The road to recovery for individuals facing an eating disorder takes strength, stamina and perseverance. Those who are coping often benefit from a team of professionals that truly care about their patients. They require a team that has developed a comprehensive, personalized and intimate treatment plan for them to follow. That team can be found at Oliver-Pyatt Centers. Our team understands every individual comes from a different background bringing unique challenges and traits along with them. Our professionals work one-on-one with patients to provide a treatment catering to their specific needs and maximizing their chances for a full recovery.
Patients are the number one priority at Oliver-Pyatt Centers. They are treated in an intimate environment with a high staff-to-patient ratio. Treatment plans are highly customized and include thorough medical and psychiatric care to patients, individual psychotherapy, daily exposure therapy and extensive aftercare planning. Each particular program acts as a catalyst to the patients healing process and brings hope for their future following treatment.
In 2008, Oliver-Pyatt Centers opened Casa Rosada; as the first Casa (house) welcoming young women struggling with eating disorders to begin their holistic road to recovery. Clinical Director, Dr. Casey Fields, oversees the multidisciplinary team here that ensures sustainable recovery for patients.
“It is difficult to choose one part of my experience at Oliver-Pyatt Centers that was most meaningful. I can’t speak highly enough of Oliver-Pyatt Centers. I have grown more here in the past four months than I have in the past few years. Oliver-Pyatt Centers as a whole has made me a better person and for that I am incredibly grateful. However, if I had to choose one part of my experience I would deem most meaningful, I would have to choose my experience with my primary therapist in Casa Rosada. I can’t thank her enough for her part in my growth.” – Client Testimony
Neighboring Casa Rosada is Casa Verde, Oliver-Pyatt Center’s second house which opened its’ doors in 2011. Clinical Director, Dr. Benaaz Russell oversees the team at this location and ensures the philosophy of collaboration is held among team members and outpatient providers.
Casa Azul is the most recent center established in 2013. Dr. Tali Yuz-Berliner acts as the clinical director at this location and works collaboratively with a team to create a personalized, attentive experience for each patient.
Each Oliver-Pyatt Centers’ home has no more than 12 patients attending at a time, allowing us to implement consistent care and personalized programming for all. We provide a safe space for each patient to reside while focusing on their own unique recovery. Patients are treated with the utmost of care and follow a particular treatment plan designed just for them. This is no ordinary treatment center, this is The Oliver-Pyatt Centers difference.
Chief Medical Officer Dr. Joel Jahraus, MD, FAED, CEDS is well-known and respected for his two decades of specialization in the medical management of patients with eating disorders. A board-certified physician for over 30 years, he is a recognized expert on diabetes and the medical complications of eating disorders. In this week’s blog post, Dr. Jahraus shares his insight and knowledge regarding diabulimia, a contemporary term for individuals with both Type I diabetes and an eating disorder where the individual purges by withholding his or her insulin.
1. How would you define diabulimia?
Diabulimia is a contemporary term for individuals with Type 1 diabetes and an eating disorder where the individual purges by withholding his or her insulin, thereby, making food ingested ineffective for use by the body. This action results in weight loss and severe systemic complications, including diabetic ketoacidosis which is potentially lethal.
2. Do you consider diabulimia to be a real diagnosis, or just a way to describe a variation of bulimia (since it is not specifically in the DSM 5)?
It is a contemporary word that bridges the terminology between diabetes and bulimia, but is not stated specifically as diabulimia as a mental health diagnosis in the DSM V.
3. How common is this type of eating disorder? Especially for women?
I co-chaired an international consensus panel on this evolving illness in 2009 in Minneapolis, MN. In doing that literature search we found it exists in the following percentages among different age populations:
2% of preteen girls
11-15% of midteen girls
30-39% of late teen girls
4. What are the top signs of this eating disorder?
The typical presentation is similar to other eating disorder patients with body image issues, and other mental health concerns. However, the difference is these individuals “purge” by withholding their insulin. Insulin is important in effectively utilizing calories ingested for health. Without insulin the body does not utilize these calories and the individual loses weight; the net impact is similar to anorexia or bulimia. However, the typical complications of diabetes are then much accelerated and the mortality or death rate from premature death increases dramatically:
Mortality rates (Nielson 2002):
Type 1 DM: 2.5%
Anorexia nervosa: 6.5%
Combined Type 1 DM and Anorexia nervosa: 34.8%
Jennifer Kreatsoulas, PhD, RYT is a yoga teacher and yoga therapist specializing in eating disorders and body image. In recovery herself, Jennifer is extremely passionate about helping others reconnect with their bodies and be empowered in their lives. Jennifer works with clients in person and via Skype. She also teaches yoga at the Monte Nido Eating Disorder Center of Philadelphia, is a partner with the Yoga and Body Image Coalition, and leads trauma-sensitive yoga classes. In this week’s post, Jennifer gives insight into her own recovery journey and how she learned to respect recovery as a lifestyle.
“I’m not going to help you manage an eating disorder,” my dietician flat out said to me shortly after I discharged from intensive outpatient treatment. “I’ll continue to work with you, but I won’t help you be a functioning anorexic.”
Whoa! Harsh, right? Brutally harsh, I’d say.
Her words hit me hard in the gut. I felt nauseas and defensive. I was at once insulted and found out by her remarks. After months of inpatient, day, and IOP treatment, and a commitment to long-term outpatient work with my team, I was insulted that my integrity and dedication to recovery wasn’t obvious. Had I not just left my family for a month, taken leave from my job, eaten meals I was terrified of, gained weight, persevered through calorie increases and exercise restriction, and turned myself inside out every day to heal my mind and body? Honestly, what else did she or anyone else want from me?
Still, way, way deep down, I knew my dietician was right. Yes, I had done and accomplished quite a bit during all that treatment; no one was taking that away from me. However, I admit, at the time, living as a “functioning anorexic” was quite appealing. The perfect solution.
If I could pull off being a “little sick and a little well,” if I could do just enough to keep my team and my family off my back, then surely, I’d be “doing” recovery. I’d just be doing it on my terms—or, I should say, the eating disorder’s terms. I’d prevent weight gain, still have room for a little hunger, and feel in charge of my life.
Living this way did not get me very far, and it wasn’t long before I was weary of performing, pretending, and being untruthful to myself and those I love. Merely functioning wasn’t as “safe” as I’d thought it would be. In fact, it was the exact opposite, as the threat of returning to treatment consistently came back in play every few weeks.
I may have dabbled with how “recovered” I was willing to be, but there was positively no way I would settle for being a chronically ill mother and wife. That’s where I drew the line.
And so, I kicked myself into gear by taking a more genuine and sincere approach to healing from rather than merely managing the eating disorder. I did this by adopting the attitude that recovery is a lifestyle, not a side job or something “extra” we must do.
Between therapy appointments and going to groups and keeping food logs, recovery can feel like a time-consuming side job. Over time, this attitude toward recovery can cause us to become resentful. The more resentful we become, the less motivated we are to keep up our efforts.
When respected as a lifestyle, recovery serves as the foundation from which we must attend to everything in our lives to keep us well and moving forward. To make recovery a lifestyle, I strive to let every choice I make be informed by this question: Is “x” going to support me in my healing or is it going to work against me?
Reflecting on this question guides me to honesty with myself about the people, places, and things in my life that merely help me manage an eating disorder versus those that support me in healthful ways. I choose to avoid the landmines and replace them with things that empower me and build me up. It’s not always easy, but this system of self-accountability has made a profound difference in my approach to recovery and deepened my commitment to myself.
Take a pause and ask yourself: Am I managing or healing the eating disorder? Are there thoughts, rituals, and behaviors in place that covertly are in cahoots with the eating disorder?
There’s no shame in your answer. What’s most important is taking this time to get brutally honest with yourself. I encourage you to tap into your resilience and slowly but steadily begin to loosen the grip on things that do not serve you in healthful ways and replace them with thoughts, rituals, and behaviors that do.
As you shift away from the “functioning” and “managing” mentality and embrace an intention of healing, life will ultimately become more filled with you and the goodness you have to offer this world—your gifts, talents, and passions. And I promise you, it is so worth it!