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Mind-Body Connection of Eating Disorders: How to Treat Both for Overall Health
Eating disorders are one of the deadliest mental illnesses, second only to opioid overdose. Eating disorders affect at least nine percent of the population worldwide and more than 28 million Americans will experience an eating disorder in their lifetime. Since the pandemic, these numbers have only continued to rise. For those who are uninsured or underinsured, many do not have access to treatment. The new Center for Eating Disorders & Body Positivity at Bergen New Bridge accepts all patients for treatment regardless of their ability to pay and takes a unique approach to helping those it serves. A focus is placed on balancing the mind body connection through nutritional counseling, group therapy, family therapy, and individual counseling.
Featured Speakers:
Steven Vayalumkal, MD, is the lead Psychiatrist of our Eating Disorders & Body Positivity Clinic. Dr. Vayalumkal obtained his medical degree from St. George’s University and completed his residency in psychiatry at Bergen New Bridge Medical Center, where he served as Clinic Chief Resident during his third year and Executive Chief Resident during his final year of training. Dr. Vayalumkal strives to deliver the best possible care to each one of his patients.
Adrienne Mariano, MA, LPC | Steven Vayalumkal, M.D.
Adrienne has been in the mental health field since 2005. Adrienne’s passion always has been to help others and to provide an empathic ear to those who need to be heard. Adrienne graduated from Montclair State University in 2005 with a major in Psychology and minor in Criminal Justice. Adrienne then went to John Jay College of Criminal Justice in 2009 and studied Forensic Mental Health Counseling for her master’s program. After this Adrienne worked at Tully House in Newark as a counselor, helping rehabilitate men transitioning from prison to the halfway house and preparing them for release. Adrienne developed new programming such as poetry club, which was a creative outlet for the inmates. Adrienne has worked in Bergen County since 2012 and has worked in different capacities at Bergen New Bridge Medical Center. Adrienne started as an intake specialist in the access center, then became the access center manager and then the director of behavioral health services. In this role, Adrienne has embraced working with the patients and advocating for placement options that were not available to the county hospital, such as group homes. Adrienne has now recently been promoted to the role of Senior Director of Behavioral Health which focuses on developing programming within the hospital. Adrienne is currently in the process of opening The Center for Eating Disorders and Promoting Body Positivity at Bergen New Bridge Medical Center. This innovative program will serve those who are seeking outpatient services that are suffering from eating disorders with quality care.Steven Vayalumkal, MD, is the lead Psychiatrist of our Eating Disorders & Body Positivity Clinic. Dr. Vayalumkal obtained his medical degree from St. George’s University and completed his residency in psychiatry at Bergen New Bridge Medical Center, where he served as Clinic Chief Resident during his third year and Executive Chief Resident during his final year of training. Dr. Vayalumkal strives to deliver the best possible care to each one of his patients.
Transcription:
Mind-Body Connection of Eating Disorders: How to Treat Both for Overall Health
Cheryl Martin (Host): It's estimated that more than 28 million Americans will experience an eating disorder in their lifetime. Since the pandemic, these numbers are on the rise. Up next, a closer look at eating disorders and a new innovative program focusing on mind and body.
This is Wellness Waves, a Bergen New Bridge Medical Center podcast. I'm Cheryl Martin. I'm delighted to have with me this episode, Dr. Steven Vayalumkal, lead psychiatrist for the Center for Eating Disorders and Body Positivity, and Adrienne Mariano, the Senior Director of Behavioral Health Services. So glad to have both of you on. Let's get right into it. Tell me first, doctor, what are the different types of eating disorders and their prevalence?
Dr Steven Vayalumkal: Sure. There are many different types of eating disorders that are affecting, you know, the general population. I'm sure the most common ones are the ones that people are most familiar with, are anorexia nervosa and bulimia nervosa.
Anorexia nervosa is an eating disorder characterized by a negative self-image, weight loss, significant weight loss, that can lead to major health problems and difficulties with maintaining appropriate weight. The prevalence of anorexia nervosa is about 0.6%, but it is higher in females than in males. In females, it's about 0.9%. In males, it's about 0.3%.
The next major eating disorder we're dealing with is bulimia nervosa, which is characterized by a cycle of binge eating episodes, and then results in compensatory behaviors such as self-induced vomiting or laxative use, which are designed to compensate for the effects of binge eating. And the prevalence of that, overall, is 0.3% of the general population. But again, like with anorexia nervosa, it is higher among females than in males.
Cheryl Martin (Host): What are some of the other eating disorders that we don't hear as much about?
Dr Steven Vayalumkal: So, there is also binge eating disorder, which is a relatively new disorder that's been added to the DSM, and it's characterized by recurrent episodes of binge eating to the point of discomfort, feelings of loss of control over eating, experiencing feelings of shame, distress, guilt. However, one characteristic feature that differs from bulimia is that there is no compensatory behavior to make up for the binge eating episodes. So, this is strictly related to binge eating episodes. And this is one of the more common eating disorders that we see in the United States.
And another common eating disorder is avoidant or restrictive food intake disorder, which is a disorder that is similar to anorexia in that patients are restricting their food intake secondary to negative self-image, feelings that they themselves are overweight even though that may not be the case.
And another eating disorder that we're seeing in the general population is called orthorexia. This is a term that isn't officially in the DSM-5, but it is something that we're becoming more aware of as clinicians. And this is a disorder in which patients are obsessed with eating healthily or making sure they're eating the right foods. So, they're obsessively checking ingredients in their foods, checking nutrition facts. They're cutting out various food groups that they perceive to be unhealthy. And they become very distressed emotionally when healthy foods or foods that they perceive to be healthy are unavailable to them.
So, these are just some examples of the types of eating disorders that we're seeing in the general population and that we're trying to help treat effectively.
Cheryl Martin (Host): Adrienne, can you talk about the rise of cases that we've seen since the pandemic and the correlation?
Adrienne Mariano: Absolutely. So with the pandemic, we've seen a rise in most eating disorders that the doctor has talked about previously. So with the trauma of the pandemic, people really didn't really have access to foods, people were scared to go to the grocery store, so we have seen a rise not just in our adult population, but also our child and teenager population with anorexia and also binge eating disorder and also bulimia as well, the top three there.
So, people have been really also in front of the computers more often if they are working from home or they're going to be on Zoom for school. So, coming out of the pandemic, some people were very concerned about their body image and how it was different from the start of pandemic until now. So, we're seeing a lot of people coming to us and researching about eating disorders, trying to get treatment because they had no coping mechanisms that they usually had when the pandemic had started. So, there was isolation that people experienced. There was a lack of connection. Maybe they were in previously in treatment before, and they had to go virtual only, so there was not an eye on them where they can be seen and their eating habits really observed while they were in treatment. So, we had seen a rise in cases of eating disorder since the pandemic.
Cheryl Martin (Host): You mentioned that some people have come in because they have noticed these patterns. But overall, do the majority of people who have an eating disorder recognize it as such and then come in for help?
Adrienne Mariano: So, some of them do realize that they do have disordered eating, whether it be they notice that they are binge eating and they're using purging to get rid of that with bulimia. Or sometimes they also have the reverse effect where we have people that come in and have noticed that their family members have been saying things to them like, "You are looking very skinny and you're not eating enough," so they might be pushed by family or friends. Also, I think doctors in the medical field have been more aware of the signs to really help their patients. So, they might be going to the doctor's office for a different condition and they're doing lab work and they're doing testing and they notice that there's a lot of things that are abnormal, so that kind of sets the tone and the conversation with their patients on what's really going on. So, sometimes we do people referred from the doctor's office that the doctor has noticed different abnormal labs, and that started the conversation about how they're eating.
Cheryl Martin (Host): So if there's someone listening to this podcast and they have not sought help, when should a person seek medical help, or even if it's a loved one who notices these patterns?
Adrienne Mariano: It's always best to consult help early on if possible. They should be aware of the warning signs that come up with people that are involved with eating disorders. The whole body is affected when somebody is experiencing an eating disorder, whether it be physically, also emotionally. So when somebody is anorexic, for example, you can see that they're losing a significant amount of weight. They are also running the risk physically of cardiac arrest and things like that. So, that's important to face head on with a loved one if they're noticing specific things about their loved one to foster a conversation and being empathetic in that conversation to offer support for them.
Cheryl Martin (Host): Yeah, I asked that question because I know several people who are anorexic, one not on a personal level, and I've often wondered if family members have gone to this person because it's obvious just in looking at her that she is. But I have just wondered if anyone has said anything, especially her children, about it.
Adrienne Mariano: Exactly, that's where it starts. If there is a question about somebody and you want to be able to be a supportive person and they're very concerned about their loved one's safety and their wellbeing, it's always important to face those things head on. And I know that it might be hard to do so because it's uncomfortable to talk to somebody and you're not really sure of what to say, but you always are showing that person that you care by bringing something up. So if the person has family that are concerned, they should be having a conversation with them. For example, they could say something like, "I've noticed that you've been losing a significant amount of weight. I'm concerned that that's affecting your health. Can you tell me what's going on? Or is there a way that I can help you through this?"
Cheryl Martin (Host): Well, the great news is Bergen New Bridge Medical Center is being proactive with this, and you have a new innovative program focusing on mind and body. Talk about this program, doctor, especially body positivity and how it relates to eating disorders.
Dr Steven Vayalumkal: Yeah, sure. Absolutely. So, I'll begin with the body positivity aspect of it, because I think that's a very important topic I want to touch on with regards to the eating disorders. So, a lot of times, with patients who are dealing with eating disorders, one of the core symptoms that we see is that they have a negative perception of themselves and negative body image. So, they feel uncomfortable in their own skin. They feel awkward about their body. They feel as though they're either underweight or overweight, and they're dealing with all these perceptions of how they feel about themselves, but also how other people feel about themselves as well. And I think that's one of the core aspects that we need to really target when we're dealing with patients who are suffering with eating disorders.
And so, we focus on body positivity, which is not focusing on so much the negative body image and the negative perceptions that patients have about themselves, but focusing on changing those views and focusing on the positive aspects of their body and helping patients feel more comfortable and more confident in their own skin and celebrating and appreciating their natural body shapes and their physical appearance of all different varieties. And I think that's very important.
And so, the program that we offer here at Bergen, it's an outpatient partial hospitalization program. It runs five days a week and it's about six hours per day for roughly six to eight weeks for patients 18 and older. So, they meet with myself as the psychiatrist and they also meet with our clinicians, our dieticians, and we come up with a comprehensive plan to help address the patient's symptoms in regards to their eating disorders, provide education to themselves and family members if they so wish to get them involved regarding the symptoms that they're dealing with, potential complications that they could face as a result of their eating disorder and focusing on changing their habits and changing their perceptions of themselves. And part of that too is helping to add myself as a psychiatrist, prescribing medications to help with symptoms, working with dieticians to come up with meal plans and learning coping skills and coping strategies to help with these negative emotions. So, we try to have a comprehensive approach to treating eating disorders.
Cheryl Martin (Host): Now, what is the difference between inpatient residential treatment versus outpatient? Because this is outpatient, correct?
Dr Steven Vayalumkal: Yes, that's correct. This is outpatient. There are different levels of care depending on the severity of the patient's illness and what kind of medical care or psychiatric care the patient needs. So, the highest level of care is inpatient. So, that's when a patient is medically unstable. They have severely low body weight. They're having abnormal heart rhythms because of their eating disorder and their medical complications, low blood pressure, refusing to eat. So at that point, they would require medical attention and they would have to be admitted to the hospital. And they may also require psychiatric attention too. Let's say, as a result of negative self-image, they're having thoughts to hurt themselves, suicidal thoughts, or they are engaging in self-harming behaviors.
And then, stepping down from that, there's residential treatments where patients are medically stable, but they do have some ongoing psychiatric issues that would be too severe to be treated in an outpatient setting, but not severe enough that they would require an inpatient hospitalization.
And then, a step down from that is a partial hospital program, which is what our program is. They would go to a program several times a week, so in our case it's five days a week. And they're medically stable and psychiatrically stable, but they are still having symptoms regarding their eating disorder that require treatment. So, they're restricting their food intake or their engaging in binging and purging episodes.
And then, a step below that is regular outpatient followup where they would be meeting with their provider on a regular basis. It wouldn't be every day. But at that point, they would be medically stable and psychiatrically stable, and they're focusing on their recovery and maintaining their recovery from their eating disorder.
Cheryl Martin (Host): So, I would assume then the goal of the Center for Eating Disorders and Body positivity is to arrest the situation at this level so they don't move upward.
Dr Steven Vayalumkal: Yes, exactly. And just that Adrienne had mentioned, the earlier the patients come seek treatment, the better, just to make sure that their illness doesn't progress and that they don't get worse. So, our goal ultimately is for patients to be in recovery so that they can maintain their outpatient followup and lead healthy and productive lives.
Cheryl Martin (Host): What kind of a response are you seeing where there is this focus on balancing the mind and the body?
Adrienne Mariano: I think that we've actually seen a really positive turnaround for that. A lot of people are looking for that mind body connection because, especially with eating disorders, you can't separate the two. You have so much going on with just the food, but there's lot of emotion behind the food, so you can't separate the mind with the emotion from your food intake. So, it's really becoming aware of what those thoughts are, what the emotions are behind that, and then also treating what's going on with the eating disorder. So, you have to relearn how to actually eat and have a relationship with food. So, it's not just going to be we have to separate the psychiatric issue from the eating disorder. Everything is going together and plus you have that medical component interacting with the two of those things. Because when you are restricting or when you're purging, that is a significant toll on your body, especially if you been doing this for quite some time. Some people that suffer from eating disorders, they've been doing this in secret, to the point where nobody really knows about it until they're at the point where they're having significant health issues because of it. So, you can't really separate the two when you're treating an eating disorder.
Cheryl Martin (Host): Now, what are the implications for the underserved population seeking out treatment? They may be underinsured or they don't have insurance.
Adrienne Mariano: So, I'm really proud that we have this at Bergen New Bridge because when we started developing this program, doing research, there's not a lot of programs out there that are treating eating disorders, number one. Number two, the programs that are out there, they're just taking patients that have the ability to pay, whether it be commercial insurance or it's self-pay. So, you are neglecting a whole population that still needs treatment and they're not able to access that. So at Bergen New Bridge, we don't just take people that have private insurance, we do serve them. But we also take patients that have New Jersey Medicaid and Medicare. And if they don't have any insurance at all, we can offer them charity care if they qualify for that as well. So, we're serving all types of different patients, giving them access to treatment because sometimes it could be literally life and death. And if you're taking out a whole subculture of a population that's dealing with eating disorders, you're not really treating eating disorders in general, you're kind of picking and choosing who you want to treat. And that's not what we do here.
Cheryl Martin (Host): That is great. Is there anything else either one of you would like to add on this vital topic?
Adrienne Mariano: I think that I can add with the positive body image, it's just really important to have that incorporated into a treatment program because it's not just us talking about bodies, but also examining what we are learning from social media, images and TV and news outlets on how people are supposed to look and how we're supposed to view our bodies. So, starting with that and picking out those messages that we're receiving from social media or receiving from even our family members intentionally or not.
It's really important to access recovery because, like our doctor had said negative body images so closely tied with eating disorders because it's talking about low self-esteem. It's talking about how we view our bodies and because we're not fitting that certain stereotype or we don't look a certain way, you're not fitting that, so you have a lot of guilt and shame and that's a personal character flaw in the eyes of person of an eating disorder when it's really not.
Not all people fit a certain body type, especially people of color or people that belong to the LGBTQ community. So, we have to embrace all body types in all communities that are involved because it's not just young white females that suffer from eating disorders. Men also suffer from eating disorders. So, bringing out the awareness and being able to treat this population is very important.
Cheryl Martin (Host): Well said. Doctor, you get the final word on this.
Dr Steven Vayalumkal: Just like Adrienne had touched on earlier, we are seeing a rise in eating disorders among the general population, but also here too in Bergen County. And I hope that patients aren't afraid to seek help, whether by themselves or with the support of their family members and friends. And I hope that we can make a positive impact on the community and help people get the treatment that they need.
Cheryl Martin (Host): Dr. Steven Vayalumkal and Adrienne Mariano, thanks so much for educating us about eating disorders and also the new treatment program at bergen New Bridge Medical Center.
You can visit our website newbridgehealth.org to learn more about the Center for Eating Disorders and Body Positivity. That's newbridgehealth.org. To make an appointment, call 800-730-2762. That's 800-730-2762. If you found this podcast helpful, please share it on your social channels, and be sure to check out the podcast library for other topics of interest to you. And thanks for listening to this episode of Wellness Waves.
Mind-Body Connection of Eating Disorders: How to Treat Both for Overall Health
Cheryl Martin (Host): It's estimated that more than 28 million Americans will experience an eating disorder in their lifetime. Since the pandemic, these numbers are on the rise. Up next, a closer look at eating disorders and a new innovative program focusing on mind and body.
This is Wellness Waves, a Bergen New Bridge Medical Center podcast. I'm Cheryl Martin. I'm delighted to have with me this episode, Dr. Steven Vayalumkal, lead psychiatrist for the Center for Eating Disorders and Body Positivity, and Adrienne Mariano, the Senior Director of Behavioral Health Services. So glad to have both of you on. Let's get right into it. Tell me first, doctor, what are the different types of eating disorders and their prevalence?
Dr Steven Vayalumkal: Sure. There are many different types of eating disorders that are affecting, you know, the general population. I'm sure the most common ones are the ones that people are most familiar with, are anorexia nervosa and bulimia nervosa.
Anorexia nervosa is an eating disorder characterized by a negative self-image, weight loss, significant weight loss, that can lead to major health problems and difficulties with maintaining appropriate weight. The prevalence of anorexia nervosa is about 0.6%, but it is higher in females than in males. In females, it's about 0.9%. In males, it's about 0.3%.
The next major eating disorder we're dealing with is bulimia nervosa, which is characterized by a cycle of binge eating episodes, and then results in compensatory behaviors such as self-induced vomiting or laxative use, which are designed to compensate for the effects of binge eating. And the prevalence of that, overall, is 0.3% of the general population. But again, like with anorexia nervosa, it is higher among females than in males.
Cheryl Martin (Host): What are some of the other eating disorders that we don't hear as much about?
Dr Steven Vayalumkal: So, there is also binge eating disorder, which is a relatively new disorder that's been added to the DSM, and it's characterized by recurrent episodes of binge eating to the point of discomfort, feelings of loss of control over eating, experiencing feelings of shame, distress, guilt. However, one characteristic feature that differs from bulimia is that there is no compensatory behavior to make up for the binge eating episodes. So, this is strictly related to binge eating episodes. And this is one of the more common eating disorders that we see in the United States.
And another common eating disorder is avoidant or restrictive food intake disorder, which is a disorder that is similar to anorexia in that patients are restricting their food intake secondary to negative self-image, feelings that they themselves are overweight even though that may not be the case.
And another eating disorder that we're seeing in the general population is called orthorexia. This is a term that isn't officially in the DSM-5, but it is something that we're becoming more aware of as clinicians. And this is a disorder in which patients are obsessed with eating healthily or making sure they're eating the right foods. So, they're obsessively checking ingredients in their foods, checking nutrition facts. They're cutting out various food groups that they perceive to be unhealthy. And they become very distressed emotionally when healthy foods or foods that they perceive to be healthy are unavailable to them.
So, these are just some examples of the types of eating disorders that we're seeing in the general population and that we're trying to help treat effectively.
Cheryl Martin (Host): Adrienne, can you talk about the rise of cases that we've seen since the pandemic and the correlation?
Adrienne Mariano: Absolutely. So with the pandemic, we've seen a rise in most eating disorders that the doctor has talked about previously. So with the trauma of the pandemic, people really didn't really have access to foods, people were scared to go to the grocery store, so we have seen a rise not just in our adult population, but also our child and teenager population with anorexia and also binge eating disorder and also bulimia as well, the top three there.
So, people have been really also in front of the computers more often if they are working from home or they're going to be on Zoom for school. So, coming out of the pandemic, some people were very concerned about their body image and how it was different from the start of pandemic until now. So, we're seeing a lot of people coming to us and researching about eating disorders, trying to get treatment because they had no coping mechanisms that they usually had when the pandemic had started. So, there was isolation that people experienced. There was a lack of connection. Maybe they were in previously in treatment before, and they had to go virtual only, so there was not an eye on them where they can be seen and their eating habits really observed while they were in treatment. So, we had seen a rise in cases of eating disorder since the pandemic.
Cheryl Martin (Host): You mentioned that some people have come in because they have noticed these patterns. But overall, do the majority of people who have an eating disorder recognize it as such and then come in for help?
Adrienne Mariano: So, some of them do realize that they do have disordered eating, whether it be they notice that they are binge eating and they're using purging to get rid of that with bulimia. Or sometimes they also have the reverse effect where we have people that come in and have noticed that their family members have been saying things to them like, "You are looking very skinny and you're not eating enough," so they might be pushed by family or friends. Also, I think doctors in the medical field have been more aware of the signs to really help their patients. So, they might be going to the doctor's office for a different condition and they're doing lab work and they're doing testing and they notice that there's a lot of things that are abnormal, so that kind of sets the tone and the conversation with their patients on what's really going on. So, sometimes we do people referred from the doctor's office that the doctor has noticed different abnormal labs, and that started the conversation about how they're eating.
Cheryl Martin (Host): So if there's someone listening to this podcast and they have not sought help, when should a person seek medical help, or even if it's a loved one who notices these patterns?
Adrienne Mariano: It's always best to consult help early on if possible. They should be aware of the warning signs that come up with people that are involved with eating disorders. The whole body is affected when somebody is experiencing an eating disorder, whether it be physically, also emotionally. So when somebody is anorexic, for example, you can see that they're losing a significant amount of weight. They are also running the risk physically of cardiac arrest and things like that. So, that's important to face head on with a loved one if they're noticing specific things about their loved one to foster a conversation and being empathetic in that conversation to offer support for them.
Cheryl Martin (Host): Yeah, I asked that question because I know several people who are anorexic, one not on a personal level, and I've often wondered if family members have gone to this person because it's obvious just in looking at her that she is. But I have just wondered if anyone has said anything, especially her children, about it.
Adrienne Mariano: Exactly, that's where it starts. If there is a question about somebody and you want to be able to be a supportive person and they're very concerned about their loved one's safety and their wellbeing, it's always important to face those things head on. And I know that it might be hard to do so because it's uncomfortable to talk to somebody and you're not really sure of what to say, but you always are showing that person that you care by bringing something up. So if the person has family that are concerned, they should be having a conversation with them. For example, they could say something like, "I've noticed that you've been losing a significant amount of weight. I'm concerned that that's affecting your health. Can you tell me what's going on? Or is there a way that I can help you through this?"
Cheryl Martin (Host): Well, the great news is Bergen New Bridge Medical Center is being proactive with this, and you have a new innovative program focusing on mind and body. Talk about this program, doctor, especially body positivity and how it relates to eating disorders.
Dr Steven Vayalumkal: Yeah, sure. Absolutely. So, I'll begin with the body positivity aspect of it, because I think that's a very important topic I want to touch on with regards to the eating disorders. So, a lot of times, with patients who are dealing with eating disorders, one of the core symptoms that we see is that they have a negative perception of themselves and negative body image. So, they feel uncomfortable in their own skin. They feel awkward about their body. They feel as though they're either underweight or overweight, and they're dealing with all these perceptions of how they feel about themselves, but also how other people feel about themselves as well. And I think that's one of the core aspects that we need to really target when we're dealing with patients who are suffering with eating disorders.
And so, we focus on body positivity, which is not focusing on so much the negative body image and the negative perceptions that patients have about themselves, but focusing on changing those views and focusing on the positive aspects of their body and helping patients feel more comfortable and more confident in their own skin and celebrating and appreciating their natural body shapes and their physical appearance of all different varieties. And I think that's very important.
And so, the program that we offer here at Bergen, it's an outpatient partial hospitalization program. It runs five days a week and it's about six hours per day for roughly six to eight weeks for patients 18 and older. So, they meet with myself as the psychiatrist and they also meet with our clinicians, our dieticians, and we come up with a comprehensive plan to help address the patient's symptoms in regards to their eating disorders, provide education to themselves and family members if they so wish to get them involved regarding the symptoms that they're dealing with, potential complications that they could face as a result of their eating disorder and focusing on changing their habits and changing their perceptions of themselves. And part of that too is helping to add myself as a psychiatrist, prescribing medications to help with symptoms, working with dieticians to come up with meal plans and learning coping skills and coping strategies to help with these negative emotions. So, we try to have a comprehensive approach to treating eating disorders.
Cheryl Martin (Host): Now, what is the difference between inpatient residential treatment versus outpatient? Because this is outpatient, correct?
Dr Steven Vayalumkal: Yes, that's correct. This is outpatient. There are different levels of care depending on the severity of the patient's illness and what kind of medical care or psychiatric care the patient needs. So, the highest level of care is inpatient. So, that's when a patient is medically unstable. They have severely low body weight. They're having abnormal heart rhythms because of their eating disorder and their medical complications, low blood pressure, refusing to eat. So at that point, they would require medical attention and they would have to be admitted to the hospital. And they may also require psychiatric attention too. Let's say, as a result of negative self-image, they're having thoughts to hurt themselves, suicidal thoughts, or they are engaging in self-harming behaviors.
And then, stepping down from that, there's residential treatments where patients are medically stable, but they do have some ongoing psychiatric issues that would be too severe to be treated in an outpatient setting, but not severe enough that they would require an inpatient hospitalization.
And then, a step down from that is a partial hospital program, which is what our program is. They would go to a program several times a week, so in our case it's five days a week. And they're medically stable and psychiatrically stable, but they are still having symptoms regarding their eating disorder that require treatment. So, they're restricting their food intake or their engaging in binging and purging episodes.
And then, a step below that is regular outpatient followup where they would be meeting with their provider on a regular basis. It wouldn't be every day. But at that point, they would be medically stable and psychiatrically stable, and they're focusing on their recovery and maintaining their recovery from their eating disorder.
Cheryl Martin (Host): So, I would assume then the goal of the Center for Eating Disorders and Body positivity is to arrest the situation at this level so they don't move upward.
Dr Steven Vayalumkal: Yes, exactly. And just that Adrienne had mentioned, the earlier the patients come seek treatment, the better, just to make sure that their illness doesn't progress and that they don't get worse. So, our goal ultimately is for patients to be in recovery so that they can maintain their outpatient followup and lead healthy and productive lives.
Cheryl Martin (Host): What kind of a response are you seeing where there is this focus on balancing the mind and the body?
Adrienne Mariano: I think that we've actually seen a really positive turnaround for that. A lot of people are looking for that mind body connection because, especially with eating disorders, you can't separate the two. You have so much going on with just the food, but there's lot of emotion behind the food, so you can't separate the mind with the emotion from your food intake. So, it's really becoming aware of what those thoughts are, what the emotions are behind that, and then also treating what's going on with the eating disorder. So, you have to relearn how to actually eat and have a relationship with food. So, it's not just going to be we have to separate the psychiatric issue from the eating disorder. Everything is going together and plus you have that medical component interacting with the two of those things. Because when you are restricting or when you're purging, that is a significant toll on your body, especially if you been doing this for quite some time. Some people that suffer from eating disorders, they've been doing this in secret, to the point where nobody really knows about it until they're at the point where they're having significant health issues because of it. So, you can't really separate the two when you're treating an eating disorder.
Cheryl Martin (Host): Now, what are the implications for the underserved population seeking out treatment? They may be underinsured or they don't have insurance.
Adrienne Mariano: So, I'm really proud that we have this at Bergen New Bridge because when we started developing this program, doing research, there's not a lot of programs out there that are treating eating disorders, number one. Number two, the programs that are out there, they're just taking patients that have the ability to pay, whether it be commercial insurance or it's self-pay. So, you are neglecting a whole population that still needs treatment and they're not able to access that. So at Bergen New Bridge, we don't just take people that have private insurance, we do serve them. But we also take patients that have New Jersey Medicaid and Medicare. And if they don't have any insurance at all, we can offer them charity care if they qualify for that as well. So, we're serving all types of different patients, giving them access to treatment because sometimes it could be literally life and death. And if you're taking out a whole subculture of a population that's dealing with eating disorders, you're not really treating eating disorders in general, you're kind of picking and choosing who you want to treat. And that's not what we do here.
Cheryl Martin (Host): That is great. Is there anything else either one of you would like to add on this vital topic?
Adrienne Mariano: I think that I can add with the positive body image, it's just really important to have that incorporated into a treatment program because it's not just us talking about bodies, but also examining what we are learning from social media, images and TV and news outlets on how people are supposed to look and how we're supposed to view our bodies. So, starting with that and picking out those messages that we're receiving from social media or receiving from even our family members intentionally or not.
It's really important to access recovery because, like our doctor had said negative body images so closely tied with eating disorders because it's talking about low self-esteem. It's talking about how we view our bodies and because we're not fitting that certain stereotype or we don't look a certain way, you're not fitting that, so you have a lot of guilt and shame and that's a personal character flaw in the eyes of person of an eating disorder when it's really not.
Not all people fit a certain body type, especially people of color or people that belong to the LGBTQ community. So, we have to embrace all body types in all communities that are involved because it's not just young white females that suffer from eating disorders. Men also suffer from eating disorders. So, bringing out the awareness and being able to treat this population is very important.
Cheryl Martin (Host): Well said. Doctor, you get the final word on this.
Dr Steven Vayalumkal: Just like Adrienne had touched on earlier, we are seeing a rise in eating disorders among the general population, but also here too in Bergen County. And I hope that patients aren't afraid to seek help, whether by themselves or with the support of their family members and friends. And I hope that we can make a positive impact on the community and help people get the treatment that they need.
Cheryl Martin (Host): Dr. Steven Vayalumkal and Adrienne Mariano, thanks so much for educating us about eating disorders and also the new treatment program at bergen New Bridge Medical Center.
You can visit our website newbridgehealth.org to learn more about the Center for Eating Disorders and Body Positivity. That's newbridgehealth.org. To make an appointment, call 800-730-2762. That's 800-730-2762. If you found this podcast helpful, please share it on your social channels, and be sure to check out the podcast library for other topics of interest to you. And thanks for listening to this episode of Wellness Waves.