Guided by her decades of experience in helping women, men and teens of all genders heal from eating disorders, Dr. Amy Boyers co-founded Galen Hope to offer clients the most effective therapies for anorexia, bulimia, binge-eating disorder and co-occurring disorders.
In this interview, Dr. Boyers discusses the challenges families face when their teen is struggling with an eating disorder, Galen Hope’s approach to treatment, and the remarkable transformation that can occur as clients gain confidence in their recovery.
Can you give us a sense of the things parents or caregivers should look for in recognizing that a child has an eating disorder?
It’s not easy for parents to recognize the signs and symptoms of an eating disorder.
A lot of times it will start with what seems like a really appropriate decision to be healthier. “I’m going to start to exercise more. I’m going to eat less junk food.” That’s music to every parent’s ears. To see your adolescent start to take more responsibility for their own well-being. We all wait for that.
Like they really are starting to think more like a young adult. This is the stuff we want them to do.
And then it moves from “I’m eating a little healthier,” or “I’m cleaning up my diet a little bit,” to wow, this is becoming really rigid. This is now impacting our ability to go out for dinner. Parents may notice there’s a lot more resistance around meals, or my child is no longer sitting with us at dinner. My child is insisting on eating in his or her room alone, or now my child has their own special foods. Or, I’m finding that I have to change the way I cook or the foods that we order to make sure that my child eats.
It’s a slow lowering of the bar. So sometimes parents don’t realize how low the weight has gotten or how restrictive the eating habits have become or how frequent the symptoms are.
For a lot of parents, if they have multiple children, if they have careers, you may not be with your children at every meal. Especially once they’re older and they’re leaving the house more and they’re going out with friends and they have activities after school. You may not know that your child didn’t eat dinner or if they ate dinner, they purged it afterward, because you just think they’re doing homework. You’re doing your thing. They’re doing theirs. After dinner, everyone kind of goes into their rooms, and the kids are doing their homework and on the phones with their friends.
So you may not be cued in to the number of symptoms that are actually happening right under your nose – until they rise to a level where either there’s a medical event or you actually see something. For example, you might notice something in the bathroom. You might notice that your child’s hair is falling out. You might notice that maybe your child is getting dizzy when they stand up, or they’ve fainted.
Sometimes it does have to rise to the level of a medical issue for this to be brought to the attention of the families. Bodies want to adapt. Our body will do its best to keep us going so it can be hard to recognize the symptoms.
Is there a sense of denial when someone has an eating disorder? What drives them to pick up the phone and call?
There are a few scenarios that we typically see.
One is someone who understands that they have an issue, that they have a problem that’s debilitating them, that’s impairing their ability to function, and they feel like they just can’t live this way anymore. Maybe they’ve been getting treatment in an outpatient setting and it’s just not enough. And so they may be looking for a more intensive experience.
But I would say that’s probably not the majority of the people who we hear from.
Typically, they have gotten feedback from maybe more than one person in their life, including a therapist who may know them very well. They are being told that they are just are not able to function the way they used to, that their problems are overwhelming the people around them, and that they seem to really be suffering. So that is often what will drive someone to call.
Oftentimes, someone who’s close to them will make that first call. It could be their therapist, a parent or a sibling. Sometimes that person will check out who we are, find out what we offer, and then bring that back to the person and say, “I found this program. I think this could be really helpful for you.”
Sometimes people are in a process of contemplating, “What do I need?” And so they’ve opened up their mind to the possibility that they need something more.
But maybe there are factors in their life that make it difficult to pull the trigger. Maybe they have a job. Maybe they’re close to the end of a semester. Maybe they have some sort of activity or project that they’re looking forward to in the near future. And they want to try to make it to that.
But what we see over and over again is that your mental health cannot wait. It’s not going to get better by muscling through and finishing whatever that is.
Sometimes people need to do that. There are very practical reasons why. There may be an obvious point where they can wind down that activity, like the end of a semester, and then start a program like this. But typically, that doesn’t work out very well for people, unfortunately.
Why is it crucial to treat both the eating disorder and other conditions that may contribute to it?
I always say that every eating disorder has a story, and the task of therapy is really to figure out what that story is.
A piece of the story may be told by the family. A piece of the story may be told by peeling away the eating disorder symptoms, stabilizing the eating disorder and seeing what’s underneath. And then part of the story will be told by the individual.
Our job as clinicians is to help put all those pieces together to create a coherent narrative. If there are other comorbid conditions, those are worthy of the same amount of attention and treatment as the eating disorder.
If we do not do a full exploration of what those issues are, that eating disorder is going to come back. Because not only is the eating disorder a disorder, it’s also a coping mechanism. It’s often something people use to keep a lid on other problems.
We, as a team, spend a lot of time thinking about who this person was before all this stuff started. What was important to them? Who were the people in their lives that were important to them? And we work with them from day one, even if they’re not ready to embrace that yet, to start to think about, “How am I going to reconnect to that?”
So when their life starts to look normal again, when they’re starting to have goals outside of treatment, that’s very exciting for us. They get a lot of applause in staff meetings.
We have a great time doing what we do. And even if a staff member isn’t on your team, that person may still play a very active role behind the scenes in our meetings, talking about things that they think could be helpful to a client. At Galen Hope, you don’t just interact with the people on your assigned team. You interact with just about everyone on the staff, and so you never know who’s going to come up with that suggestion that creates that breakthrough moment for somebody.
So everybody gets very excited about each individual person’s treatment plan.
Is there anything else you’d like to share?
One of the things that’s really important to me as a clinician, and it’s been a central focus for me as a psychologist, is this idea of becoming a well person.
That is not only a journey for the clients. It’s a journey for the families.
One of the things I think that we do really well, both in our family programming and in our work individually with families, is teaching them how to have a well child, whether that child is a child or an adult.
A lot of times that person has been treated like they are fragile. They’ve been identified as a person who’s been struggling, who can’t take on responsibility. And a lot of times we see at first that this person can do more. They’re ready. The family has to learn to relate to them in a new way and expect them to be well, rather than expect them to be unwell. That is something that we do really well as a program.
THE ROAD TO WELLNESS STARTS BY SEEKING HELP. TODAY.
Built on the principles of assertive community treatment, Galen Hope is an eating disorder and mental health treatment center offering individualized treatment options that include Intensive Outpatient (IOP) and Partial Hospitalization Programs (PHP). As a “Community of Integrated Wellness,” we pride ourselves in fostering a thoughtful and meaningful care experience that can guide our clients on their road to recovery and increased quality of life, regardless of diagnosis. Galen Hope currently offers separate, age-specific programming for female and transfeminine adolescents ages 12-17 and adults 18 and up, as well as gender-specific programming for males and transmasculine individuals with eating disorders and primary mental health diagnoses.
To learn more, or to join our community for integrated wellness, please contact us today.
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