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Frequently asked question about eating disorders
Do you see a thin or a large woman? Created by Emily Wierenga
The Eating Disorders Clinical and Research Program (EDCRP) at Massachusetts General Hospital provides outpatient evaluation and treatment for adults, adolescents and children ages ten and up with feeding and eating disorders.
In order to provide optimal care for our patients, we deliver mental health treatment within a multidisciplinary team. We have found that patient interests are best served when primary care and mental health clinicians practice within the same hospital system and can communicate easily with one another about treatment progress and planning.
We offer a detailed diagnostic evaluation with each new patient who is seeking to begin treatment for an eating disorder or related concerns. This comprehensive evaluation will:
Patients will receive immediate feedback as to what treatment plan is recommended. Depending on clinician availability, we will do our best to accommodate individuals with established Mass General primary care physicians with ongoing care at the EDCRP. Patients without Mass General primary care physicians will be directed to ongoing care options in the greater Boston area, depending on their individual treatment needs.
Learn more about treatment options
We are now accepting requests for one-to-two session diagnostic evaluations regardless of primary care affiliation. We may be able to follow for ongoing care those patients who have already established their primary care at Mass General. We are currently running a waiting list of three months, and our ability to follow patients depends on individual clinician capacity.
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We are an exclusively outpatient service. Our experience has taught us that some patients will benefit from either a partial hospitalization program or inpatient care to address urgent medical and nutritional issues prior to outpatient care in our program in order to achieve their therapeutic goals.
We are happy to provide feedback about the recommended clinical setting for initiating care in the pre-appointment screening.
Our patients with an eating disorder often encounter medical problems and nutritional concerns that benefit from specialty care. We focus on treating the individual with a team approach, identifying appropriate clinical services to coordinate care.
Dr. Eddy is the co-director of the EDCRP, and an associate professor of psychology at Harvard Medical School. Dr. Eddy received PhD in clinical psychology from Boston University, completed her predoctoral internship at the University of Chicago Medical Center, and her postdoctoral at Massachusetts General Hospital and Harvard Medical School.
Dr. Eddy focuses her research on the diagnostic classification of eating disorders, particularly among children and adolescents. She is currently Principal Investigator on an NIMH-funded study of the neurobiology underlying illness course and recovery in adolescents, and on a treatment trial testing a newly developed cognitive behavioral therapy for avoidant/restrictive eating disorders.
Dr. Thomas is the co-director of the EDCRP, and an associate professor of psychology at Harvard Medical School. She completed her PhD in clinical psychology at Yale University, her predoctoral clinical internship at McLean Hospital/Harvard Medical School, and her post-doctoral research fellowship jointly at Massachusetts General Hospital and McLean Hospital.
Dr. Thomas’s research focuses on atypical eating disorders, as described in her book Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem? She is currently principal investigator on several studies investigating the neurobiology and treatment of avoidant/restrictive food intake disorder.
Dr. Zayas is a staff psychiatrist at Mass General and an instructor in psychiatry at Harvard Medical School. He received his medical degree from Weill Cornell Medical College in New York City. He completed both his adult psychiatry residency and child and adolescent psychiatry fellowship in the Massachusetts General Hospital and McLean Hospital training programs.
Dr. Zayas specializes in the psychopharmacologic and behavioral treatment of eating disorders, particularly as they pertain to males.
Dr. Becker is a staff psychologist at Mass General and an instructor in psychiatry at Harvard Medical School. Dr. Becker completed her predoctoral and postdoctoral fellowship in clinical psychology as a clinical and research fellow at Mass General. She received her PhD from the University of Georgia and completed her predoctoral internship at Massachusetts General Hospital/Harvard Medical School.
Dr. Becker has clinical expertise in dialectical behavioral therapy and cognitive behavioral therapy. Her primary research interests include exploring emotional and personality influences on eating behaviors as well as investigating biological, hormonal and behavioral differences among individuals with low weight eating disorders.
Laurie is a clinical nutrition specialist at the Division of Adolescent and Young Adult Medicine at MassGeneral Hospital for Children. She received her undergraduate degree in Dietetics from the University of Connecticut, completed her dietetic internship at Loyola University Chicago and earned her Masters of Education in Health Promotion from Plymouth State University. Laurie provides nutrition counseling to children, adolescents and young adults who are concurrently receiving medical care in Adolescent Medicine and/or psychiatric care in the EDCRP. She is known among patients and parents for her warm and nurturing approach.
Ani Keshishian is the clinical research coordinator for the EDCRP. Ani graduated magna cum laude in 2016 from Boston University with a BA in psychology. Ani has prior clinical and research experience as a research assistant at the Translational Research Program at Boston University and a residential counselor at the Cambridge Eating Disorder Center. Ani coordinates patient intake for the clinic, as well as several ongoing research projects.
PLEASE NOTE: If you are a patient at EDCRP or would like to become a patient, please contact us by telephone at 617-726-8470 to protect patient confidentiality
Lauren Breithaupt, MA, is a predoctoral clinical psychology fellow in the cognitive-behavioral scientist track. She completed her doctorate in clinical psychology at George Mason University, where she was funded by two National Science Foundation fellowships. Lauren’s research uses basic science paradigms to inform applied efforts towards eating disorder prevention. She specializes in evidence-based treatments, such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).
Dr. Becker is the founding director of the EDCRP. She is Maude and Lillian Presley Professor of Global Health and Social Medicine and Associate Professor of Psychiatry at Harvard Medical School.
Dr. Becker received her medical training at Harvard Medical School and completed her psychiatric residency and research fellowship at the Massachusetts General Hospital. She also received a doctoral degree in anthropology from the Harvard Graduate School of Arts & Sciences and a master's degree in epidemiology from the Harvard School of Public Health. Currently, Dr. Becker is vice chair of the Department of Global Health and Social Medicine and director of the Social Sciences MD-PhD Program at Harvard Medical School. Her research interests lie in the domains of cultural psychiatry and global mental health.
Dr. Franko is the associate research director of the EDCRP and consultant in psychiatry at Mass General. She received her PhD in clinical psychology from McGill University in Montreal. She is currently professor in the Department of Counseling and Applied Educational Psychology at Northeastern University and serves as the vice provost for academic affairs.
Dr. Franko’s research focuses on obesity prevention, the use of technology in addressing eating disorder risk, and the longitudinal study of eating disorders. Her most recent work has been to develop online programs for adolescents to prevent eating disorders and improve body image.
Cathryn Freid, PhD, is a clinical psychologist in private practice in Newton, Massachusetts, specializing in evidence-based treatment (e.g., CBT, FBT) for eating disorders and comorbid conditions, including anxiety disorders, OCD and depression. Dr. Freid completed her PhD at Vanderbilt University, her predoctoral internship at the University of Chicago Medical Center, postdoctoral fellowship at the Center for Anxiety and Related Disorders at Boston University and has held professional positions at McLean Hospital and Brigham and Women’s Hospital.
Dr. Freid provides clinical supervision to trainees in the EDCRP. Her interests include evidence-based and transdiagnostic treatment, co-occurrence of eating disorders and anxiety and working with adolescents, young adults, parents and families.
Our research efforts have been supported by the National Institutes of Health, the Rubenstein Foundation, the Hilda and Preston Davis Foundation, the Klarman Family Foundation and other generous patrons. We have cultivated research collaborations with national and international leaders in the eating disorder field within the United States, United Kingdom, Hong Kong and Fiji.
Because a comprehensive diagnostic system is critical for etiological inquiry, clinical communication, case detection and treatment planning, our classification research explores how eating disorder categories can be improved by refining specific diagnostic criteria or adding new diagnoses. Our ongoing classification studies are done in partnership with investigators in the Mass General Neuroendocrine Unit. This work focuses on neurobiological, endocrine and genetic underpinnings of these disorders.
The Role of Estrogen in the Neurobiology of Eating Disorders
Requirements for participation:
Payment for participation up to $500 and parking/ transportation expenses offered
For More Information Please Contact:
Avoidant/restrictive food intake disorder (ARFID) is characterized by eating a limited volume or variety of food for reasons that are not associated with weight and shape concerns, such as taste selectivity, low appetite or fear of aversive consequences such a choking or vomiting. Our study aims to investigate how ARFID can affect different hormones and regions of the brain. In this study, we use MRI, psychological assessments and evaluation of hormones in the blood to better understand brain and hormone activity, as well as behavioral markers of ARFID.
This is a longitudinal study, which means we will monitor participants over the course of two years. We hope to identify mechanisms that might influence the development of and recovery from ARFID and how these factors might differ across individuals in the study.
If you are between the ages of 10-22 and think you may have ARFID or related symptoms (e.g., picky eating), you may be eligible for this study.
This study includes:
If you are interested in participating, please fill out our enrollment survey.
You may also contact Olivia Wons for more information:Email: firstname.lastname@example.orgPhone: 617-726-0047
Learn more about ARFID in this recent news story from WCVB Boston: "Is your 'picky eater' actually struggling with an eating disorder?"
In addition to our diagnostic classification studies, EDCRP and Neuroendocrine Unit studies aim to understand and treat osteopenia and osteoporosis, which are common consequences of anorexia nervosa and other low weight eating disorders. This research endeavors to develop and test novel hormonal treatments for anorexia nervosa and the common comorbid symptoms of depression and anxiety.
Learn about our ongoing research
Field Trial of DSM-5 Feeding and Eating DisordersThis study was conducted in three clinical settings: the Klarman Eating Disorders Center, the Mass General Weight Center, and the Mass General Pediatric Gastrointestinal Unit. The DSM-5 Feeding and Eating Disorders Work Group has used our findings, among others, to support modification of current criteria and the addition of newly discovered syndromes to the diagnostic nomenclature, including purging disorder, avoidant/restrictive food intake disorder and night eating syndrome.
Mass General Longitudinal StudyThis study mapped the course and outcome of eating disorders, addressing a central question posed by many patients and their families: “What will I be like in 5, 10, or 25 years?” We followed 246 women with anorexia nervosa and bulimia nervosa from 1987 to gather interview data about eating attitudes and behaviors, mood disorders, substance use, health, work and relationships. To date, the work has generated over 40 published articles about eating disorders, on topics such as recovery and relapse, longitudinal diagnostic crossover, alcohol and substance use, depression, pregnancy and medical complications. This study gives us the opportunity to investigate the long-term course and outcome of these illnesses, to understand mechanisms of recovery and the predictors of both wellness and poor outcome and to better describe the definition of full recovery.
The Eating Disorders Clinical and Research Program (EDCRP) provides comprehensive evaluation and a variety of outpatient treatment options for individuals ages ten and up struggling with eating disorders from compassionate and knowledgeable leaders in the field.
Our treatments have been shown to be effective in large-scale research studies to give you the best chance of symptom improvement. Our clinicians will recommend the treatment best matched to your individual needs.
Cognitive behavioral therapy (CBT) is based on the premise that many of the psychological features of eating disorders are actually caused by under-eating—regardless of whether you are underweight, overweight or anywhere in between. CBT is designed to help you understand how all of your eating disorder symptoms fit together and then identify strategies for targeting each one. By recording your food intake, you can identify your own unique triggers for engaging in eating disorder behaviors such as restricting, binge eating or purging. If the scale or mirror dictates how you feel about yourself, CBT can help you improve your body image and identify alternate sources of self-esteem. Later sessions focus on relapse prevention so you feel properly equipped to handle setbacks.
CBT is designed to last 20 sessions over six months.
To learn more about CBT, read Overcoming Binge Eating by Christopher Fairburn.
We also offer a new CBT program for individuals with avoidant/restrictive food intake disorder (CBT-AR) ages ten and up. CBT-AR developed here at Mass General focuses on normalizing eating, increasing macronutrient intake via food intake rather than dietary supplements and (if needed) restoring weight and growth. CBT-AR also targets the maintaining mechanisms of avoidant/restrictive eating, including sensory sensitivities, lack of interest in eating and/or fear of aversive consequences of eating (e.g., vomiting or choking) using exposure-based techniques.
CBT-AR can be delivered in an individual or family-supported format depending on patient age and treatment goals. CBT-AR is designed to last 20-30 sessions over 6-12 months.
We offer brief CBT for rumination disorder (CBT-RD) for both children and adults. CBT-RD is designed to last five to eight sessions and involves general CBT techniques tailored specifically for RD. Primary interventions include psychoeducation and self-monitoring to enhance patient awareness of regurgitation timing and triggers, diaphragmatic breathing as a habit reversal strategy, patient-specific strategies for reducing residual regurgitation episodes and relapse prevention.
For underweight children, adolescents and young adults, family-based treatment (FBT) empowers parents to take charge of normalizing their child’s eating. Rather than focusing solely on the patient, the therapist meets with the entire family (including both parents and siblings) to mobilize them to fight back against the eating disorder. FBT features specialized coaching deigned to absolve parents of blame, separate the child from the illness and help parents re-nourish their child at home.
Later sessions gradually transition eating opportunities back to the adolescent and help the adolescent return to the developmentally appropriate task of growing up—from which he or she has typically been derailed by the eating disorder.
FBT is a time-limited treatment designed to last 20 sessions over the course of 6-12 months.
To learn more about FBT, read Help Your Teen Beat an Eating Disorder by James Lock and Daniel Le Grange.
Guided self-help (GSH) based on CBT is an excellent option for adults who struggle with recurrent binge eating. In GSH, you will access tools to break the binge-eating cycle by collaboratively working through the workbook Overcoming Binge Eating with an EDCRP clinician. Key components include self-monitoring, identifying binge triggers, eliminating harmful dieting, enhancing body image and preventing relapse.
GSH is designed to last ten 25-minute sessions over the course of four months.
Some individuals find group therapy helpful, either instead of or in addition to individual or family-based treatment. We currently offer both CBT and dialectical behavioral therapy (DBT) groups for binge eating and purging. These 10-week skills-based groups are appropriate for adults (18 and up) seeking therapist and peer support to reduce bingeing and/or purging behaviors.
The group runs three to four times per year. See schedules for the Winter 2017 DBT group.
If needed, we also offer medication treatment in combination with therapy. Although medications are not a standalone cure against eating disorders, they can improve treatment response and help prevent future relapses. Eating disorders are often diagnosed along with other psychiatric conditions, which can be effectively managed with medication. We approach each case with a personalized plan based on the individual’s needs, backed by cutting-edge expertise in psychopharmacology.
Some individuals find that they are not able to beat their eating disorder through outpatient support alone. To learn more about treatment options, see these medical guidelines from the Academy for Eating Disorders.
While the EDCRP is an outpatient program, we often collaborate with our Harvard Medical School affiliates that offer high levels of care for eating disorders including:
The Eating Disorders Clinical and Research Program is committed to providing educational resources for individuals, families and the wider community with the tools they need to recognize, understand, and help others struggling with disordered eating.
Our Teen Mentor Program directed by Lazaro Zayas, MD offers adolescent girls the opportunity to learn the best ways to promote positive self-image. In meetings with our staff, the girls are exposed to mentoring workshops as well as an educational curriculum that covers various topics from culture and media to self esteem which has evidence to support the prevention of eating disorders as well as foster positive self image. These meetings also encourage the girls to discuss sources of stress in their own schools – such as bullying and pressure to achieve at the top level – that may dampen self-esteem. Then they create outreach and advocacy projects to address these issues as well as foster wellness; through this process, they strengthen their leadership and mentoring skills.
The Teen Mentor Program accepts nominations of high school students each fall. Nominated students should demonstrate leadership or mentoring qualities and have an interest in promoting wellness and positive body image awareness through outreach and advocacy.
To nominate a teen, please email Dr. Zayas at email@example.com.
The students in the 2014-2015 Teen Mentor Program created this short film as a culmination of their work. The original film, "Letters to Our Younger Selves", features fellow classmates sharing advice to their younger selves about confidence and self-image.
The Eating Disorders Clinical and Research Program helps trainees cultivate expertise in empirically supported treatments and clinical research techniques. We also provide clinical consultation and off-site workshops to practitioners outside of Mass General.
Mass General Clinical Psychology InternsOur clinical faculty provides supervision for several psychology interns per year in cognitive-behavioral therapy for eating disorders. Interns may arrange for 6-month or 12-month clinical electives and can receive training in both individual and group psychotherapy. Mentorship, supervision and case mix will be selected to create a foundation in evidence-based treatment for diagnostically diverse and complex patients.
Mass General/McLean Psychiatry ResidentsThe PGY III Psychopharmacology of Eating Disorders module provides didactic training and supervision on pharmacologic management of eating disorders. PGY IV residents may also arrange for 6-month or 12-month clinical electives at the EDCRP. Mentorship, supervision and case mix will be selected to create a foundation in psychotherapeutic and pharmacologic management of diagnostically diverse and complex patients.
Multidisciplinary Eating Disorders Case ConferenceA one-hour team clinician-to-clinician consultation is available as a pro bono service to clinicians managing challenging cases within the metro-Boston community. Clinicians are asked to present their cases at a clinical case conference and are provided with team feedback. These one-time consultations focus on topics such as optimizing communication within multidisciplinary teams, selecting the optimal level of care for a specific patient and engaging a patient who is ambivalent about relinquishing valued symptoms.
Off-Site Evidence-Based Treatment WorkshopsThe EDCRP is dedicated to the dissemination of empirically supported treatments to interested real-world practitioners. Our faculty members have led interactive workshops on the use of cognitive-behavioral therapy and family-based treatment for eating disorders locally, regionally and nationally.
To inquire about faculty availability and fee structure, please call 617-726-8470.
Mass General/McLean Psychiatry Residents and Mass General Psychology InternsResidents and interns who wish to undertake clinical research in eating disorders are invited to contact program faculty to discuss their interests and possible mentorship opportunities. A 6- to 12-month commitment is required.
Summer Research FellowshipsEach summer, the EDCRP mentors emerging scientists and students, giving them the resources and guidance they need to undertake an eight-week independent research project. Learn more about summer research fellowships at the EDCRP.
For more information about EDCRP training opportunities, please call 617-276-8470.
Please note that, per hospital-wide policy, we cannot offer unpaid research assistantships. With the exception of the Summer Research Fellowships, students who wish to work with us must first arrange to earn course credit from their undergraduate or graduate institution.
2 Longfellow Place, Suite 200Boston, MA 02114Phone: 617-726-8470
How to make an initial appointment:
If you have not been seen at Mass General previously, please register as a Mass General patient before calling the EDCRP: 866-211-6588.
The EDCRP is located in the West End Apartments, marked 2 Longfellow. Take the elevator or stairs one flight up, and we are the first door on the left (Suite 200).
You will register for your appointment with our clinic coordinator in Suite 200 at 2 Longfellow Place. We recommend that you arrive at least 10 minutes in advance of your appointment time. Barring an unforeseen emergency or delay, your doctor will meet with you on time. Traffic and parking areas can become congested in the vicinity of Mass General at certain times of the day, so please plan accordingly.
If you will late for to your appointment, please call 617-726-8470. We ask that you notify us 24 hours in advance if you need to cancel your appointment.
Your privacy and comfort are important to us. The waiting room is small and relatively private, and in most cases, you will meet with your clinician in suite 200.
Mass General offers parking for patients and visitors at the Fruit Street, Parkman Street, Yawkey Center and Charles River Plaza garages on the main campus. Get more information about parking at Mass General.
If you wish to park closer to the EDCRP, there is a non-Mass General parking garage at 62 Staniford Street, directly before a small strip of stores. However, we do not validate parking.
Thank you for your interest in the Eating Disorders Clinical and Research Program (EDCRP). The program relies on contributions to fund its ground-breaking work in eating disorder treatment, research, education and training. When you give to the EDCRP, you will create a very real impact on our ability to expand knowledge about eating disorders and their detection, treatment and prevention. You are also helping the EDCRP’s experts share that knowledge with all at risk in our community.
Give online now
Making a gift to the Eating Disorders Clinical and Research Program can be a meaningful way to remember a friend or loved one, celebrate an occasion such as a wedding or birthday or commemorate an event. Choose the option "I am making this gift in honor or memory of somebody" when making your donation online.
Through planned giving, you can achieve your charitable intentions while also establishing an income stream for yourself or beneficiaries. Call us 617-643-3879 to learn more about life income arrangements, gifts of life insurance, endowed and named gifts and bequests.
Help us share vital information about the detection and treatment of eating disorders at our public forums and educational events.
For more information on these and other opportunities for supporting the EDCRP, please contact:
Molly McCarthy Associate Director of Development Massachusetts General Hospital 617-643-8827 or toll free at 877-644-7733 e-mail: firstname.lastname@example.org
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