In many of our residential patients, evidence of one or several anxiety disorders exists prior to the onset of an eating disorder. The presence of an anxiety disorder tends to worsen eating disorder symptoms. It is often difficult to treat an individual’s eating disorder without addressing the high levels of anxiety that accompany it. At Rogers Memorial Hospital, we have a special unit within The Eating Disorder Center that treats individuals with a dual diagnosis.

Learning to lower anxiety levels increases success in recovery
From their initial assessment through the end of their stay, Rogers Memorial Hospital’s patients identify situations related to their eating and anxiety disorders that provoke intense levels of anxiety and assign an anxiety rating (on a 0-7 scale) to each of these situations. The higher the anxiety rating, the more difficult it is for these patients to encounter that situation.

Exposure in a prolonged and repetitive manner
Treatment teams at Rogers Memorial approach anxiety-provoking situations gradually. When patients are exposed to challenging yet manageable levels of anxiety (denoted by a rating of 3 on the 7-point scale), they are better equipped to resist engaging in harmful eating disorder behaviors such as restricting, bingeing, purging, and compensatory exercise.

Some patients fear certain foods, like pizza or ice cream, and anticipate unrealistic weight gain as a response to the consumption of their feared foods. The treatment team finds ways to build an experience of gradual exposure. Depending on an individual’s level of anxiety, the food may only be present in the room at first, but later is held or on the table.

Ultimately, a patient learns to overcome their fear and incorporate their feared foods into their individualized meal plans using a modified version of the exchange system similar to the one developed by the American Dietetic Association.

Anxiety levels decrease
Rogers Memorial’s patients get used to, or habituate to, their anxiety when they are exposed to that situation in a repetitive manner. Their anxiety levels decrease over time, and they are able to see that what they feared would occur in a given situation did not happen.

This gradual exposure approach is called Exposure and Ritual Prevention Therapy (ERP), which is a specific type of Cognitive-Behavioral Therapy (CBT). ERP has been shown to be the most effective in treating Obsessive-Compulsive Disorder and other anxiety disorders. This therapy is used extensively at Rogers Memorial because it allows patients the opportunity to confront their anxiety at a manageable pace, thereby increasing their self-confidence to continue their treatment.

Inarguably, self-efficacy is one of the best things patients can take with them when they leave treatment and continue with their aftercare.