eating to see if ‘Ai Pono Hawaii is the right fit for you.
