Just west of Kenmore Square, the Renfrew Center of Massachusetts exudes a positive atmosphere for women struggling with eating disorders such as anorexia, bulimia, binge-eating disorder and Eating Disorders Not Otherwise Specified (EDNOS). This facility, the 14th Renfrew Center to emerge in the United States, opened this month at 870 Commonwealth Avenue.

“We work to empower women and to have them feel that their strength comes from within,” said Lori Ciotti, site director of The Renfrew Center of Massachusetts. “They can find a way to conquer their fears and eating disorders.”

There are 14 sites of Renfrew Centers, Boston being the recent branch. Renfrew has treated 65,000 women throughout the years. Though it only opened in late January, Boston’s site is already showing signs of success.

“Right now, we are continuing to get calls,” said Ciotti, a licensed clinical social worker. “We take in patients every day. So far, we only have a handful of people but we still are getting up and running.”

Renfrew provides a daily treatment system from Monday through Friday for five hours each day. It also has an option for an evening program, three nights a week, for people who work or have school. Treatment varies with each patient, and each case is different. Renfrew has multiple levels of care for each specific type of individual.

A general schedule for a day treatment patient would start off with a check-in at 8:45 a.m. The patient would then have breakfast, based off of a specialized meal plan, with a group of other patients and therapists. After, groups would meet to discuss the feelings of each person and talk about how the breakfast effected their emotions.  The patients would then spend the rest of their day attending various meetings with nutritionists, psychiatrists and therapists. During these meetings, they will build up a better outlook on food, focus on a positive body image and be able to share their thoughts with other patients.

“Eating disorders are very complicated in structure,” Ciotti said. “It is a very challenging and layered type of disorder.”

Anorexia

According to the National Association of Anorexia Nervosa and Associated Disorders, anorexia is the third most common chronic illness among adolescents. Anorexia is mainly diagnosed when someone restricts his or her diet and refuses to eat. Some signs would be excessive weight loss, fainting and fatigue, or even dry skin and hair loss. Most people suffering with anorexia have a distorted body image and may be obsessed with weighing themselves, even though their body weight is dangerously below average. Some may express a lack of emotion and hide their thin bodies under baggy clothing.

Bulimia

People diagnosed with bulimia generally follow a binge and purge method, which is when an individual will overeat and then counteract the calories by immediately over-exercising or throwing up. People suffering from bulimia have a tendency to hide food and eat it alone. According to the National Eating Disorders Association, some signs of bulimia are unusual swelling of the cheeks or jaw area, discoloration of the teeth and calluses on the back of the hands and knuckles from self-induced vomiting.

Binge-eating Disorder

Individuals with binge-eating disorder often cope with intense emotions by eating large amounts of food. Individuals will eat because they are stressed, depressed or angry. People who suffer from this disorder tend to eat rapidly in one sitting and even when they are full.  According to the Binge Eating Disorder Association, binge-eating disorder is the most common eating disorder in the United States. An estimated 30 to 40 percent of people wanting to lose weight are diagnosed with this disorder.  Some binge-eaters tend to try to offset their massive binges by going on diets, but then bingeing again due to lack of a sufficient caloric intake. This is known as “yo-yo dieting.”

EDNOS

Eating Disorders Not Otherwise Specified refer to disorders that cause someone to have a problem or an unhealthy relationship with food but do not fit under the criteria of the other disorders. Instead, some tend to have overlapping symptoms of multiple eating disorders and have a harmful perception of food and eating. Although not much is known specifically about this disorder, it effects a larger population of people who suffer from eating disorders. According to the National Association of Anorexia Nervosa and Associated Disorders, “this category has been shown in some studies to have the highest death rates of any category of eating disorder. Fifty-two percent of eating disorder sufferers may have EDNOS.”

It’s not just one disorder

At times, some people suffering from these disorders may be diagnosed with multiple disorders. These disorders may also bring in or come with other issues such as anxiety or depression, which Renfrew also treats. If the women with eating disorders also struggle with other issues such as substance abuse or trauma, Renfrew can also help with recovery from that.

Sometimes, people can struggle with distinguishing between the line of a diet or an eating disorder. It may be difficult to stay behind the line of healthy, normal eating. However, a change of mentality can help the diagnosed maintain a balanced diet.

The Renfrew Center stresses moderation and healthy eating above diets. Renfrew’s philosophy is to have a healthy relationship with food with no off-limit foods.

“If someone begins a diet, I want to understand what their motivation is behind that diet. If there’s stress around food, it may lead you down a slippery slope,” Ciotti said. “As women we are bombarded with looking a certain way. What we try to do is do away with the whole idea of diets and talk about yourself, not using food as a vice.”

According to the National Eating Disorders Association, for females the “mortality rate associated with the illness is 12 times higher than the death rate of all other causes of death.”

Renfrew believes recovery is extremely important and loved ones should not hesitate to call for help because eating disorders are a serious illness.

“The best thing to do is to not keep it a secret,” Ciotti said. “To stay silent and allow them to suffer is something we want to avoid.”

Multiple locations across the country and facilities geared toward finding the best treatment for eating disorders make The Renfrew Center a prime choice for patients in Boston. The Renfrew Center of Massachusetts only provides outpatient and day treatment, but for patients with a more severe case, sites in Pennsylvania and Florida offer residential treatment. This just means that patients stay overnight and are helped as much as possible throughout the entire process of recovery. All the centers work together to help give patients a “good sense of themselves,” Ciotti said.

“I don’t think anyone knows 100 percent the causes of an eating disorder, which is why they’re so hard for people to overcome,” Ciotti said. “It’s hard to distinguish what happened first, the anxiety or the eating disorder. It’s like asking what came first, the chicken or the egg?”

#Barefacedbeauty

National Eating Disorder Awareness Week this year was Feb. 23 to March 1, which Renfrew opened up just in time for. During this week, The Renfrew Center Foundation had a campaign called “Barefaced and Beautiful Without and Within.” The Renfrew Center Foundation called for women to remove their makeup for a day and take a picture to post on social media such as Facebook, Twitter or Instagram with the hashtag: #Barefacedbeauty. The campaign also encouraged participants to post positive comments on photos within the social media community to be supportive. Renfrew believes this can help to promote a positive outlook on body image and spread the word for self-acceptance.

How to help

For those with friends or family members struggling with eating disorders, remaining quiet about these issues may only aggravate the problem. Renfrew emphasizes the importance of calling for help. Ciotti said the best advice would be to reach out to facilities like Renfrew to contact a therapist and set up an appointment with an professional as soon as possible.

“Body image issues go beyond eating disorders,” Ciotti said. “It’s taking a stand of action. As women, we can all be seen as beautiful regardless of what we look like.”