Wealth can exacerbate eating disorders but also open options for recovery
With eating disorders, an often misunderstood mental-health condition, on the rise, demand for recovery options is also surging
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Eating disorders are often misunderstood mental health disorders and they are not restricted to any one segment of society.
Worryingly, eating disorders are on the rise in Canada, especially since the acute phase of the COVID-19 pandemic.
Anorexia, bulimia, binge eating, and other disordered patterns can be mistaken as “choices” or “attention-seeking” behaviours by those who are uninformed of the true nature of these debilitating illnesses.
In fact, these conditions are misunderstood in many ways and health consequences can be very serious, ranging from neurological to cardiovascular and other damage, to death.
And treatment resources cannot keep up.
Here, several experts discuss the complexity of these conditions and how wealth can manifest and affect eating disorders, but also allow for options such as private recovery facilities.
Ben McCutchen, Homewood
What services does Homewood Health Centre offer in relation to eating disorders?
“Homewood Health Centre has a long history of treating patients with eating disorders. Our 21-bed inpatient program … offers evidence-based, personalized treatment to individuals 16 and older.
In my experience, patients can fall between the cracks when their eating disorder is severe enough that it cannot be managed on an outpatient basis, but not so severe that it requires medical management in a hospital setting – our program is particularly well-suited to support these individuals.
The program focuses on normalizing eating, restoring physical and emotional health, and interrupting eating disorder symptoms.
Our team uses an evidence-based approach to understand the many dimensions of someone struggling with an eating disorder, which include one’s perception (i.e. the way you see yourself), emotions (i.e. how you feel about your body), cognition (i.e. your thoughts and beliefs about your body), and behavior (i.e. the actions you take that are directly related to your appearance).
Our team also recognizes that a person’s experience of an eating disorder will often involve the people around them, and support is provided to improve family, marital and personal relationships.
Finally, research tells us that eating disorders rarely occur in isolation (our internal measurements indicate that 70-80 per cent of our patients are experiencing concurrent depression and/or anxiety), and so our psychiatrist and clinical team emphasize the identification and treatment of co-occurring mental-health conditions.”
What are some of the risks of untreated eating disorders?
“Early identification of eating disorders is important to ensure proper access to treatment. The risks of non-treatment for eating disorders are high and can include the development of other co-occurring mental health conditions, prolonged suffering, serious physical complications, and even death.
Unfortunately, many people across Canada will experience difficulties or delays in accessing the right treatment for their condition. In my experience, many patients will suffer from an eating disorder for years before receiving treatment.
The good news is that there are effective treatments for eating disorders. In the outpatient setting, this can include specific evidence-based psychotherapies for eating disorders, and, in some cases, medications.
When outpatient treatment is not sufficient, inpatient treatment can be an effective option. In our eating disorders program at Homewood Health Centre, 90 per cent of patients were below the clinical threshold for an eating disorder at the end of the program. In addition, patients displayed positive improvements in anxiety, depression, self-care, and functioning.”
Can you offer some insight into why wealth does not exclude individuals from mental-health disorders?
“While socioeconomic status can predispose individuals to certain mental-health conditions, many of the factors that increase the risk of developing a mental-health condition are universal and occur irrespective of wealth.
These include biological or genetic factors, the experience of trauma or adversity, and cultural and societal factors.
Historically, eating disorders were thought to be more common in wealthy individuals. More recent studies have demonstrated that eating disorders are not correlated with socioeconomic status or household income, however, there is a higher reported prevalence of eating disorders in higher-income countries.
One reason that anyone can be susceptible to an eating disorder is widespread societal and cultural pressures, such as unattainable beauty standards, a cultural preoccupation with thinness, and a widespread ‘diet culture’ that contribute to unhealthy eating patterns. These pressures are likely magnified by social media.”
Can you describe the characteristics of Homewood as a private, luxury recovery option?
“Homewood Health operates a premium, private, highly individualized program at The Residence at Homewood in the woods on 50 acres.
It provides utmost discretion while delivering world-class concurrent treatment for trauma, PTSD, addiction, depression, anxiety, and more. Whether it’s the concierge pre-admission, chef-prepared nutritious meals, the refined and well-appointed suites, or the range of amenities and accessible services (professional on-site gym, personal training, yoga, massage therapy, manicured walking trails, tennis courts, nutritionist, acupuncturist, strength & conditioning coach), The Residence at Homewood creates an environment that supports the therapeutic process.
The psychiatrist-led, multidisciplinary team works in concert with each individual for a truly personalized treatment plan.”
Sarah Boss, The Balance
What programs does The Balance offer to adults struggling with eating disorders?
“At The Balance, we recognize that each individual’s struggle with eating disorders is unique and demands a comprehensive, personalized approach. We offer a combination of medically monitored treatment, psychotherapy, nutritional counselling and holistic therapies, such as yoga, mindfulness, and art therapy.
Our programs are designed not only to address the physical manifestations of eating disorders but also to confront the underlying psychological issues that often accompany these disorders.”
Does recovery from an eating disorder entail a one-time treatment?
“Eating disorders require lifelong management and a set of recovery tools. Often, individuals who have recovered must be mindful of their triggers and patterns, while also maintaining a healthy relationship with food and their bodies.
Recovery tools can include regular therapy sessions, maintaining a balanced diet, frequent check-ins with healthcare providers, and participation in support groups.
We also emphasize the importance of stress management, body acceptance, and self-care.”
How does wealth affect people in terms of eating disorders?
“Our specialized focus on ultra-high-net-worth individuals stems from the understanding that wealth does not exempt anyone from mental-health struggles. In fact, the stress of managing significant wealth, corporations, or family businesses can exacerbate mental health issues, including eating disorders.
At The Balance, we offer a confidential, serene environment where these individuals can focus on their recovery without distractions or fear of judgment.”
Can you describe what The Balance offers as a private, luxury recovery option?
“The Balance thrives on its ability to create a personalized, bespoke recovery experience. This means adjusting our therapies and activities to cater to each individual’s preferences and needs.
We ensure private accommodations, one-on-one therapy sessions, personalized meal plans, and a host of luxurious amenities that contribute to a comfortable recovery journey.
We also offer flexibility in terms of visitation and communication with loved ones, allowing our clients to maintain their outside relationships while focusing on their recovery.”
Jan Gerber, Paracelsus Recovery
What programs does Paracelsus Recovery offer to adults struggling with eating disorders?
“Eating disorders constitute a particular challenge for the affected person as well as the clinicians. They are complex and often very hard to treat psychological disorders.
Thus, when treating patients for eating disorders, or when disordered eating is identified as part of the problems of a client, we normally involve a psychiatrist from the Zurich University Clinic who is a specialist in eating disorders as the case manager and treating psychiatrist, who then works alongside our very experienced team of specialists from various fields.
Paracelsus Recovery has a 360-degree approach to mental health in general and eating disorders in particular, i.e., we identify and treat the underlying reasons for the condition (which may be psychological, medical, genetic, social, spiritual, or more often a complex combination of parameters), as well as the symptoms.
Our programs for eating disorders are a combination of psychotherapeutic modalities, which are individually tailored to a client, but would normally involve therapeutic methods that have the clinical evidence to work best for eating disorders.
[These can include] specialised CBT programmes (CBT-E, for example), as well as medical and complementary treatments and therapies, from IV treatments to rebalance a client’s biochemistry of the brain and body, to nutritional supplements and special meal plans. (Our chefs are specially trained in nutritional science and we have two nutritional scientists full-time on staff for this; they work together with the lead medical doctor and dieticians to develop meal plans, supplements and IV prescriptions, etc.)
[Treatment can also include] personal training, physiotherapy, yoga, acupuncture, etc. The array of complementary treatments we can offer is massive. Equine assisted therapy often works well for eating disorders, for example.
Additionally, treatments with ketamine or classic psychedelics, such as psilocybin, can have significant positive effects for eating disordered patients.”
Does recovery from an eating disorder entail a one-time treatment?
“This is also very individual. Ideally a therapeutic team (psychiatrist, counsellors, etc.) identify, together with a client, which tools may work best. This depends on ability, preference, motivation, etc.
We focus on stabilising and treating the underlying issues so that the pressure on the eating disorder (which is a coping mechanism for underlying pain) is relieved as much as possible.
Symptomatic tools around eating and meals can be very helpful to retrain the brain and develop healthy(er) eating habits. They can include “one bite at a time,” instead of focusing on a whole meal, creating a low-stress environment around meals (e.g. listening to music and following the lyrics while eating, playing games, looking at positive images or videos while eating, watching a comedy show, etc.), apps can be helpful to help developing a healthier relationship with food, … involving a dietician to support in meal planning, logging, etc.
What can really be a game changer is a focus on or discovery of spirituality and spiritual healing, if this is accessible for a patient. We humans are all spiritual beings with spiritual needs. Particular practices, from meditation to spending more time in nature, to deeper spiritual work, practices of breathwork, sound healing, etc. can all be very supportive elements in long-term or lifelong recovery and management of an eating disorder.”
How does wealth affect people in terms of eating disorders?
“Paracelsus Recovery’s expertise is not only making sense of and treating the most complex mental-health issues, but particularly also the intersection of mental health and wealth. Living with, and particularly growing up in, significant wealth can have a tremendous mental-health impact. I can only name some examples, as this is equally complex:
- Boredom, lack of purpose, combined with wealth is a dangerous mix and can often lead next gens, in particular, down a road of drugs, risky sexual practices and a general feeling of emptiness that is medicated with short-term pleasures.
- Trust issues, loneliness [including questioning] “Who can I trust,” “Are friends or romantic partners interested in me because of my status or me as a human being?”
- “Affluent neglect:” emotionally unavailable or physically not-present parents are more common with wealthy families, due to various reasons, {such as] parents engaged in running a company or social duties or charities, etc., the engagement of nannies, private or boarding schools and tutors, etc.; often with the best intentions.
- Lack of structure: the ability to do whatever one feels like whenever they feel like it is not good for mental health.
- Impact on self-esteem if other family members (parents, founders, successor-siblings, etc.) have accomplished significant material successes.
- Limited freedom of career or relationship choices (essentially, wealthy families can be considered a minority like any other minority, who form an in-group where they trust peers, but members are often discouraged to mingle romantically or otherwise with the “out-group”).
- Limited access to culturally competent and trustworthy mental-health support or care.”
Can you describe the characteristics of Paracelsus Recovery as a private, luxury recovery option?
“We only treat one client at a time with a whole team of experienced specialists.
Every treatment plan is 100 per cent individually tailored; the diagnostics are the most extensive one can find, including head-to-toe medical checkups, genetic testing, extensive testing and treatment of gut health and functional medicine, etc.
We offer a very discrete and luxurious, comfortable environment with a top-notch service level, with the spirit of a family business. Clients have their dedicated 24/7 live-in therapist, a dedicated team of clinical coordinators, their dedicated psychiatrist and access to a team of 20-plus specialists, their own dedicated gourmet chef, maid, etc. and we have a small fleet of Bentley limousines with drivers that are dedicated to our clients during their time with us.
But most of all, with so many specialist therapists from various disciplines and all emotionally invested in our clients’ journeys, we can create a healing environment that is not only choreographed like Swiss clockwork and packed with state-of-the-art treatment modalities, but that is very human and understanding at its core.”
Responses have been lightly edited for clarity and length.
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