Orlando Eating Disorder Treatment
Specializing in Anorexia, Bulimia, Binge Eating, Orthorexia & Compulsive Exercising 

Do you have thoughts around food/eating that can, at times, be all-consuming and interfere with your quality of life?

At GroundWork in Orlando, we understand that many silently struggle with personal challenges around food and eating. These challenges may feel hopelessly frustrating in personal attempts to overcome by willpower alone since there are often core issues driving these thoughts, urges, and behaviors. With the support of a trusted therapist, many clients may begin to heal as they understand the origin for these issues, find hope in overcoming them, and feel genuinely supported with a roadmap for recovery.

At GroundWork, we utilize an evidence-based treatment approach using CBT to help women, men, and teens suffering from anorexia, bulimia, or binge-eating disorders. We also provide support to individuals who suffer from disordered eating patterns, clinical or not, that may interfere with one’s quality of life.

One of the most important concepts to understanding eating disorders is recognizing that eating disorders are not simply about food. At GroundWork Counseling, our therapists provide Cognitive Behavioral Therapy (CBT) to adults and older adolescents with anorexia, bulimia, binge eating disorder, orthorexia and other eating disorders as well as exercise addiction, which often co-occurs with eating disorders.

Cognitive Behavioral Therapy (CBT) is the foremost evidence-based treatment for adults and teens with eating disorders. It has been tested and proven to be highly successful in the treatment of eating disorders in numerous clinical trials. Research studies confirm that approximately two-thirds of the clients who complete CBT treatment have a very good response.

Along with CBT, GroundWork Counseling’s eating disorder therapists also incorporate mindfulness, intuitive eating, mindful eating, appetite awareness training, and nutrition counseling into the treatment approach.

If you believe you or a loved one may have an eating disorder, you can learn more about the most common eating disorders here:

Anorexia Nervosa

Anorexia nervosa is an eating disorder that is characterized by low body weight, distorted body image and an obsessive fear of weight gain. Individuals with anorexia nervosa frequently control body weight by starvation, vomiting, purging, compulsive exercising, and by using diuretics and diet pills.

Although individuals who suffer from anorexia nervosa exhibit problems associated with food and the body, anorexia is not only about the food.  Anorexia often develops as an unhealthy way of coping with overwhelming and distressing emotions.  Frequently, anorexia is coupled with issues that include perfectionism, identity problems, control issues, low self-esteem and unhealthy boundaries.

If left untreated, anorexia nervosa can become chronic and even life-threatening. Although teenage girls and young women most often seek treatment for anorexia, anorexia can affect both men and women of any age. Early diagnosis and treatment greatly improves the chances for recovery.

Physical Symptoms of Anorexia Nervosa include:

• Extreme weight loss
• Low blood pressure, which may cause fainting or dizziness
• Irregular heart rhythms and/or slow heart rate
• Frequently feeling cold
• Tiredness
• Inability to sleep
• Poor circulation
• Hair that is thin and/or falls out
• Interruption or cessation of menstruation in females
• Constipation
• Growth of baby fine hair all over the body
• Collection of fluid in ankles during the day and around eyes during the night
• Dehydration

Behavioral and Emotional Characteristics of Anorexia Nervosa include:

• Refusal to maintain body weight at or above a minimally normal weight for age and height
• Refusal to eat many types of foods (i.e. carbohydrates or other foods that are deemed ‘fattening or bad’)
• Obsessive food rituals such as eating food in a certain order, rearranging food on a plate, excessive chewing.
• Denial of seriousness about low body weight
• Denial of hunger
• Food restriction
• Distorted view of weight or body shape
• Intense fear or anxiety about gaining weight
• Excessive exercise, defined as rigid routines of 2+ hours per day
• Lack of emotion
• Mood swings and/or irritability
• Obsessive thoughts about food, weight and appearance
• Frequently skipping meals or making excuses not to eat
• Perfectionism
• Social withdrawal from friends, family and activities
• Possible purging behaviors (i.e. self-induced vomiting, excessive use of laxatives or diet pills)

Bulimia Nervosa

Bulimia Nervosa is an eating disorder that is categorized by “binging” (eating very large amounts of food) within a short period of time (sometimes in secret). The individual then finds ways to “purge” the excess food by self-induced vomiting, laxative and diet pill abuse, extreme exercise and food restriction. People with bulimia nervosa often purge as a weight control strategy and because the excessive food consumption brings on feelings of anxiety and shame. Individuals with bulimia may be of normal or above normal weight and size, but as with anorexia nervosa, the preoccupation with body size, shape and weight and the desire to lose weight are present.

Perfectionism and poor self-image are typically at the root of the disorder. Binging is often a way to deal with distressing emotions and purging is seen as a way to control. By purging, the individual with bulimia nervosa feels in control of their weight, which often makes them feel more in control of their lives. For many, purging gives stress relief and helps them to deal with their distressing emotions.

Physical Symptoms of Bulimia Nervosa include:

• Eating large amounts of food until one feels pain or discomfort
• Eating more food in a binge episode than in a typical
• Forcing one’s self to vomit or exercise excessively
• Abusing laxatives, diuretics or enemas after eating
• Using dietary or herbal supplements for weight loss
• Immediately going to the bathroom after or during meals
• Damaged gums and discolored and/or damaged teeth
• Electrolyte imbalances
• Constipation
• Dehydration
• Swollen throat
• Esophagus tears

Behavioral and Emotional Characteristics of Bulimia Nervosa include:

• Preoccupation with weight and body shape and size
• Fear of gaining weight
• Endlessly worrying and complaining about being too fat
• Having a very negative and distorted view of one’s body
• Eating very large quantities of food at once
• Avoids eating with others

Binge Eating Disorder

Binge Eating Disorder is an eating disorder that is categorized by a repeated, overpowering need to eat an unusually large amount of food within a short period of time. Individuals with a binge eating disorder may not be hungry and could even be full when a binge-eating episode occurs. The individual would like to stop the uncontrollable urge to eat, but the intense need to consume food feels like it is not within their control. Their inability to control food intake leaves the binge eater feeling guilty and depressed, and often leads to eating in secret. The individual with a binge eating disorder does not use compensatory behaviors such as vomiting, abusing laxatives, or compulsive exercise after a binge.

Binging is often a coping mechanism to deal with distressing emotions such as anxiety, anger or fear. Dissatisfaction with one’s body, relationship issues and work stress are often also an issue. Although up to 40% of binge eaters are of normal weight, many individuals who binge eat are obese or morbidly obese.

Physical Symptoms of Binge Eating Disorder include:

• Eating, within a certain period of time, a much larger amount of food than most people would eat under similar circumstances
• A lack of control over eating when binging
• Eating until feeling uncomfortably full
• Eating alone because of feelings of embarrassment about how much one is eating
• Feeling disgusted, guilty or depressed after eating
• Binge eating occurs at least once per week

Behavioral and Emotional Characteristics of Binge Eating Disorder include:

• Using food to alleviate stress, anxiety or tension
• The urge to keep eating even when full
• Eating in secret
• Hiding or hording food so it can be eaten later
• Frequently dieting without lasting result
• Body dissatisfaction
• Feelings of shame, depression and loneliness
• Avoids conflict and expressing feelings

 Orthorexia Nervosa

Although widely discussed by eating disorder therapists, currently, the DSM-5 does not recognize Orthorexia Nervosa as a clinical diagnosis, yet it is similar to other eating disorders.  The National Eating Disorders Association acknowledges Orthorexia Nervosa and states that individuals who have an “unhealthy obsession with healthy foods” to the point that eating healthily has become a fanatical, obsessive, psychologically controlling and sometimes physically dangerous problem for them could be considered Orthorexic. Just as individuals with anorexia nervosa or bulimia nervosa are obsessed with calories and weight, so orthorexics obsess about healthy eating.

Individuals with Orthorexia may appear to be greatly interested in and inspired by health. However, there are typically underlying motivations which can include self-esteem issues, looking for spirituality through food, using food to create an identity and a compulsion for complete control. Individuals with Orthorexia Nervosa may become socially isolated because they often plan their life around healthy food. They become unable to eat intuitively – to know how much they need to eat, when they are hungry or when they are full. As their life is consumed with eating healthily, they often have little room in life for anything except thinking and planning about healthy food intake.

Behavioral and Emotional Characteristics of Orthorexia Nervosa include:

• Guilt and self-loathing when not eating healthily
• Constantly looking for ways certain foods are unhealthy
• Inability to eat a meal that was prepared by someone else without trying to control what is served
• Feeling in control when following the perfect diet
• Putting one’s self on a ‘nutritional pedestal’, wondering how others could eat what they eat
• Love, joy and creativity take a back seat to following the perfect diet

Exercise Addiction/Exercise Dependence/Compulsive Exercising

Exercise addiction, exercise dependence or compulsive exercising very commonly co-occurs with Anorexia Nervosa, Bulimia Nervosa and Orthorexia: approximately 39–48% of people suffering from eating disorders also suffer from exercise addiction and like other addictive behaviors, excessive exercise often is described as compulsive by psychologist. As with most behavioral addictions, Cognitive Behavioral Therapy (CBT) is the recommended treatment. CBT aims to help the individual with exercise addiction to correct automatic thoughts that are related to the need to control one’s body and the belief that exercise is always a good thing, even if it is done obsessively.

When it comes to treating exercise addiction or exercise dependence, stopping to exercise is not the required goal. Because moderate exercise is considered to be a healthful habit, a typical goal of therapy will be to exercise moderately instead of compulsively and excessively and in some instances, a new type of exercise may be recommended.

Symptoms of Exercise Addiction, Exercise Dependence or Compulsive Exercising include:

• Tolerance – a need for intensified amount of exercise to achieve the desired effect
• Withdrawal – demonstrated by withdrawal symptoms for exercise, such as anxiety and fatigue; the person may exercise to relieve or avoid symptoms of withdrawal
• Intention Effect – exercise is performed in larger amounts or over longer periods of time than was intended
• Lack of Control – a desire or unsuccessful attempt to reduce or control exercise
• Time – a great deal of time is spent in specific activities so that exercise can be obtained (e.g., physical activity vacations)
• Reduction in Other Activities – social, recreational, occupational activities are reduced or given up because of exercise
• Continuance – exercise is continued in spite of having a recurrent physical or psychological problem that may have been caused or worsened by exercise (e.g., lifting weights despite injury)

Whether assessing or treating exercise addiction it is always important to be attuned to the common co-occurring disorders, especially if it is an eating disorder or food related problem. If only the exercise addiction is treated, as exercise is reduced, a person will resort to increased bulimia or anorexic behavior in order to maintain low weight levels. Similarly the eating disorder specialist must attend to exercise behaviors in order that increased caloric intake is not compensated for by more intense exercise.