Photo courtesy of Alsana.
Group therapy is a large part of dealing with eating disorders during a patient’s stay at Alsana.
Eating disorders are a severe condition of not just the body, but the mind.
Although the study of eating disorders is a young field, Margherita Mascolo explained, research has shown it is a dangerous and progressive mental illness that can damage every single organ and the whole body, “from the inside out.”
“It’s a very isolating disease, and we are social creatures by nature,” said Mascolo, who is chief medical officer of Alsana, the new residential eating disorder center that has opened in Birmingham. “What do we do to celebrate a birthday, a promotion, a wedding? We have a meal.”
On Jan. 28, the thirteenth Alsana eating disorder treatment center in the country opened up along the U.S. 280 corridor, at 5101 Cyrus Circle. It offers a residential program with an adapted care model for clients through their stages of recovery. Alsana’s existing intensive outpatient program, previously called Castlewood, has relocated to the new facility from Inverness.
The American Psychiatric Association describes eating disorders as illnesses where people experience severe disturbances in their eating behaviors, related thoughts and emotions, often with a pre-occupation about food and their bodies that limits them from participating in life.
Eating disorders manifest in a variety of ways, with the most common types including anorexia, where someone restricts calorie intake and the body is starved to get weight down; bulimia, where someone consumes food and then uses compensatory behaviors, like throwing up, exercising or taking laxatives to keep weight down; and binge eating, where a person eats objectively large amounts of food in a compulsive way. However, symptoms vary case by case and manifest in different ways and subtypes.
An eating disorder is complex and not just about behaviors, Alsana Senior Director of Clinical Services Amber Parris said, and ithas a psychological component that must also be treated.
Alsana approaches the eating disorder by trying to understand why it was necessary to the client to begin with. It also offers 24/7 RN nursing, the highest level of care without going to the hospital.
“That is one of the difficult things about
treating eating disorders, because the food and the body is a part of every human’s existence, right? Like we can’t get through our lives without feeding ourselves, and we can’t help it that we hold emotions in our bodies. This is how we are, a part of our biological makeup,” Parris said.
Out of all the psychiatric illnesses, eating disorders have some of the highest mortality rates. According to the National Institute of Mental Health, anorexia is the most fatal of all mental illnesses, with a mortality rate of about 10 percent. In addition, Parris said, suicide is a major risk for someone with an eating disorder, so mental health and eating disorders are entwined in understanding and appropriately treating them.
It is also important to note, Parris said, that eating disorders are progressive and can sometimes be hidden and manageable at first but eventually bleed into all areas of someone’s life. It can be difficult for a person to go to school or work because their mind is so preoccupied with distress over meal planning, calorie counts, weight and keeping the harmful behaviors hidden.
Photo by Alyx Chandler.
Clients work with therapists, dieticians, psychiatrists, nurses and in groups with peers during their stay. A typical day includes various types of group therapy, exposure to food and cooking in the kitchen, equine therapy and field trips that involve movement and fun in the fresh air.
“Over time, people stop engaging in life and start pulling away from what’s really important to them: relationships, jobs, really their value system. … The eating disorder becomes a way of survival and a way of living so it takes over all that once was important,” Parris said.
The residency at Alsana operates by making sure clients are medically stable and then re-introducing food in a manageable way, Parris said, so clients can safely explore their relationship with food and their bodies away from the world without outside shame.
Clients work with therapists, dieticians, psychiatrists, nurses and in groups with peers during their stay. A typical day includes various types of group therapy, exposure to food and cooking in the kitchen, equine therapy and field trips that involve movement and fun in the fresh air.
“There’s not a lot of resource centers in the Southeast. When people need to go to treatment, they have to hop on a plane and go across the country and that can often be a deterrent for people who need help,” Parris said. “… My heart behind this facility was to make it a place where people could come and be detached from the world and kind of escape and truly seek healing in an environment they want to be in.”
At the residential level of care, the typical stay is about 40 days, though outpatient and additional partial treatment usually extend the total care time to 90-120 days.
Parris said people don’t always recognize eating disorders because of the many misconceptions people have of them, especially in thinking that they mainly show in malnourished bodies. Most of the time, eating disorders aren’t distinguishable by the naked eye, she said, and many people who have them can be high-functioning, high-achieving and also hide a “secret life on the side” through an unhealthy way of treating their body.
“Oftentimes, I think it’s not until someone is medically compromised or they stop engaging in their life that they really start to notice. There’s a huge spectrum way before that where people are really struggling,” she said.
The feelings of shame and denial that come with eating disorders push people to hiding behaviors, which is why it’s so important to approach them “from a place of empathy and support and wanting to understand them and help them,” Mascolo said.
“[Eating disorders] affect people of all shapes and sizes, of all genders, of all socioeconomic classes. This isn’t a disease of white women, which is what the media has portrayed for so many years, and it’s not a disease about vanity,” Mascolo said, adding that many eating disorders go undiagnosed due to lack of knowledge or the inability to recognize symptoms.
Parris said people often ask what leads to an eating disorder, and she explains it is a result of many different things.
“There’s no one thing, but there’s something in someone’s life that was so painful, that was so unmanageable, so chaotic, so out of control, that it warranted a response from our clients to find a way to cope in their lives, and the way that they found involved food and body control,” Parris said.
Parris said Alsana works with all major insurance companies, which is the most frequent way people are able to come for treatment, though some people pay privately. Alsana also fights for single case agreements on the behalf of a client who is unable to come through insurance or other means.
Alsana offers a free online eating disorder support group and other resources at alsana.com. If you or someone you know may have an eating disorder, call or text the confidential helpline at 888-337-8776 to help understand the symptoms and how to proceed.
