Behavioral Health

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Eating and weight disorders are serious but treatable conditions that can affect anyone at any age. Eating disorders are psychological conditions that cause people to develop unhealthy eating habits. Eating disorders can affect eating habits as well as thoughts and emotions. They can also affect your attitudes toward food as well as body weight and shape. At the Center of Excellence in Eating and Weight Disorders, we treat all eating and feeding disorders in children, adolescents, and adults, including:

Our medical team includes psychiatrists, licensed clinical psychologists, registered dieticians, advanced post-doctoral fellows in psychology, and advanced psychology externs who work under faculty supervision. You can expect the highest quality care based on the most advanced scientific research.

Enhanced Cognitive Behavioral Therapy

Enhanced cognitive behavioral therapy (CBT-E) addresses how thoughts, feelings, and behaviors contribute to the development and maintenance of eating disorders. It focuses on how you have developed and maintained worrisome eating behaviors. We concentrate on you, not your diagnosis. The treatment has several parts: evaluation of shape and weight, dietary restraint, and mood dependent eating. This treatment is appropriate for most eating disorders as it provides the insight and tools to effectively manage eating after treatment is over in order to prevent relapse.

Learn more about CBT-E. 

Acceptance-based Mirror Exposure

Body image concerns play a serious role in most eating disorders. It is also the symptom most resistant to treatment. Addressing body image issues is essential to successful eating disorder treatment, since failure in this area can derail eating disorder recovery.

People with body image problems and eating disorders tend to avoid looking at themselves in the mirror. To help you overcome that obstacle, we offer acceptance-based mirror exposure treatment.

This mirror work involves having you look at your own body in a mirror and describe what you see. We repeat this process each session, watching your descriptions carefully. Whenever you use judgmental language, your therapist will request that you use only neutral, factually descriptive language. The goal is to shift the way you process or make sense of your self-image.

Dr. Tom Hildebrandt is a pioneer of this treatment, and provides expert care.

Family-Based Therapy – The Maudsley Approach

Maudsley family-based therapy is an evidence-based treatment for adolescents and young adults with eating disorders. The name comes from the Maudsley Hospital in London, where family-based treatment was first used to help teens with anorexia nervosa.

Family-based therapy understands that the family unit is a key resource to helping people with an eating disorder. This is especially true for young people who rely on their families for all types of support.

Treatment takes place weekly or bi-weekly for six to nine months. We train parents to help their children re-learn how to eat in order to achieve an appropriate weight for their age and height. We focus intently on behavioral change around eating so that our patients adopt healthy eating habits. 

Exposure-based Family Therapy (FBT-E)

An alternative to traditional family-based therapy, this approach treats eating disorders by helping you accept or change your food-related attitudes. Treatment includes three parts:

  • Target disgust-based aversion to food and visceral body image feelings associated with eating
  • Address food-related worries— through imaginal and worry-based exposure, fears— through exposure with response prevention, and the inflexible thinking that encourages these worries and fears with acceptance based mirror exposure
  • Train parents to help their children through the treatment process 

LEARN Weight Management Program

This weight management approach addresses binge eating disorder and obesity. The acronym LEARN represents the five essential components of the program:

  1. Lifestyle Making lifestyle changes that support weight loss and ongoing maintenance
  2. Exercise — Moving is an important lifestyle choice of a positive and enjoyable activity
  3. Attitudes — Shifting attitudes to helps manage triggers to overeating by reducing blame and eliminating the stigma that has been associated with body weight
  4. Relationships — Supporting positive attitudes and lifestyle changes to help nurture healthy relationships
  5. Nutrition — Learning how food can be a source of nutrition rather a source of upset that may lead to overeating can be empowering

The program uses a collaborative approach, bringing together helpful aspects of psychotherapy and education. During program meetings, we alternate short periods of instructional learning with periods of discussion and problem solving. We offer this program in a group or one-on-one settings, depending on your needs.

The overall goal of the LEARN program is to emphasize ways to engage and react to the environment. If you have strong physiological or emotional responses to food, we can teach strategies to help you overcome cravings. We offer behavioral training to help you regular your responses to triggers such as food, emotions, and certain situations. We may encourage exposure to these cues repeatedly, until you no longer have the psychological and emotional response. We also teach you to change the environment when possible. For instance, you may want to avoid dinner buffets or you may need to leave a certain situation.

Bariatric Surgery Evaluation

Our Bariatric Surgery Evaluation Program can help you determine if you are a candidate for weight loss surgery. If you are overweight or obese, weight loss (bariatric) surgery may be an option.

Excess weight is not a mental health problem. However, psychological symptoms can be common before and after weight loss surgery. We suggest adults and adolescents participate in treatments to address eating disorders and mood problems both pre- and post-surgery. These conditions might include depression, psychological disorders, and social impairments.

Mount Sinai offers the following resources for obesity and weight management problems before, after, or instead of bariatric surgery:

  • Family-based weight loss
  • Individual cognitive behavioral therapy
  • Support through the Noom health app

These and any of the other services we provide are available to help you address your mental and physical challenges related to eating disorders.

Dr. Robyn Sysko is a pioneer of the Bariatric Surgery Evaluation Program.