It’s estimated that 9% of the U.S. population will have an eating disorder in their lifetime, according to the National Eating Disorders Association. A program at Burrell called RecoverED Eating Disorder Services, has been treating clients for about four years. It recently received the designation of Eating Disorders of Excellence by the Missouri Eating Disorders Council for providing “integrated, evidence-based treatment.”
Program Coordinator Stephanie Robbins said she worked behind the scenes for five years to get it up and running. She knows what it's like to struggle with an eating disorder and said her journey to recovery has allowed her to find her voice and to use that voice to help others find theirs.
The RecoverED team of about 15, consisting of therapists, psychiatrists, dieticians and case managers, collaborates with physicians to treat people of every gender and income level.
“We treat all types of eating disorders," said Robbins. "The primary ones that we see are going to be anorexia, bulimia and binge eating disorder. We also see clients coming in with ARFID, which is avoidant restrictive food intake disorder. We see that a lot with autism spectrum and sensory processing disorder. It's a little bit different of an eating disorder because there's not any kind of body image concerns, but still a struggle with food and with eating."
And they're seeing a high rate of atypical anorexia, especially in older adults, where a person has all of the symptoms of the disorder but they're not considered medically underweight.
Eating disorders can lead to serious medical complications, according to Robbins. She said a person can be in a medical crisis before their labs show anything abnormal. That’s why RecoverED is working to educate medical doctors. And they teach clients to pay attention to their bodies.
Robbins said they often see a history of trauma with those who develop eating disorders, especially abuse that was associated with food insecurity or rigid rules around food. But there are other reasons why a person develops an eating disorder.
“There’s so much influence with social media and this constant pressure to be thin," she said. "And that really — we see a much higher occurrence of eating disorders in people who have engaged in any type of dieting. It's a really big predictor of who's going to develop an eating disorder.”
There are various treatment methods, and they vary from patient to patient. She said they use cognitive behavioral therapy. Several clinicians are also trained in Eye Movement Desensitization and Reprocessing or EMDR for trauma. According to the American Psychological Association, EMDR therapy focuses on the memory and works to change the way memory is stored in the brain. With kids, there are other approaches.
“We do play therapy, we do art therapy, we integrate yoga and movement," she said, "and so we really try to look at it through every angle of what's going to work for each individual person and kind of tailor their treatment to their needs.”
They’re also planning a garden where clients can help grow fruits and vegetables. The plan is to teach them not only how to grow food but also how to cook it and to replicate that at home. Surplus produce will be offered to those receiving services. Robbins said they see a lot of food insecurity – 50% of their clientele is on Medicaid.
The opening of the eating disorder program at Burrell has made it easier for southwest Missouri residents to seek treatment.
Robbins said, before RecoverED opened in Springfield, the closest treatment facilities were in Kansas City, St. Louis and Tulsa. She said seeking treatment far away often disrupts lives.
“You have to commit to 'I have to leave my family, my school, my job, my support system to go get help for a few weeks,' " she said, "however long insurance will let you stay and then kind of be thrown back in with no resources. So now what we're doing is giving people the option, 'I can stay home, I can continue working, I can stay in school, but I can get that treatment faster' because, when they're having to decide to give up everything for a little while to go into treatment, they don't do it very quickly, so they're getting sicker and sicker while they're waiting.”
There are approximately 165 active clients currently in the RecoverED program. Robbins said they saw an uptick in eating disorders during the pandemic "when everybody was kind of a little bit alarmed that maybe there wasn't going to be food at the grocery store, and there were long lines to get in, and it was very scary to be out in public because nobody really knew what to expect. And so that was part of it, that there was a lot of food insecurity that was associated with that. And then the other part of it is if someone was living in a toxic home environment, maybe with an abuser, they were trapped. And so, you know, talking about how eating disorders are a coping skill, that's kind of what they turn to when everything felt so out of control, it was like, 'I'm going to control my food. I'm going to try to control my body,' and so that's why we saw it really rise.”
RecoverED offers two levels of outpatient care. One is intensive, Robbins said. It’s more structured and includes 12 hours a week of programming. Up until a few weeks ago, it was face to face with only local clients. But Burrell recently launched a virtual intensive outpatient program "to just try to better serve some of those people that are coming to us around the state that need a higher level of care and don’t have access,” she said.
Signs of eating disorders can include isolation during family meals or dinner out with friends and systematically cutting out food from one’s diet and not adding other things back in. She advises anyone who suspects someone might have an eating disorder to offer support and suggestions for seeking help.
“Because if you can provide some solid resources, that person might be a little bit more open to hearing it," she said. "Still, it kind of has to be done on their own time. We see people all the time who start with us and then they kind of fall off for a little while and then they'll come back and say, 'OK. I thought I could handle this, but I just can't.' And so just really being that solid support system for, like, 'OK. I know you need this help. I'm going to support you and help you get it however I can.' ”
She said full recovery from an eating disorder is possible.
