What we treat

eating disorders 4

At the Center for the Treatment of Eating Disorders, our expertly trained staff has experience with the full spectrum of eating disorders. These disorders can affect the lives of patients in different ways — and can stem from different causes — which is why we’ve developed the skills to provide children, adolescents and adults with treatments that are tailored to a person’s individual situation.

Eating disorders come in many forms. The most common ones we treat include:

  • Anorexia nervosa: A disorder in which people obsess about their weight and what they eat. They maintain a body weight well below what’s normal for their height and age, often through starving or excessive exercise.

    Signs include:

    - Eating tiny portions, refusing to eat, not being hungry
    - Avoiding fat, sugar and meat
    - Intense fear of being or becoming fat
    - Feeling fat even though thin
    - Unusual eating habits
    - Exercising too much
    - Depression and low self-esteem
    - Withdrawing from family or friends
    - Perfectionism
    - Feeling “huge” after eating small portion and possibly purging

    Symptoms include:

    - Unhealthy weight loss (more than 15% of body weight or much weight loss in a short span of time)
    - Stomachaches, headaches, dizziness
    - Feeling cold much of the time
    - Constipation
    - Loss of muscles
    - Loss of menstrual periods
    - Weakening of bones
    - Heart rate, blood pressure and body temperature below normal
    - Brittle hair and nails, hair loss

  • Bulimia nervosa: A disorder in which there’s a cycle of binging and purging calories through actions like vomiting, laxatives or compulsive exercise. It’s related to self-image.

    Signs include:

    - Binge eating followed by purging
    - Unusual food choices or cravings
    - Vomiting, laxative use or diuretic use
    - Disappearing after eating, often to the bathroom
    - Excessive exercise to “get rid of” calories
    - Shame or guilt after eating
    - Feeling out of control about eating
    - Eating secretly or hiding food
    - Obsession about appearance and body
    - Depression and low self-esteem
    - Poor self-control in areas other than eating

    Symptoms include:
    - Frequent changes in weight
    - Stomach pain
    - Muscle weakness and tiredness
    - Constipation or diarrhea
    - Loss of dental enamel
    - Irregular menstrual periods
    - Enlargement of cheeks and neck
    - Changes in blood chemistry
    - Sore throat and swollen glands

  • Avoidant/restrictive food intake disorder (ARFID): Unlike people with disorders such as anorexia nervosa and bulimia nervosa, those with ARFID are not concerned about weight or appearance. They have issues consuming certain foods, which can lead to nutritional problems. ARFID often begins in infancy or childhood.

    Signs include:
    - Restricted eating or feeding
    - Inability to eat certain foods based on texture or smell
    - Excluding entire food groups
    - Avoiding situations with food

    Symptoms include:
    - Significant weight loss or failure to achieve expected weight gain
    - Significant nutritional deficiency
    - Dependence on oral nutritional supplements

  • Other specified feeding or eating disorder (OSFED): When a person has an eating disorder that does not meet the criteria for anorexia, bulimia, ARFID or binge eating disorder (episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances), he or she is diagnosed with OSFED. This could include:
    - Atypical anorexia nervosa (features of anorexia, without low weight)
    - Subthreshold bulimia nervosa (bulimia at a low frequency or short duration)
    - Purging disorder (when an individual purges but doesn’t binge)

The treatments that work

At Children’s, we use tried-and-true eating disorder treatments that are supported by medical studies. Therapy sessions may focus on discussing eating habits, relationships with others (such as interactions via social media), perfectionism, low self-esteem and developing healthy coping skills.

Here’s more information on some of our treatments:

Family-based therapy (FBT) is the leading treatment for eating disorders in children and adolescents. It’s also called the Maudsley Approach. Studies show that up to 75 to 90% of adolescents with anorexia nervosa are fully recovered by their five-year follow-up visit after FBT. This therapy has also been adapted for use in bulimia nervosa and atypical eating disorders, such as ARFID. In FBT, parents are seen as the best resource for their child’s recovery and play an active and positive role in order to help their child to:

  • Return to a healthy weight and growth pattern
  • Resume normal eating 
  • Resume age-appropriate independence with eating 
  • Return to normal development

Enhanced cognitive behavioral therapy (CBT-E) is the leading evidence-based treatment for all eating disorder diagnoses in adults, and has been adapted for use with adolescents. It is designed to produce changes in thinking (cognitive change), and focuses on what is keeping the eating problem going. The therapy is tailored to a specific eating problem. The patient and the therapist will become experts in the eating problem and what is keeping it going, and will work as a team to help overcome the eating problem. The patient will be given tasks to complete between therapy sessions to assist in making changes. Depending on a person’s needs, the patient and the therapist may work on:

  • Over-evaluation of shape and weight
  • Dietary rules and under-eating 
  • Being underweight 
  • Mood-related changes in eating 
  • Low self-esteem 
  • Perfectionism 
  • Interpersonal problems

Additional information on this treatment method is available here.

Interpersonal therapy (IPT) is a time-limited, focused therapy developed for the treatment of depression that has been adapted for eating disorders and a range of age groups including adolescents and adults. It recognizes the importance of current interpersonal relationships in the recovery process. Interpersonal therapy is recommended in the National Institute for Clinical Excellence (NICE) guidelines for the treatment of depression and eating disorders.

Cognitive remediation therapy (CRT) has been described as “thinking about thinking” therapy. It was initially developed for patients with brain injuries. The therapy uses simple exercises to strengthen thinking skills. Research in patients with eating disorders has shown that these patients also have deficits in their thinking. In particular, patients with eating disorders tend to have inflexible thinking and difficulty seeing the “big picture.” CRT uses exercises and games to help patients improve their thinking and learn new strategies to solve problems.

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is an individual treatment developed to treat anxiety and mood disorders. The UP uses principles and strategies that come from cognitive-behavioral therapy (CBT) and from theories of emotion regulation. Therapy is personalized to meet individual needs, and may include several of the following goals and strategies:

  • Awareness and interpretation of emotional experiences
  • Identification and prevention of problematic behaviors that are driven by emotions
  • Identification and interpretation of physical sensations in an accurate and adaptive way
  • Exposure to thoughts or situations that trigger emotional responses

The method that’s best for you

We see most of our patients in our outpatient, or clinic, program, but if you or your child needs medical care for an eating disorder, we may arrange a stay in our inpatient, or hospital, program. We’re the only hospital-based eating disorder program in the Twin Cities to offer immediate inpatient care 24 hours a day for patients who need medical treatment. We offer separate inpatient units for children and adults. Younger patients stay at Children’s Hospitals and Clinics of Minnesota, while our adult inpatient program is located at Abbott Northwestern Hospital.

During a hospital stay, we will help you or your child attain a more stable medical condition and prepare for outpatient treatment. We’ll also teach you and your family strategies to make positive changes at home.

And as an organization dedicated to family-centered care, we offer many child and family services and resources, such as interpretive services.


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