Eating Disorder Services

From anorexia nervosa, to bulimia nervosa, to Binge-Eating Disorder, to any other type of eating disorders, Rago & Associates is nationally and internationally known for their strong professional training and experience with virtually every kind of eating disorder in men and women across all age groups.



The American Psychiatric Association has classified eating disorders into several categories: anorexia nervosa, bulimia nervosa, binge-eating disorder, eating disorder-NOS and body dysmorphic disorder.

The classification system developed by APA is somewhat helpful, but it actually leaves many people feeling confused and invalidated about their eating disorders. Did you know?…One survey found that 52 percent of people with eating disorders did not meet the criteria for Anorexia or Bulimia Nervosa? They ended up in a confusing subcategory called, “Eating Disorder Not Otherwise Specified (NOS).” With our current classification system, many people end up wondering, “Do I even have an eating disorder?”

Looking at the different types of eating disorders can often make people feel left out, as if they really don’t have an eating disorder. There is really an overemphasis placed on thinness in this field. If people are extremely underweight they may be able to have their eating disorder validated by family, friends, professionals and the medical community. But, did you know, eating disorders can happen to males and females across all ages and people with eating disorders come in every shape and size! The myth that thin, young females are the only ones with eating disorders has caused hundreds of people to be misdiagnosed and confused about their own problem. Eating disorder studies have been able to factor eating disorders down to a few key issues. Do these sound familiar to you? You may have an eating disorder if you:

  • • Are preoccupied with food, weight and body image (ask yourself: “what percentage of your day do you spend thinking about food, weight and body image?”)
  • • Have an intense drive for thinness and body perfection. (regardless of what you weigh)
  • • Tend to struggle with restricting(dieting, attempting to delay or prevent eating), purging, bingeing (a feeling of loss of control over eating ) and/or compulsive overexercise.
  • • Have very distressing feelings about your body.

These are really the issues of concern when diagnosing eating disorders. People who are underweight or overweight may have weight management as one aspect of their treatment, but really treating the entire mind, body and soul is crucial to achieve lasting and full recovery.

People with eating disorders spend tremendous amounts of time in fear, guilt and shame regarding their bodies. Control is a big issue, ranging from complete, obsessive control over eating to feeling completely in despair and out of control. Their entire self-worth may be at stake upon eating the wrong thing or believing this day that their bodies look so wrong.

Healthy people feel comfortable with their bodies, eat when they are hungry, stop when they are full, plan and eat meals and snacks they enjoy, and have a stable, healthy body weight.

At Rago & Associates we are dedicated to supporting and guiding you on the way to full and complete recovery from eating disorders. We will work with you and your family to create a treatment plan for eating disorder recovery that is as special and unique as you are. And we will help you every step of the way. Whether you have just begun to wonder about an eating disorder, or if you have been stuck or struggling for years, our experience, expertise and resources will always come up with more ideas. Instead of blaming yourself or your loved one, try something new and experience the “Ragos” difference.


Anorexia nervosa literally means “fear of fatness.” Anorexia is characterized by an intense drive for thinness. These people are literally consumed by and driven by trying to restrict and avoid certain foods and to engage in activities that could cause weight loss, such as intense exercise or severe food restriction. People with anorexia have odd eating habits and preoccupations. As they restrict food more and more, they become increasingly preoccupied with food and body imagery concerns. You may see a person avoid eating with others, socially isolate themselves, have little energy and have difficulty sleeping at night. When an anorexic begins restricting food, the person may seem and feel pretty normal. That’s because a body can use the reserves and resources it has stored up in the past. However, as time goes on, an anorexic person can have increasing medical problems and physical and emotional symptoms.

Weight may drop dangerously in anorexia nervosa. However, a person with anorexia nervosa may be at any part of the weight spectrum. We have met many people whose weight would be classified as “overweight,” but they starve themselves for long periods of time, and have the same mind set as all anorexic people.

To meet the full criteria for “anorexia nervosa” a person must be 15 percent below their ideal body weight. Females also have to miss their period for three months. However, we consider people with this mind set to be anorexic, even if they don’t meet the body weight and menstrual loss criteria. The APA would classify these individuals as “eating disorder-NOS” (not otherwise specified)


In bulimia nervosa, a person has episodes of binge eating. That’s when they eat more food than they intend to, then are so upset about what they ate that they become obsessed with ways to purge. This may include throwing up food or over-exercising. There are many other types of purging, but they will not be discussed here since these behaviors tend to have a “contagious” effect. People who have anxiety about their eating and body image don’t need new tips about how to rid themselves of what they eat. Please speak to your counselor privately about the ways that you may try to rid yourselves of food, fat and calories.

Some people with bulimia eat normally throughout the day and also binge and purge. Other people with bulimia alternate bingeing with restricting snacks and meals. People with bulimia often have co-occurring problems with substance abuse, depression and relationship problems. Counseling can address all of the underlying issues and co-existing issues of concern, along with developing a healthy lifestyle that eliminates bingeing and purging.

A hybrid of these problems is called bulimarexia. That’s when a person eats small amounts of food, and does not binge, but then purges these small amounts. The person with bulimarexia has many of the same symptoms of anorexia. Basically, you could consider this a “purging anorexic”.

Eating Disorder- NOS means “Eating Disorder- Not Otherwise Specified.” It is the American Psychiatric Association’s classification for eating disorders that do not meet all of the strict criteria for the above categories. Obviously, the more frequent and the more severe the symptoms, the more problematic the eating disorder is and the more urgently the person needs to get help.

Night eating syndrome is another type of eating disorder. In night eating syndrome, the individual restricts food as much as possible during the day and then has large binges at night.


In 2014 Binge Eating Disorder was finally officially recognized by the American Psychiatric Association as an Eating Disorder. Binge Eating Disorder is closely related to Anorexia and Bulimia, but in this disorder clients may not restrict their food, but they do find themselves bingeing and experiencing a loss of control over their eating. The experience of binge eating is very distressing and it can often lead to much weight gain for the sufferer. This can lead to painful shame and isolation, leaving the person in a vicious cycle. Recovery from Binge Eating Disorder has a component of nutrition planning to help understand and avoid the cycle that the person is feeling trapped in. The counseling part of BED recovery consists of finding out and understanding the roots of the problem, and the current issues that maintain the struggle.

People can develop Binge eating problems at any age, and clients report that both binge eating and restricting often lead to the numbing of feelings. While adults may have a multitude of healthy and unhealthy coping options available to them (from going out for a drive to calling a friend to drinking too much), children have very limited access to help when they are overwhelmed. Binge eating or restricing foods may be the only ways they can come up with to numb out and escape when they are emotionally overwhelmed with loneliness, depression, anxiety, family problems, loss, trauma or any other concerns.


People with eating disorder have taught us that BODY IMAGE is one of the most difficult and triggering aspects of an eating disorder, and one of the things that holds them back greatly from a full recovery. Body Image is complicated, resistant to change, and it can be a very negative force in our self-esteem. It is important that any good eating disorder program will help you with the development of a positive body image. Rago & Associates is committed to helping you with body image issues as an integral part of your eating disorder treatment. We have many ways to accomplish good body image, and several therapists who specialize in this. Don’t give up on your body image. Try some new approaches to finally feel good about every aspect of yourself.


People with eating disorders typically have over-concern with, and excessive criticism of their bodies.Their thinking can become rigidly fixated on body criticism.

This can sometimes lead to another psychiatric concern called “body dysmorphic disorder” or BDD.

Body dysmorphic disorder is defined as an excessive preoccupation with a real or imagined defect in personal appearance. People with BDD have an irrational, or distorted perception of how they look, and are obsessed with certain characteristics of their appearance. They may exaggerate a perceived flaw out of proportion, and have trouble controlling obsessive, negative thoughts about the “flaws” in their appearance. This perceived flaw may be related to a specific part of the body, specific parts, skin, hair or facial characteristics. Reassurance from others does not seem to diminish the negative self-talk because it is so irrational and so strong. People with BDD may consider themselves so unattractive that social anxiety may develop due to fear of rejection from others based on this “flaw”.

Signs and symptoms of body dysmorphic disorder include “checking” the appearance of the specific body part in mirrors or other reflective surfaces, frequently touching and measuring the area of concern, being very anxious and preoccupied about the body, constantly weighing oneself, wearing baggy clothing or attempting to conceal the area, avoiding taking pictures, time-consuming grooming rituals and avoiding social situations for fear that people will notice the perceived flaw.

Counseling with a knowledgeable professional who specializes in body imagery concerns can help those with BDD overcome these destructive and negative behaviors and attitudes toward the self. In particular, challenging and facing the fears and behaviors one by one can allow the person to see themselves more accurately, and have their attitudes toward their body eventually correct. When BDD co-exists with eating disorder behaviors, it is important to treat them simultaneously. The normalization of eating and exercise behaviors helps people to have an accurate body image.


One main reason to seek treatment for an eating disorder is the way it destroys your quality of life. Eating disorders often co-occur with depression, anxiety disorders, obsessive compulsive disorders, social isolation, exhaustion, problems with other relationships and family problems. The age-old “chicken and egg” question seems to apply. Did the depression cause the eating disorder, did the eating disorder cause the depression or did they come at the same time, caused by other factors? In therapy, you can sort out these answers, and receive treatment for symptoms in all categories that concern you.

The other main reason to recover from your eating disorder is to halt the development of the medical side effects that occur with eating disorders. People with anorexia and bulimia nervosa are at risk for untimely death due to heart attack, electrolyte imbalance and dehydration. Severe malnutrition occurs from purging, restricting and over-exercising, and the longer you have an eating disorder, the higher your medical risk will become. In fact, the mortality rate for people with an eating disorder 10 years or longer is 10 percent. That means one in ten people will die of medical complications associated with eating disorders. Predicting who will die and when is particularly difficult with a chronic eating disorder. Please get help and find your path to recovery!


At Rago & Associates we offer research-based, creative, innovative and state of the art treatment for eating disorders. It is important to begin with a thorough assessment of your symptoms and the building of a treatment plan. Your treatment plan is the strategy that you and your counselor will use for your recovery. You, and your counselor together will make the blueprint for your recovery. It will be modified as you go along. It is often useful to include family members and friends to provide the support and resources needed for recovery.

It is often useful to find complementary, additional resources for treatment. Some common additions to your treatment team could include medical monitoring resources, evaluation for psychiatric medication, nutritional counseling, exercise consultation and support. You will be treated with respect and you will be involved in all aspects of planning your care.

At Rago & Associates, we would like to be your consultants as you travel your path to recovery from an eating disorder


Hate dieticians? We hear that many people who have eating disorders don’t like working with a dietician. Maybe it wasn’t the right dietician. Maybe they didn’t help you own your body again. Our dieticians will listen to your fears and goals, and make recommendations that are not punishing to you. We know it’s your body. We want to help you with any blind spots you may have about eating and your body, or any areas where you are stuck. We vow to collaborate with you and care about you, and share our resources and ideas so that you can step by step recover from your eating disorder. From nutritional stabilization all the way to intuitive eating, you can trust that our staff of specialized dieticians will be an integral part of your recovery. Let’s go to the grocery store. Let’s make a meal for your family. Creative, caring, innovative approaches will help you solve the problems that have kept you stuck for too long.

Life is to be enjoyed, and so is food and so is your body. Challenge yourself to take the best care of You, and eat in a way that is truly satisfying.

Contact Us About Eating Disorder Services

Dr. Maria Rago can connect you with the services and people she believes can best help you or your loved one.