Eating Disorder Therapy

Intensive OCD and Eating Disorders Treatment

Castlewood stands out from most facilities because of our dedication to treating OCD and eating disorders simultaneously and intensively. Clients with both a significant anxiety disorder, as well as an eating disorder, need an individualized plan that provides equal attention to each issue. As eating disorder symptoms improve, it is not unusual for the anxiety symptoms to worsen. If only the eating disorder is addressed during active treatment, then after discharge the anxiety symptoms can escalate to the point that eating disorder recovery is negatively impacted. For this reason, all Castlewood clients with eating disorders and OCD (or other types of anxiety issues) receive simultaneous treatment from a dedicated staff of skilled anxiety therapists and eating disorder clinicians.

Understanding Eating Disorders and OCD

OCD, or Obsessive Compulsive Disorder, is an anxiety disorder. OCD is characterized by having obsessions or compulsions that are so severe that they interfere with daily life. Obsessions are persistent and intrusive thoughts and ideas. Compulsions are repetitive behaviors (rituals) that are used in order to relieve the distress that someone is feeling. For some people, food and eating behaviors are used to control the severe feelings of anxiety that they experience.

Some commons compulsions seen in clients with OCD and Eating Disorders include:

  • Weighing multiple times a day
  • Body checking compulsions
  • Extensive food rituals
  •  Compulsive hand or body washing
  • Compulsive behaviors unrelated to food or weight as would be typical of a client with OCD and no eating disorder

Clients with eating disorders and OCD may frequently have obsessions including:

  • Fear of gaining weight or “being fat”
  • Self-loathing thoughts related to body size or a particular body part
  • Obsessive worry related to appearance or clothing
  • Fear of food  or germ contamination
  • Obsessions unrelated to food, body or weight as seen in someone suffering from OCD without an eating disorder
OCD, when combined with an eating disorder, produces a cycle of emotion and activity that is viciously cyclic, and almost impossible to break out of without professional help for both the anxiety disorder and the eating disorder components. OCD often develops in childhood or during the teenage years, and strikes both male and females. Often someone with OCD (or other anxiety disorders) will avoid situations that trigger their obsessive thoughts. Avoidance is a major focus of therapy in someone with anxiety.

OCD and Eating Disorder Treatment Approaches

In addition to eating disorders, someone with OCD may also have depression, addiction issues, and other types of anxiety. Our OCD and eating disorder treatment team includes clinicians with sub-specialties and experience in these areas, so that a comprehensive care plan can be developed for each client’s unique set of needs. Severe OCD, whether with associated eating disorders, addiction, or depression, typically requires psychotherapy, medication, or a combination of both treatments. Psychotherapy approaches at Castlewood include Cognitive Behavior Therapy, in particular exposure and response prevention therapy (ERP). ERP therapy helps clients gradually face fears and anxieties in a gradual and supported manner. Clients are asked to identify situations that provoke anxiety (situations that are typically avoided, or are difficult to experience with utilizing rituals), and then gradually and repeatedly are exposed to these situations. For someone with OCD, this may mean not engaging in rituals and compulsive behaviors. With consistent exposure to feared situations, clients allow themselves to see that what they fear will happen in the anxiety-provoking situation will not actually occur, and that rituals are not needed to control the anxiety response. ERP therapy helps reduce anxiety in a naturally progressive manner. Antianxiety medication and antidepressants are the most common drugs prescribed for the early treatment phases of OCD and eating disorders. The ultimate goal is to help clients learn to manage both their anxiety and eating disorder through skill development and reinforcement, so that pharmaceutical management isn’t necessary. At Castlewood, each client works closely with a primary therapist and dietitian. Adjunctive care is simultaneously provided in group and individual settings by licensed therapists with subspecialty experience and education in other areas, including addictions or OCD.
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