Why Timing Matters
Here is something I say often in my practice: when it comes to an eating disorder, throw everything and the kitchen sink at it.
Specialized treatment is an investment. It can mean therapy, nutrition support, medical care, family involvement, or more support than anyone expected to need. I don’t minimize that.
But especially with teens, there is a real opportunity in intervening early.
The hope is that one day a young person can look back and say, “I struggled with an eating disorder as an adolescent,” and have it be something they went through — not something that followed them into their twenties and became increasingly woven into how they eat, cope, socialize, move through the world, or understand themselves.
The longer these patterns are practiced, the more familiar they can become. Food rules turn into routines. Avoidance gets reinforced. Behaviors that may have started as a way of managing anxiety, distress, control, or body image can begin to feel like simply who I am.
That is why I believe in taking early signs seriously. Not because every instance becomes an eating disorder — and not because anyone should panic. But because catching something early, when possible, matters.
And if an eating disorder has already been present for years, that does not mean accepting less.
If anything, this is when more can be better — bringing in the right people, looking at what has and hasn’t worked, and building enough support around someone for recovery to have room to take hold.
Specialized eating disorder treatment takes time, energy, and money. I know that matters. But so does losing years of life to an eating disorder. Getting more of that life back is worth investing in.
— Bella Shirinyan, LMFT
What this can look like
- Restriction or chronic under-eating
- Binge eating or loss of control
- Purging or other compensatory behaviors
- ARFID, sensory, or fear-based avoidance
- Compulsive or compensatory exercise
- Orthorexic or rigid food patterns
- Body-image distress or preoccupation
- Food rituals, rules, or increasing preoccupation
We work with anorexia, bulimia, binge-eating disorder, ARFID, OSFED, and disordered eating that may not fit neatly into a diagnosis.
Purging or compensatory behaviors can include self-induced vomiting, misuse of laxatives or diuretics, fasting, or other attempts to compensate for eating.
Eating disorders and disordered eating can also occur alongside anxiety, OCD, depression, trauma, perfectionism, substance use, and self-harm.
Eating disorders do not have a look
Someone can be struggling significantly at any body size. Weight, appearance, or the absence of visible weight change cannot tell us how much distress someone is experiencing or how serious an eating disorder may be. You do not have to look sick to need support.
You don’t need to wait for a diagnosis
Disordered eating can be serious even when it does not fit neatly into a diagnosis. Increasing food rules, avoiding meals or social situations, changes in exercise, growing distress about body shape or weight, and feeling preoccupied with food can all be reasons to pay attention.
Reaching out early does not mean assuming the worst. It creates space to understand what is happening and decide what level of support makes sense.
How specialized eating disorder therapy can help
Specialized eating disorder therapy is individualized rather than built around a single diagnosis or prescribed path. We look at the eating-disorder behaviors themselves and at what may be sustaining them — including anxiety, trauma, perfectionism, emotional regulation, relationships, and the need for control or safety.
Care may include individual therapy, family involvement, collaboration with a registered dietitian and medical provider, and practical support outside the weekly session. The goal is not simply to stop behaviors, but to build enough understanding, flexibility, and support for recovery to become sustainable.
When more support is needed
Sometimes outpatient therapy is the right level of care. Sometimes an eating disorder needs more support. When appropriate, care may include closer collaboration with medical providers and dietitians, additional therapeutic support, or referral to a higher level of care.
The goal is to match the level of support to what someone needs now — and to adjust that support when needs change.
Care can extend beyond the therapy room
At-the-Table Support
Guided support for the emotions, rituals, and avoidance that can arise around meals.
ExploreBeyond the Therapy Room
Practical support for restaurants, grocery stores, travel, and everyday recovery challenges.
ExploreCollaborative Care
Coordination across therapy, nutrition, and medical care when a connected treatment team is needed.
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