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What are Eating Disorders?

Eating disorders are serious and complex mental health conditions characterized by severe disturbances in eating behaviors and related thoughts and emotions.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) published by the American Psychiatric Association, there are several primary types of eating disorders, each with unique symptoms and diagnostic criteria:

1. Anorexia Nervosa: Characterized by restricted food intake leading to a significantly low body weight, an intense fear of gaining weight or becoming fat, and a distorted body image. Individuals with anorexia often deny the seriousness of their low body weight and may categorize themselves as overweight even when they are underweight.

2. Bulimia Nervosa: Involves episodes of eating an unusually large amount of food in a specific period of time (binge eating), followed by inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, misuse of laxatives, fasting, or excessive exercise. Like those with anorexia, individuals with bulimia are overly preoccupied with their body shape and weight.

3. Binge Eating Disorder: Similar to bulimia nervosa in terms of engaging in recurrent episodes of binge eating, but without the regular use of compensatory behaviors that characterize bulimia. Individuals with binge eating disorder often experience guilt, shame, and distress about their binge eating, which can lead to more binge eating.

4. Avoidant/Restrictive Food Intake Disorder (ARFID): Not just "picky eating," ARFID involves a disturbance in eating resulting in persistent failure to meet appropriate nutritional and/or energy needs. It may include an apparent lack of interest in eating or food, avoidance based on the sensory characteristics of food, or concern about aversive consequences of eating.

The DSM-5 criteria for these disorders emphasize that the eating behaviors negatively affect physical health or social functioning. The cause of eating disorders is believed to be a combination of genetic, biological, environmental, and psychological factors.

Treatment typically involves a comprehensive approach that includes medical and nutritional support, along with psychotherapy. Cognitive-behavioral therapy (CBT) is commonly used to address the underlying cognitive patterns that contribute to the disorder. Treatment teams often include psychologists, psychiatrists, dietitians, and other health professionals to address the full spectrum of needs associated with eating disorders.

Frequently Asked Questions

Services

What types of services do you provide?

We provide two main services: psychopharmacology evaluations and medication management. First, you’ll meet with a provider for an evaluation to determine your treatment plan, which may include medication, therapy, lifestyle changes, or other recommendations. Second, if medication is appropriate, our providers will help you manage and adjust your medication to make sure it works effectively.

What is the difference between therapy and medication management?

Therapy, sometimes called “talk therapy,” involves talking with a mental health professional to address mental health issues through dialogue and behavioral strategies. Medication management, on the other hand, is a medical approach where a mental health professional prescribes, monitors, and adjusts psychiatric medication to treat mental health conditions to address your physiological symptoms. Often, a combination of talk therapy and medication management is beneficial.

Does this replace my need for a therapist?

Our providers are here to address your concerns and offer support, but it’s important to note that they are not meant to replace a licensed therapist. Evidence suggests that for many mental health conditions, a combination of medication and psychotherapy is the most effective approach.

How does online psychiatry work?

Virtual psychiatry works just like in-person psychiatry, except instead of sitting in a doctor’s office, you’ll talk to your provider during live video appointments.

What should I expect during a mental health assessment or evaluation?

You’ll connect 1:1 with your new provider to discuss your needs. If appropriate, they’ll prescribe medication and send it to your pharmacy of choice. Regular check-ins will help you track how you’re feeling and any side effects, and your provider will make any needed adjustments.

How do I prepare for my first appointment? How long are typical appointments?

Before your scheduled appointment, you’ll receive new patient forms, which you’ll need to complete in advance. We will also ask for your insurance information, a valid form of identification, a list of any of your current medications, and any relevant medical records or previous psychiatric evaluations.

Typical appointment times vary depending on the nature of your visit and your treatment plan. Initial consultations usually last around 60 minutes, during which you'll have an in-depth discussion with your provider. Follow-up appointments are typically shorter, ranging from 15 to 30 minutes, but this may be adjusted based on your specific needs and progress.

What should I do in case of an emergency or crisis?

If you’re having a medical or mental health emergency, call 911.

Call or text 833-773-2445 for 24/7 Crisis and Mental Health Support from the Massachusetts Behavioral Health Help Line.

How do I schedule an appointment?

To schedule an appointment, please fill out our Appointment Request Form. Someone from the Monomoy Health team will contact you for more information and to help schedule your first appointment. We look forward to working with you!

Do you offer virtual/online appointments?

Yes, we offer virtual appointments. That means you can meet with your provider from the comfort of your home. We recommend choosing a well-lit and quiet space for your meeting.

Are my appointments and information confidential?

Yes. We adhere to the highest standards of privacy and confidentiality to ensure that your personal and medical information is safe, and privacy is a top priority in our practice. For more information, please download our HIPAA policy.