Monthly Archives - March 2019

What is Bulimia Nervosa?

Bulimia nervosa is a serious eating disorder that requires a comprehensive treatment program for successful recovery. Like other eating disorders, bulimia is complicated and not fully understood, but some of the contributing factors include genetics, environment, psychological, and cultural influences.

According to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, bulimia nervosa is characterized by the following:

  • Recurrent episodes of binge eating (characterized by eating large amounts of food in a short period and a sense of loss of control over eating behaviors)
  • Use of inappropriate compensatory behaviors, such as self-induced vomiting, laxative or diuretic abuse, fasting and/or obsessive exercise
  • The binge eating, and compensatory behaviors occur at least once a week for three months
  • Self-evaluation is inappropriately influenced by the person’s weight and shape
  • The disturbance does not occur exclusively during episodes of anorexia nervosa

Signs and Symptoms of Bulimia Nervosa

Individuals suffering from bulimia may show several signs as a direct result of self-induced vomiting or purging, and even more so if the binge-purge cycle is repeated often. Other signs and symptoms of bulimia can include:

  • Noticeable weight fluctuations
  • Skipping meals or taking small portions of food at regular meals
  • Stealing or hoarding food in strange places
  • Drinking excess amounts of water or non-caloric beverages
  • Excessive, rigid exercise regimen
  • Unusual swelling of the cheeks or jaw area
  • Calluses on the back of the hands and knuckles
  • Discoloration or staining of the teeth
  • Creation of complex lifestyle schedules or rituals (to allow time for binge eating and purging sessions)
  • Withdrawal from friends, family, and/or activities
  • Behaviors and attitudes indicating a preoccupation with the importance of weight loss, dieting, and control of food
  • Self-evaluation is inappropriately influenced by the person’s weight and shape
  • Extreme mood swings

Health Consequences of Bulimia Nervosa

The binge-purge cycle of bulimia can damage your body, and as it worsens, the symptoms and consequences become more severe. Complications from the disorder can include, but are not limited to the following:

  • Electrolyte imbalance (can lead to irregular heartbeats and possibly heart failure and death)
  • Inflammation and/or rupture of the esophagus
  • Chronic sore throat
  • Tooth decay and/or staining
  • Chronic irregular bowel movements and constipation
  • Pancreatitis
  • Gastric rupture
  • Hair loss
  • Depression
  • Chest pain

How We Treat

Bulimia nervosa can be life-threating, but recovery is possible with a comprehensive treatment program that addresses the specific needs of the client. At River Centre, our professional treatment team works with the client and their families to customize a treatment plan. We combine evidence-based therapeutic interventions with support and individual attention to help clients address the underlying issues of their eating disorder.

Clinical treatment approaches include:

  • Enhanced Cognitive-Behavioral Therapy
  • Individual Therapy
  • Group Therapy
  • Family Therapy
  • Nutritional Rehabilitation
  • Medical and Medication Services

Our treatment program offers a comprehensive spectrum of services for treating eating disorders and co-occurring conditions such as low self-esteem, depression, anxiety, OCD, and trauma. The levels of care we provide help to target the needs of our clients.

Bulimia Treatment at River Centre

You do not have to be alone in your struggle; River Centre is here for you. If you or a loved one would like more information about bulimia treatment, call us today at 866.915.8577 or complete our contact form. Our admissions team is here to assist you.

Vegetables and Fruit Heart Shaped

The Role of a Registered Dietitian

An important part of National Nutrition Month® is Registered Dietitian Nutritionist Day, a time to increase awareness of this important role and recognize them for their commitment to helping people enjoy healthy lives. Since eating disorders are complex, it is important to have a diverse, and collaborative treatment team. In addition to therapists, psychiatrists, nurses, and family members, an experienced and knowledgeable dietitian is vital to positive treatment outcomes.

What does it mean to be a dietitian?

Amy Good, RD, LD, River Centre Dietitian, shares, “Being a dietitian, to me, is an important role. More than ever before, we are being inundated with nutrition information, much of which is conflicting and confusing to the layperson. Working with individuals with eating disorders has really opened my eyes to this problem. Before, I understood there was a lot of misinformation regarding nutrition, but it wasn’t until I saw this misinformation pushing someone into disordered eating that I realized how significant of an issue it is.”

At River Centre, Amy meets with clients to evaluate their nutritional deficiencies, unhealthy food, and weight-related behaviors. Using a thorough assessment, she learns more about the client’s current dietary intake, eating patterns, beliefs about food and weight, supplement use, and overall weight history. In addition to assessing clients, Amy listens to clients to gain a better understanding of their emotions around food and helps set goals to meet their specific needs. The valuable insight she gains about client’s emotional connection to food helps therapists and psychiatrists work through the contributing factors related to their eating disorder.

With many myths around food and nutrition, Amy uses one-on-one nutrition counseling sessions to help educate clients as they work through these misconceptions. “I take my role of deciphering nutrition information very seriously. My goal is to help individuals understand how nutrition plays a role in their health and how they can improve their nutritional status and take back the control over their life that they had previously been giving to food. I have found immense satisfaction in observing my clients have “aha moments” where they are able to connect the dots of nutrition misinformation they believed, the truth about nutrition that I’m able to teach them, and the connection this has to their disordered eating habits. This moment is a catalyst for change in the recovery process and I couldn’t be more honored to help someone discover it.”

In addition to working directly with clients, she monitors weight trends, creates nutritional activities, and researches guidelines and nutritional information to incorporate into the treatment program.

Nutritional Care at River Centre

Our approach to re-nutrition is non-judgmental, allowing our clients to explore the fundamental psychological issues causing or maintaining their eating disorder. A supportive, structured meal plan is individually tailored to each client to help them achieve and maintain healthy body weight, but more importantly, to help them become more comfortable around the process of eating. We focus on helping clients feel secure in expressing the emotions triggered food and eating. The family plays an important role in successful recovery, therefore; we encourage their involvement. When clinically appropriate, we provide hands-on training to family members in learning and practicing skills to make off-campus meals a success.

We know that most people suffering from an eating disorder have great apprehension around meals. We are committed to providing a clear rationale and explain the details behind our nutritional rehabilitation.

If you or someone you know is suffering from an eating disorder, River Centre can help.  Call our admissions team today at 866.915.8577 or complete our contact form for more information.


What is anorexia?

Anorexia nervosa is a serious mental illness characterized by significant weight loss; difficulties maintaining appropriate body weight and, for some, body dysmorphia.  At any given time, anorexia nervosa will affect 0.3-0.4% of young women and 0.1% of young men, and it has the highest mortality rate of any mental illness.

The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition states the following are present in all diagnosed cases of anorexia nervosa:

  • Restriction of energy intake, resulting in significantly low body weight
  • Intense fear of gaining weight or becoming fat (despite having a significantly low body weight)
  • Disturbance in the experience of body weight or shape; undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight

Although all criteria from the DSM-5 may not be met, a serious eating disorder may still be present.

Signs and Symptoms of Anorexia Nervosa

You cannot tell if someone is struggling with anorexia just by looking at them; individuals do not need to be underweight or emaciated to have the disorder. Symptoms of anorexia nervosa vary on the length and severity of the disorder, and may include the following:

  • Weight loss (significant or sudden)
  • Preoccupation with weight, body, food, calories, fat grams, exercise and/or dieting
  • Refusal to eat certain foods or food groups
  • Complaints of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
  • Distorted self-image
  • Expressed anxiety about gaining weight or being “fat”
  • Denial of hunger
  • Development of food rituals (e.g. eating foods in certain orders, excessive chewing, rearranging food on a plate)
  • Avoidance of meals as well as other situations involving food
  • Participation in an excessive, rigid exercise regimen
  • Engage in compensatory behaviors (subjective bingeing, purging, laxatives, exercise)
  • Withdrawal from friends, family and/or activities
  • Increased irritability
  • Concern about eating in public
  • Limited insight into and/or denial of the above mentioned unhealthy behavioral or cognitive patterns
  • Primary amenorrhea (failure to start menstrual cycle)
  • Secondary amenorrhea (loss of period) or has irregular periods
  • Difficulty concentrating
  • Dizziness
  • Dental issues, such as enamel erosion, cavities, and tooth sensitivity

Health Consequences of Anorexia Nervosa

Anorexia can seriously damage your body, as it takes a greater physical toll than most other mental health conditions. Some of the physical consequences can appear:

  • Slow heart rate and low blood pressure; the risk for heart failure increases, as heart rate and blood pressure decrease
  • Reduction of bone density (dry, brittle bones); the risk for osteoporosis/osteopenia increases as bone density decreases
  • Muscle loss and weakness
  • Dehydration (which can result in kidney failure)
  • Fainting, fatigue, and overall weakness
  • Dry hair and skin, hair loss
  • Growth of a downy layer of hair (lanugo) all over the body, including the face, to keep the body warm

 How We Treat

Anorexia can be severe, and even deadly. Without treatment between 5-20% of individuals with anorexia will die from the condition, with treatment the number decreases to 2-3%.  At the River Centre Clinic, we provide an individualized treatment plan designed to meet the specific needs of each client.

Clinical treatment approaches include:

  • Enhanced Cognitive-Behavioral Therapy
  • Individual Therapy
  • Group Therapy
  • Family Therapy
  • Nutritional Rehabilitation
  • Medical and Medication Services

Our highly skilled interdisciplinary team members work closely with clients to design a treatment plan based on the initial assessment and then apply that plan within the framework of evidence-based treatment principles. Clients play a vital role in helping set realistic treatment goals that will help them address the underlying issues of their eating disorder.

Anorexia Treatment at River Centre

You are not alone in your eating disorder; River Centre is here for you. If you or a loved one would like more information about our treatment of anorexia in our programs, call us today at 866.915.8577 or complete our contact form.  Our admissions team is here to assist you.