Eating disorder resources for families & friends

Two commonly confused terms, body dysmorphia and gender dysphoria, refer to distinct terms that involve dissatisfaction with one’s body. Although they may seem similar, they are pretty different, have different characteristics, and are addressed differently. Understanding these differences is key for recognizing and supporting individuals dealing with either.

What Is body dysmorphia?

Body Dysmorphic Disorder (BDD), or body dysmorphia, is a mental health condition where an individual becomes excessively preoccupied with perceived flaws in their physical appearance. These flaws are often minor or entirely imagined, yet they cause significant distress and impact daily life.

Key characteristics of body dysmorphia:

• Obsessive focus on appearance: Someone struggling with body dysphoria may fixate on specific features—such as skin, hair, nose, or body shape—that they perceive as not “normal”.
• Distorted perception: Often, someone struggling gets stuck in their thoughts. Family or friends may try to tell them nothing is wrong, but they continue to believe in their own perceptions.
• Compulsive behaviors: Body dysphoria can often lead to compulsive actions such as checking mirrors or begin to develop eating disorder behaviors to attempt to modify their body.
• Emotional distress: The preoccupation with appearance can lead to anxiety, depression, and isolation, severely impacting a person’s quality of life.

What is gender dysphoria?

Gender dysphoria, relates to the distress experienced when there is a conflict between an individual's assigned gender at birth and their true gender identity. While the term “dysphoria” simply refers to a state of dissatisfaction or unease, in this context, it’s tied specifically to gender identity.

Key characteristics of gender dysphoria:

• Incongruence with gender identity: Individuals with gender dysphoria feel that their body does not align with their true gender. This can result in discomfort with specific body parts (e.g., chest, genitals) or general unease with how others perceive their gender.
• Desire for transition: Many people with gender dysphoria experience a strong desire to transition to their true gender, whether through social changes (name, pronouns, clothing) or medical interventions (hormone therapy, surgeries).
• Emotional distress: The experience of body dysphoria can lead to significant emotional suffering, including anxiety, depression, and in severe cases, suicidal thoughts. This often stems from the difficulty of living in a body that feels incongruent with one’s gender identity and from societal stigma or lack of acceptance.

Although the terms sound similar, there is often confusion between gender dysphoria and body dysmorphia.

How dysphoria and dysmorphia relate to eating disorders

Eating disorders, such as anorexia nervosa, bulimia nervosa, and binge-eating disorder, are often connected to body dysmorphia and, in some cases, gender dysphoria. Eating disorders are marked by an unhealthy relationship with food and body image, and they can arise when individuals attempt to cope with negative feelings about their bodies.

Body dysmorphia and eating disorders share a common thread: both involve an unhealthy fixation on appearance and body image. For individuals with body dysmorphia, concerns about weight or body shape may lead to disordered eating as a way to control or "fix" perceived flaws. For example, someone obsessed with their body size may engage in extreme dieting, purging, or over-exercising to achieve an unattainable body ideal.

While body dysmorphia disorder is classified as a mental health disorder by the APA and listed as such in the DSM–5 (the official listing of mental health disorders), and it can be comorbid with a variety of eating disorders, gender dysphoria is not listed as a disorder or a mental health illness.  

For transgender and gender non-conforming individuals, disordered eating may develop as a coping mechanism for dealing with body-related distress. In some cases, individuals with gender dysphoria may restrict their eating in an attempt to change the way their body looks or suppress features that feel misaligned with their gender identity. For instance, a transgender man may engage in extreme dieting to reduce the size of their chest or hips.

The incidence of eating disorders is much higher in transgender community than in the cisgender population.

In fact, 16% of college-aged transgender students surveyed in a 2015 survey had experienced or were experiencing an eating disorder. And at Monte Nido, we know from our data that 36% of all clients identify as LGBTQIA+.

Societal pressures to conform to beauty ideals, combined with the stress of living in a body that doesn’t align with one’s gender identity, can make those with gender dysphoria particularly vulnerable to developing disordered eating patterns.

Gender identity and self-image

It is still far too common for both laypeople and professionals, to conflate the body-image issues arising from a gender identity dissatisfaction with those resulting from a mental health disorder like body dysmorphia.

To put in simpler terms, a person with gender dysphoria is not mentally ill; they are dissatisfied with the gender assigned at their birth.

A person with body dysmorphia has a disorder in which they perceive their body or face as “ugly,” “fat,” or otherwise unattractive despite medical or personal reassurances.

Gender identity and self-image are inextricably linked; for a woman to look in the mirror and see a man is disorienting and distressing. Discrepancies between a person’s assigned gender and their true gender, in addition to the presence of discrimination and misunderstandings by the general public towards transgender issues, can lead to other mental health disorders, such as anxiety, depression and OCD, all of which are more prevalent in the transgender community than the non-trans community.

This all ties back to the main distinction about the difference between gender dysphoria and body dysmorphia – one involves a distorted perception of their body and the other doesn’t.

Health risks related to dysphoria and dysmorphia

Eating disorders are among the most dangerous mental health conditions, resulting in gastrointestinal, endocrine, cardiopulmonary, and neurological complications.  Without receiving anorexia treatment, there may be a mortality rate of as much as 4%.  Other eating disorders such as bulimia nervosa can result in dental problems and issues with the esophagus due to frequent vomiting. In all eating disorders, poor nutritional balance or even malnutrition are risks.

A transgender identity in and of itself carries no inherent health risks.  However, when a person decides to make the transition, they normally begin with hormone treatments, whether reassignment surgery is planned to happen or not. By introducing estrogen or testosterone, there is a slightly increased risk of cancer, and more common risks of low or high blood pressure, blood clots, dehydration, electrolyte imbalance, and liver damage. An important thing to note is that due to discrimination and societal pressure, transgender people are less likely to go through “above the board” healthcare providers, meaning the hormone treatments they receive may not be properly balanced for their body, exacerbating some of the issues raised above.

Both transgender people and people with body dysmorphia have higher than average rates of mental health and behavioral health disorders.  Prominent among these are depression and anxiety.  Both of these mental health disorders are normally caused by a combination of genetic and environmental factors, just like gender dysphoria and body dysmorphia.  In many cases, a specific trigger such as a traumatic event (i.e. abuse, a bad breakup, being in a car accident, etc.) sets off a previously hidden disorder.

In fact, our research at Monte Nido research suggests that 63% of LGBTQIA+ adults in our residential treatment programs met criteria for PTSD, compared to 45% cisgender heterosexual individuals.

The one common health risk of dysphoria and dysmorphia

Depression and anxiety are contributing factors in the one health risk that’s common to both gender dysphoria and body dysmorphia: suicide.  Rates of suicidal ideation (that is, thoughts of suicide), attempted suicide, and actual suicide are all much higher in transgender populations and in populations experiencing body dysmorphia than in the larger populace.

Body dysmorphia

• 80% of individuals have suicidal thoughts
• 24-26% have attempted suicide
• Complete suicides percentage is unknown, but thought to be very high

Transgender population

• More than 50% of transgender males have attempted suicide
• 30% of transgender females have attempted suicide
• More than 40% of non-binary adults have attempted suicide

The combination of a negative or distorted self-image and a severe mental health disorder like depression, or the combination of a mental health disorder and the societal pressures and discrimination received by transgender people, put an already at-risk group of communities even further at risk.  With the already high risk of medical complications resulting in fatalities that are associated with anorexia nervosa and other eating disorders, this creates the need for specialized, intersectional strategies for anorexia treatment in the transgender population.

A personally designed treatment plan including psychiatric treatment (if necessary) with body positivity training and behavioral therapy like Dialectical Behavior Therapy (DBT) or Cognitive Behavioral Therapy (CBT) can help people rehabilitate their body image and break out of the repeated patterns of behavior that come with both eating disorders and body dysmorphia.

While the journey to eating disorder recovery is rarely an easy one, it can be made even more difficult when added to the societal pressure and stigma associated with a transgender identity. The professional team of doctors, nurses, therapists, and psychiatrists treating a transgender individual must take into account factors beyond those which normally accompany a diagnosis of anorexia nervosa or another eating disorder. These include:

Hormone treatments

For some extreme cases of anorexia nervosa, hormone therapy is used to counteract osteoporosis and other symptoms coming from a nutritional deficiency. For transgender individuals who have begun hormone treatments to hasten their transition, medical professionals must coordinate these two types of hormone treatments to meet the client’s needs.

Body dysmorphia treatment without judgment

At the center of any effective treatment program for a trans person with an eating disorder has to be a strong understanding that gender dysphoria is not a mental health disorder.  Trans people are already at higher risk for developing body dysmorphia disorder and subsequently an eating disorder, and they face enough discrimination that they are less likely to seek medical care or psychiatric care. They need a care provider which can treat the actual disorders with sensitivity to gender dysphoria.

Gender-specific eating disorder treatment

Quite often, people seeking eating disorder treatment are more comfortable among their own gender (the distorted perceptions of “attractiveness” or past triggers of abuse are common reasons behind this), and this remains true in the trans population. The person’s true gender must be accounted for and their wishes respected during treatment.  For example, a non-binary trans person may be uncomfortable in a female-only treatment program.  For this reason, an anorexia treatment center should be flexible enough to accommodate each client’s needs in regards to gender identity.

Achieving a Full Recovery Regardless of Gender

At Monte Nido, we believe that every person deserves to find hope that their eating disorder can be treated, and full recovery can be achieved. The compassionate, empathetic staff at each of our many locations are experienced in helping people of all genders regain their lives and move on to a brighter future, free of disordered body image. If you or a loved one has received a diagnosis of an eating disorder, or simply feel you need help, contact us today to get started on the gender-affirming path to a recovered life.

A Discussion of the Similarities and Differences

When someone has an eating disorder, their goal is to eliminate the disorder from their life. In most cases, this involves engaging in an appropriate treatment program. The phrases “recovery,” “in recovery” and “recovered” are often used interchangeably, which can be confusing for the people involved in the process, as well as those who have loved ones with an eating disorder. For this reason, it is important to define these terms clearly.

Defining Eating Disorder “Recovery”

Recovery is the process by which someone overcomes an eating disorder. During recovery, patients undergo a variety of therapies to help them understand why their disorders exist and to challenge these disordered thoughts and behaviors. During this process, they may also address co-occurring issues, such as depression, anxiety, personality disorders or other problems that make eating disorders more difficult to treat.

For many patients, recovery will continue even after treatment. The process of recovery is not complete until the individual is no longer affected by the eating disorder in any way. The recovery process looks different for every patient, and the time it takes to complete can vary considerably. Some people could have a recovery period that lasts for many years, while others may recover fully within months of completing a professional treatment program.

Defining “In Recovery”

When someone is “in recovery,” it means they are in the process of recovering from an eating disorder. This may mean you are actively involved in an eating disorder treatment program. For example, you may be undergoing treatment at a residential treatment  program, or you may be in a day treatment program. The phrase “in recovery” could also be used to refer to someone who has completed a treatment program but does not consider himself or herself to be fully recovered from the eating disorder. This individual may be living everyday life outside of treatment, but he or she continues to deal with urges to engage in disordered eating behaviors, such as bingeing, purging or severely restricting food intake.

Defining “Fully Recovered”

To be “fully recovered,” an individual must be completely free from all symptoms of his or her eating disorder. In addition, the person must have also accepted his or her natural body size and shape, and he or she will no longer engage in any behaviors related to food or body size that could be considered self-destructive. Instead, this person will have an appropriate perspective on food, body weight, body image and other such issues. Full recovery is the ultimate goal of anyone who has an eating disorder, as it signals the individual is now free from the majority of the negative effects of the illness.

Why It Matters

When the terms “in recovery” and “fully recovered” are not properly defined and understood, it can be confusing for all those involved. It can be difficult to understand what someone means when they say one of these phrases. In addition, opinions on whether full eating disorder recovery exists may also differ, so having clear definitions is important. Furthermore, understanding these definitions makes it easier for people who need to recover from an eating disorder to set goals and develop a clear vision of what they want their future to look like.

Different Perspectives on Eating Disorder Recovery

While someone is enrolled in an eating disorder treatment program, they are likely to be described as “in recovery”. However, there is also a school of thought that believes everyone who has ever been diagnosed with an eating disorder remains “in recovery” for the rest of their lives, even if they are no longer experiencing any of the symptoms of the disorder. In fact, programs subscribe to this school of thought and pass this way of thinking on to their patients. Other people, however, believe it is possible to become fully recovered, which means the eating disorder is no longer having any impact on the individual’s life.

Is It Possible to Achieve Full Recovery?

When it comes to the possibility of a full recovery from an eating disorder, people disagree. While some people believe an individual will continue to deal with triggers and a desire to engage in disordered eating behaviors for the rest of their lives, other people believe it is possible to eventually free yourself from these issues entirely.

Among those who believe in the possibility of a full recovery, it is important to note that full recovery doesn’t necessarily occur when treatment ends. It is possible to complete a treatment program, be free of symptoms and still be considered “in recovery”. In such cases, the individual is no longer experiencing the symptoms of the eating disorder but continues to deal with poor self-image or spends too much time focusing on food.

Similarities and Differences Between “In Recovery” and “Fully Recovered” for Eating Disorders

To help both patients and their families better understand the terms “in recovery” and “fully recovered”, below is a discussion of the similarities and differences between these two terms.

Similarities

Some of the similarities between people in recovery and those who are fully recovered include:

• A history of an eating disorder
• Both people who are in recovery and fully recovered from an eating disorder have dealt with this condition at one time.
• Recognition of the existence of the eating disorder
• Both people who are in recovery and fully recovered from an eating disorder have acknowledged the existence of this issue.
• Active pursuit of recovery
• Both people who are in recovery from an eating disorder and those who are fully recovered have taken steps to eliminate the symptoms of this disorder and achieve full recovery.

Differences

Some of the differences between people who are in recovery and those who have fully recovered include:

• Body image
• Someone who is in recovery may still deal with a negative or distorted body image. Someone who has fully recovered, on the other hand, will have a more positive and realistic view of his or her body.
• Enrollment in a treatment program
• Someone who is in recovery may be actively participating in a treatment program. However, someone who is considered fully recovered is no longer undergoing professional eating disorder treatment.
• Disordered eating
• Someone who is in recovery may occasionally engage in disordered eating behaviors or at least have the urge to do so. Someone who has fully recovered is no longer dealing with this issue.
• Fear of relapse
• An individual who is in recovery may have an intense fear of relapsing. However, if an individual is fully recovered, he or she will no longer fear relapse or consider it a possibility.

Achieving Full Eating Disorder Recovery

The idea that full recovery is possible brings hope to many people who have been diagnosed with eating disorders, as well as to those who simply suspect they may have a disorder based on the problems they are experiencing. While the road to a full recovery may be long, it will be worth the time and effort. Not only will you return to a healthy sense of self and no longer engage in disordered behaviors, but you will also be free from any preoccupations related to the eating disorder.

The first step in achieving full recovery from an eating disorder is to enter an appropriate treatment program. For example, if you are interested in full anorexia recovery, you need to explore anorexia nervosa treatment options. When it comes to professional eating disorder treatment, a wide variety of options exist. One of the most important choices you will make with regard to eating disorder treatment options involves choosing between residential eating disorder treatment and outpatient treatment. While residential eating disorder treatment programs require you to remain on-site for the duration of the treatment program, outpatient treatment programs do not. There are both advantages and disadvantages to each type of program, so it is important to weigh your options carefully.

Another important issue to consider when working toward a full recovery from an eating disorder is the different therapies and treatments available from the program you choose. In general, it is best to look for a program that offers a wide variety of options and customizes each treatment program to meet the needs of individual patients. Some of the most common treatments available from bulimia and anorexia treatment centers include individual counseling, group therapy, family therapy, exercise education, nutrition education, medical care, and psychiatric treatments.

Whether they are looking for anorexia treatment centers or centers specializing in another eating disorder, many patients will also need to consider other more practical factors when selecting an eating disorder treatment program. Some of these more practical considerations include cost, location, and whether the program accepts your insurance policy. If you want to be fully recovered from an eating disorder, however, the quality of the treatment you receive must be your top priority. If cost is an issue, many eating disorder treatment programs offer payment plans to make treatment more affordable.

Get Help from Monte Nido

At Monte Nido, we believe that full recovery is possible for any patient with an eating disorder, and we operate all of our programs under the guidance of this belief. We give our patients the hope and encouragement they need to work toward a future that does not include their eating disorders.

Monte Nido offers anorexia treatment, bulimia treatment, and treatment for all other types of eating disorders. All of our treatment programs are customized based on the backgrounds, preferences, and needs of each patient. Our bulimia and anorexia treatment programs have excellent success rates, with the majority of our patients reporting positive results. Recovery is possible with the right treatment. Monte Nido believes in your ability to recover, and we are here to help show you the way. Please contact us today to learn more.

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The Difference Between Inpatient and Outpatient Eating Disorder Treatment

When searching for mental health treatment options, you’ll often come across the terms inpatient treatment and outpatient treatment. Both play vital roles in mental health care, but they differ significantly in terms of intensity, structure, and support. If you're navigating these options, particularly for conditions like eating disorders, understanding the differences will help you make the best decision. Below, we’ll break down these levels of care to help guide your choices.

1. Outpatient Treatment: Independent Living with Regular Support

Outpatient treatment is designed for individuals who are medically stable and able to manage their condition with less frequent care. This treatment is ideal for those who can live independently while attending therapy sessions on a weekly basis.

●     Who it’s for: Individuals with mild symptoms or those who have stabilized after higher levels of care.

●     Treatment structure: Regular appointments with therapists, psychiatrists, or dietitians, typically one to two sessions per week.

●     Benefits: Offers flexibility allowing individuals to continue with work or school while receiving ongoing support.

Outpatient care is a great option if you're looking for flexible treatment without the need for 24-hour supervision. It's suitable for people in the recovery phase or those whose illness is manageable with periodic therapy.

2. Intensive Outpatient Treatment (IOP): More Frequent Support for Recovery

Intensive Outpatient Programs (IOP) offer a higher level of support than standard outpatient care. IOP typically involves attending therapy sessions multiple times a week, but participants still live at home and can maintain some of their daily responsibilities.

●     Who it's for:Individuals who are medically stable but require more structured support to manage symptoms and reduce harmful behaviors.

●     Treatment frequency:Typically involves weekly individual sessions with a therapist and dietitian as well as several hours of group therapy roughly three to five days per week.

●     Benefits: Provides more focused attention without the need for overnight stays, allowing individuals to continue working or attending school.

IOP is often recommended for those who are managing their eating disorder and other mental health disorders and need a higher level of care to reduce harmful behaviors.

3. Partial Hospitalization Program (PHP): Daylong Treatment with Evening Independence

For those who need more intensive care, Partial Hospitalization Programs (PHP)offer group therapy typically five to six days a week while still allowing individuals to return home at night. PHP is typically a step down from residential care, but still provides significant structure and supervision.

●     Who it’s for: People who require intensive support but can live independently outside of a treatment center at night.

●     Treatment structure:Individual sessions with comprehensive treatment team in addition to more intensive group therapy and meal support up to 6 hours per day 5-6 days per week.

●     Benefits: Provides comprehensive care, including therapy, meals, and medical monitoring, without requiring overnight stays.

PHP is a good option for individuals who need intensive mental health care during the day but are able to return home or to a transitional living situation in the evenings.

4. Residential Treatment: 24/7 Supervision and Intensive Care

Residential treatment provides around-the-clock care for individuals who are medically stable but still need significant support to address harmful behaviors and mental health challenges. This type of care involves living at the care location full-time and engaging in daily structured therapy and support.

●     Who it’s for: People who require a controlled environment to focus solely on recovery.

●     Treatment structure: Full-time residential care, with multiple daily therapy sessions, medical monitoring, and group activities.

●     Benefits: Provides a safe, controlled environment where all meals, therapies, and activities are supervised, helping individuals focus solely on their recovery.

Residential treatment is an ideal solution for those needing intensive care in a safe, controlled environment to overcome harmful behaviors and begin their recovery journey.

5. Inpatient Treatment: Medical and Psychiatric Care for Acute Symptoms

Inpatient treatment is the highest level of mental health care, typically reserved for individuals who are experiencing severe symptoms and need constant medical supervision. This level of care focuses on stabilizing acute mental health crises.

●     Who it’s for: Individuals whose symptoms pose a danger to themselves or others, or who need intensive medical management.

●     Treatment structure: 24/7 care in a hospital or psychiatric care facility with constant medical monitoring.

●     Benefits: Provides the highest level of safety and care, with a strong focus on managing severe symptoms, stabilizing the individual, and addressing any medical or psychiatric complications.

Inpatient treatment is the most intensive level of care and is essential for individuals in critical situations who require immediate stabilization and around-the-clock monitoring.

How Monte Nido Supports Complete Eating Disorder Recovery

At Monte Nido, we specialize in inpatient, residential, day (PHP & IOP), and virtual treatment for eating disorders, offering a structured environment where clients receive intensive care based on their unique needs. However, we don’t stop there. Our collaborative approach ensures that we work closely with each client’s outpatient treatment team to provide the most comprehensive care possible.

If you or someone you know is considering treatment for an eating disorder, contact us today to learn more about how we can help you on your path to recovery.