Behavioral Health

Our Programs

Mount Sinai’s Eating and Weight Disorders Program offers effective treatment options provided by psychologists, psychiatrists, mental health counselors, and dieticians. We have an outpatient program and, for additional support, an intensive outpatient program. If you have a diagnosis of obesity and obesity-related health issues, we also offer you the option of participating in our bariatric surgery evaluation program to find out if weight loss surgery is a valid option for you. 

Outpatient Program

Our outpatient program provides evidence-based treatment for children and adults who are struggling with feeding and eating disorders, including obesity. As an outpatient, typically you will visit once or twice a week for individual or family treatment sessions.

Our clinical experts are skilled in providing evidence-based treatments for eating disorders including:

  • Cognitive behavioral therapy: A form of talk therapy that helps you change harmful behaviors by altering your thinking about eating
  • Dialectical behavior therapy: Psychotherapy to help identify and change negative emotions
  • Maudsley family-based therapy: Involves parents in the treatment of a child’s eating disorders
  • Mirror exposure treatment: By looking at yourself in a mirror in a therapeutic setting, you learn to shift your body self-image
  • Prescribed pharmacological treatment: Integrates into overall therapy for eating disorders

Our clinicians customize each treatment plan for the type and severity of the disorder, your age, and any accompanying conditions that you may be experiencing, such as depression and anxiety. The types of customized care we provide allows us to meet your needs with treatments that will help you set and reach healthy goals. This program offers a number of effective treatment options that may be given on an individual basis or as part of overall family therapy. 

Intensive Outpatient Program

Our intensive outpatient program combines advanced medical and psychiatric expertise. This intensive program is effective if you require more structured treatment than available in weekly regular outpatient therapy. We offer follow-up care after residential or inpatient hospitalization and accept patients between the ages of 12 and 22. Our specialists encourage you to continue working with your outside health care providers while in our program, and we will collaborate with them during and after your participation in our program.

In addition, families learn how to manage the recovery process and cope with abnormal eating behaviors and any accompanying psychiatric problems.

This program combines a variety of evidence-based treatments, including family-based, cognitive behavioral, dialectical behavior therapy, and acceptance and commitment therapy.

In addition, the program provides clinically trained staff for meal support during the mid-morning snack and lunch. Our registered dietician tailors meals to your needs. 

Program Overview

The core treatment program takes place three days per week for three hours per day. Treatment involves the following activities:

  • One meal and one snack per day
  • Weekly multi-family group lunches at noon
  • Meal support provided at every meal and snack by trained staff
  • Weekly medical monitoring, which includes weighing and checking vital signs and urine toxicology to test for substance abuse, as needed
  • Weekly staff psychiatrist session which may include medication management or diagnostic assessments, as needed
  • Daily group therapy using interventions with evidence-based therapies to treat the eating disorder and associated mood problems, such as depression, anxiety, and substance abuse
  • A variety of therapies as appropriate, including:
    • Acceptance and commitment therapy: A type of psychotherapy that encourages mindfulness and commitment to make positive change
    • Cognitive behavioral therapy: A form of talk therapy that helps you change harmful behaviors by altering your thinking about eating
    • Cognitive remediation therapy (flexible thinking group): Addresses the type of inflexible thinking that affects mental health and eating disorders
    • Dialectical behavior therapy: Psychotherapy to help identify and change negative emotions
    • Family-based therapy: Involves family in the treatment of patient’s eating disorders
    • Interpersonal therapy: Reveals how interpersonal skills can be developed to help overcome eating disorders

Our intensive outpatient program offers opportunities for additional therapy sessions including:

  • Individual psychotherapy
  • Parent skills training group
  • Mirror exposure treatment
  • Nutritional counseling services

The experts at Mount Sinai’s Eating and Weight Disorders Program are skilled in a range of both individual and family treatments, and provide support and evaluation for possible weight loss surgery. 

Enhanced Cognitive Behavioral Therapy

Enhanced cognitive behavioral therapy (CBT-E) addresses how the combination of thoughts, feelings, and behaviors contribute to the symptoms of eating disorders. Using cognitive behavioral therapy, the psychotherapist helps reveal the patient’s thoughts that generate feelings as drivers of eating disorder behaviors. The process continues to help the patient change that thinking. As a result, behavior patterns also change along with the associated emotions.

The therapeutic process teaches active coping skills that help reduce symptoms and protect against relapsing into eating disorder patterns. Here is one source where you can learn more is about CBT-E. 

Acceptance-based Mirror Exposure

Body image concerns play a serious role in most eating disorders. Distorted body image is also the symptom that is 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.

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

This mirror work involves having the patient look at his or her own body in a mirror while prompting patients to describe what they see. This process, repeated by the patient during each session, involves the therapist monitoring the description. Whenever the patient uses judgmental language, the therapist requests the use of only neutral, factually descriptive language. The goal of describing what is in the mirror is to eliminate body image dissatisfaction. 

Family-based Therapy—The Maudsley Approach

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

Central to family-based therapy is the understanding that the family unit is a key resource in helping patients with an eating disorder, especially 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 provide supportive training to parents of the patient. Parents learn how to help their children re-learn how to eat in order to achieve an appropriate weigh for their age and height. With an intense focus on behavioral change around eating, the goal is to have the patient adopt healthy eating habits. 

LEARN Weight Management Program

An effective weight management approach for addressing binge eating disorder and obesity is LEARN, an acronym that represents the five essential components of the program:

  • Lifestyle: Helping patients make lifestyle changes that will support weight loss and ongoing maintenance
  • Exercise: Moving is an important lifestyle choice of a positive and enjoyable activity to help the patient feel well
  • Attitudes: Shifting attitudes helps patients manage triggers to overeating by reducing blame and eliminating the stigma that has been associated with body weight
  • Relationships: Supporting positive attitudes and lifestyle changes so patients nurture healthy relationships
  • Nutrition: Learning how food can be a source of nutrition rather a source of upset that may lead to overeating empowers patients to eat in ways that are healthy

The program uses a collaborative approach bringing together helpful aspects of psychotherapy and education in treatment. During program meetings, we alternate short periods of instructional learning with periods of discussion and problem solving. Mount Sinai clinicians offer this program in a group or one-on-one settings, as appropriate for the patient.

The overall goal of the LEARN program is to emphasize ways to engage and react to the environment. If a patient has strong physiological or emotional responses to food, we can teach specific strategies that have proven effective in helping substance abuse patients overcome cravings. To address the issue of cue exposure, we provide behavioral training that helps patients regulate strong responses to triggers such as food, emotions, and certain situations. To reduce sensitivity to trigger situations, we may encourage the patient be exposed to these cues repeatedly, until the psychological and emotional response is extinguished.

Patients also learn how to support their goals by changing the environment, for example by leaving when possible. 

Cognitive Behavioral Treatment for Obesity

Cognitive behavioral treatment for obesity is designed to help patients lose weight with an emphasis on weight maintenance.

Our therapists first teach patients how to establish weight loss behaviors. Then to help prevent regaining weight, we help patients with the following steps in the process:

  • Identify primary goals
  • Overcome body image concerns
  • Recognize unrealistic weight goals

Cognitive behavioral treatment for obesity involves recognizing the difference between weight loss and weight maintenance, preparing for the potential obstacles of weight maintenance, and developing the behavioral skills and cognitive responses necessary to control weight effectively. 

Bariatric Surgery Evaluation

Our experts can help you determine if you are a candidate for weight loss surgery through our bariatric surgery evaluation. For some overweight or obese individuals, weight loss (bariatric) surgery may be an option.

Excess weight is not a mental health problem, but psychological symptoms can be common before and after weight loss surgery. We suggest adults and adolescents participate in treatments that are effective in addressing eating disorders and mood problems both pre- and post-surgery, such as 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
  • Noom health

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