Anorexia nervosa and bulimia nervosa –disorders characterized by extreme eating behavior and distorted body image – are among the deadliest of psychiatric disorders, with few proven effective treatments.A landmark study, with first author Tyson Oberndorfer, MD, and led by Walter H. Kaye, MD, professor of psychiatry at the University of California, San Diego School of Medicine, suggests that the altered function of neural circuitry contributes to restricted eating in anorexia and overeating in bulimia.
The research, published June 4 in the early on-line edition of the American Journal of Psychiatry, may offer a pathway to new and more effective treatments for these serious eating disorders.“It has been unknown whether individuals with anorexia or bulimia have a disturbance in the system that regulates appetite in the brain, or whether eating behavior is driven by other phenomena, such as an obsessional preoccupation with body image,” said Kaye, director of the UCSD Eating Disorders Treatment and Research Program.
Adult ProgramsWe work with adults, of all ages and genders, struggling with difficulties with eating, weight, and/or food. We offer all levels of care, low-cost supportive housing, and a wide-range of evidence-based treatments that are tailored to your specific symptoms and goals. If you’d like a free phone-consultation with one of our therapists, and we will schedule a call with you. Testimonials “This program literally saved my life. I felt cared about and supported the whole way through and it was amazing being in a group of people who were going through the same thing and could understand how I was feeling.
It made me feel less alone and more confident that I could find a life outside my eating disorder. I finally have built a life that I can enjoy living and now have so many skills to troubleshoot tough times and thoughts. I am so thankful for program!!”Philosophy and Treatment ApproachOver the past decade, there have been tremendous advances in science that have revolutionized our understanding of eating disorders.
Technological tools such as functional magnetic resonance imaging (fMRI) have now substantiated that eating disorders have a powerful neurobiological basis. Researchers have identified specific neurobiological differences in the brains of people with eating disorders that affect how they eat, how they feel (their emotional experience), and how they make decisions.
This explains why eating disorders tend to run in families and why people with eating disorders often exhibit certain personality traits. For example, individuals with anorexia nervosa tend to be driven, perfectionistic, harm-avoidant, and obsessional. Individuals with bulimia nervosa or binge eating disorder also tend to be perfectionistic and harm-avoidant, but also impulsive and novelty-seeking.We also know that people with eating disorders struggle with emotion regulation, or the ability to successfully manage their emotions in flexible, effective ways. Some people with eating disorders are highly sensitive to emotion and experience their feelings very intensely, which is overwhelming and leads to ineffective or destructive behavior. Many of our patients have alexithymia, or difficulty identifying, labeling, and/or expressing emotion. People with eating disorders tend to be prone to anxiety and depression.
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For these reasons, the Adult Program uses Dialectical Behavior Therapy (DBT), an evidence-based treatment that is considered the “gold standard” for treating emotion regulation problems. Comprehensive or “fully adherent” DBT includes 4 components: 1) individual therapy, 2) DBT skills groups, 3) phone coaching, and 4) a consultation team to help the therapist deliver the treatment correctly and effectively. The Adult Program has all of these components, and our treatment team has been intensively trained in DBT.
Four Components of DBT. individual therapy. DBT skills groups. phone coaching.
consultation teamDBT skills groups teach strategies to increase mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation. This is a key component of DBT, and our program offers an intensive “dose” of these skills through the standard DBT groups as well as supplemental DBT groups. The phone coaching component is designed to help patients apply these skills outside of the treatment.
Patients are encouraged to call their therapist when they are having strong urges or difficulty applying a skill in their daily life.In addition to DBT, we incorporate other evidence-based treatments such as Cognitive-Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT). Our program also offers new, promising treatments such as Radical Openness DBT (RO- DBT). Whereas standard DBT was designed for patients who lack control over their emotions (“under-controlled”) RO-DBT focuses on problems of “over-control.” There is a growing evidence base for RO-DBT for individuals with anorexia nervosa.Finally, because we recognize that intensive treatment is well, intense, we have groups like expressive arts and yoga. Part of what we are teaching is balance in all things, and combining “heavier” treatments with more light-hearted ones is important! Treatment ProgramsWe provide several, helping people to re-integrate back into their lives while building lasting recovery and preventing future relapses. You can to determine the right level of care for your symptoms and your goals.
Our IOP curriculum is designed as a step-down from PHP with two primary goals: 1.) relapse prevention, and 2.) a smooth transition from treatment to life building.Consistent with the DBT model, IOP patients are encouraged to contact their primary therapists outside of program, while returning to jobs, school, relationships, hobbies—using text and phone support to help coping skills generalize to the stressors of everyday life. Your IOP treatment plan may also consist of practice with grocery shopping, meal planning, cooking, creating resumes, practicing interviewing, and many other skills as you transition fully into recovery. What does IOP include?. Mood disorder Major Depressive Disorder or Bipolar Disorder. Anxiety disorder Obsessive-Compulsive Disorder/OCD, Social Anxiety, Posttraumatic Stress Disorder/PTSD, Generalized Anxiety Disorder. Personality disorder such as Borderline Personality Disorder/BPD. Substance Abuse or DependenceOur primary treatment approach, DBT, has been shown to be effective in treating many components of these comorbid disorders.
However, in order to provide more comprehensive treatment for some of these disorders, we offer “tracks” that involve specialized programming that is imbedded into the schedule of the treatment program. Substance Abuse/ Co-Occurring Disorders.
Patients who engage in problematic substance use or abuse are recommended for this track. The therapists and medical professionals that work with our COD patients have extensive experience treating substance use disorders and follow evidence-based practices. Our COD team works with patients to determine what approach to substance use is most effective for them, whether it is abstinence, harm reduction, or dialectical abstinence.
We can offer or conduct urine toxes (“u-toxes”) when appropriate, and have the ability to detox patients in our setting.Our COD track includes groups such as.