Doorways to sponsor (iaedp™) International Association of Eating Disorder Professionals Educational June Event

Emerging Eating Pathologies: What & Why?
    This presentation will discuss how historically clinical presentations of eating disorders were stable and recently have morphed and diversified.  Three eating pathologies that have recently emerged will be discussed and these include The Dual Diagnosis of Eating Disorder and Diabetes Mellitus Type 1 (ED-DMT1), Avoidant /Restrictive Food Intake Disorder (ARFID) and Atypical Anorexia Nervosa. In addition, the presentation will explore why the acceleration in a variety of presentations may be occurring.  

For more information visit:

Ovidio Bermudez, MD, FAAP, FSAHM, FAED, F.iaedp, CEDS
Sr. Medical Director – Childhood & Adolescent Services, Chief Clinical Education Officer & Executive Ambassador, Eating Recovery Center
Ovidio Bermudez, M.D. is the Senior Medical Director of Child & Adolescent Services, Chief Clinical Education Officer and Executive Ambassador for Eating Recovery and affiliates.  He holds academic appointments as Clinical Professor of Psychiatry and Pediatrics at the University Of Colorado School Of Medicine and University of Oklahoma College of Medicine.  He is Board certified in Pediatrics and Adolescent Medicine.
Dr. Bermudez is a Fellow of the American Academy of Pediatrics, the Society for Adolescent Health and Medicine, the Academy for Eating Disorders, and the International Association of Eating Disorders Professionals.  He is Past Chairman and currently Senior Advisor to the Board of Directors of the National Eating Disorders Association, Co-Founder of the Eating Disorders Coalition of Tennessee and Co-founder of the Oklahoma Eating Disorders Association.   He is a Certified Eating Disorders Specialist and training supervisor by the International Association of Eating Disorders Professionals.
Dr Bermudez has lectured nationally and internationally on eating pathology across the lifespan, obesity, and other topics related to pediatric and adult healthcare. He has been repeatedly recognized for his dedication, advocacy, professional achievement and clinical excellence in the field of eating disorders, including Lifetime Achievements Awards from NEDA and IAEDP.

Free Parent Workshop! Topic: When Healthy Eating becomes Unhealthy

May 6th – 5:30pm-6:30pm at Doorways

What is the balance between feeding our kids “healthy” choices and teaching them it’s okay to enjoy foods with less nutritional density?
Orthorexia is the term used to define the obsession with healthy eating. Come discuss ways to encourage your kids to make good choices without creating food rules that can lead to a harmful preoccupation with food”.

Led by Bethany Dario, MPH, RDN, Registered Dietitian

Bethany Dario is a Registered Dietitian who graduated from Bluffton University majoring in Food and Nutrition with a concentration in Dietetics. She completed a clinical internship with The Cleveland Clinic and completed a Master of Public Health at Grand Canyon University. She has had specialized training in eating disorders and has treated anorexia, bulimia and binge eating disorder in both inpatient and outpatient settings. Bethany has lead body image groups for the department of Psychology and sororities within Greek Life at The University of Texas at Austin.

Healthy Eating Habits for Middle Schoolers

As your middle schooler grows and develops, you may notice they start to eat a lot more. Their body is growing and additional food fuels this growth spurt.

However, you may also notice that their eating habits start to shift. Perhaps they begin to shy away from fruits and veggies in favor of more sugar-filled, packaged foods. Whether your middle schooler is mirroring the food habits of classmates or simply wants to spend their allowance on junk food, you may start to feel like the food values you worked hard to instill during childhood have flown out the window. But there are steps you can take to help guide your pre-teen towards healthy eating habits.

Be their healthy eating role model.

The best way to reinforce your middle schooler’s healthy eating habits is to show them that healthy eating is important to you. There are many ways to do this. Eat breakfast each morning and choose the healthier option when out at a restaurant. Bring your middle schooler along on weekly grocery trips.

Most importantly, make time to enjoy healthy meals with each other as a family. This is one of the best and easiest ways to, not only model healthy habits but to also increase your child’s overall enjoyment of food. Bonus: You get to spend quality time together as a family, catching up on the events of the day.

Create an environment that encourages healthy eating.

It is much easier for your middle schooler to make good food choices if your family’s home encourages healthy eating.

So, how can you do this?

  • Ask your middle schooler to assist with the food shopping and weekly menu planning.
  • Motivate them to take ownership of one family meal each week — from planning to serving!
  • Limit the unhealthy options available in the house and make healthy options easily accessible. For example, keep fresh fruit out on the counter, chopped vegetables in the fridge, and plenty of healthy snacks in the cupboard.
  • Cook with them. You can teach them how to make their favorite dishes right at home or enroll them in a cooking class. There are a variety of great cooking classes available right here in the Phoenix area —

Initiate a food dialogue.

The way you talk to your pre-teen about food can have a big impact on their eating habits. Try highlighting the positive effects of healthy eating, rather than speaking to the negative impacts inherent in an unhealthy diet.

Here are some ideas to get you started –

  • As motivation for healthy eating, talk to your middle schooler about how food directly impacts concentration, success in school, athletic ability, and mental wellbeing. Pre-teens and teenagers can have trouble conceptualizing the long-term health risks of unhealthy eating. However, knowing the impact these choices can have on their present lives may prove more meaningful.
  • Encourage your middle schooler to eat when they’re hungry (remember: growth spurts) but to stop when they’re full. Over time, your middle schooler will begin to recognize the difference between eating out of hunger and eating from boredom or fatigue.
  • Steer clear of restricting foods or labeling them as “good” and “bad.” Alternatively, try to aim for a balance. Eat healthy foods the majority of the time and have a treat every now and again.

If you need help with your middle schooler’s nutrition or you’re concerned about their eating habits, the staff at Doorways is here to help. If you are interested in how our services may benefit your family in the Phoenix metro area, give us a call today.

Is Exercise Good for Your Mental Health?

According to the American College of Sports Medicine, there are a tremendous amount of benefits to exercising for adolescents including maintaining a healthy weight and the prevention of certain diseases later in life. Additionally, exercise provides better academic performance and the creation of a lifetime of healthy habits.

In addition to physical health benefits, adolescents who exercise also experience benefits to their mental health. Exercise can lead to lower rates of depression. These lower rates can be attributed to the fact that adolescents who exercise have a higher self-esteem which is linked to lower levels of depression. It is noted that this can be especially important for adolescent girls who tend to experience more depression than adolescent boys.


A recent publication by the Harvard Medical School evaluates a study that supports the idea that exercise is good for adolescent mental health. Particularly for those already receiving formal treatment. What they found was that for those adolescents the addition of exercise leads to a moderate improvement in their depression.


Based on the results, while exercise can help a depressed adolescent, it is not necessarily a substitute for more formal treatment. We should also note that this is referring to a healthy amount of exercise. During its Risky Business campaign, Mental Health America has discussed exercise extremes.


These extremes include those that don’t exercise enough and those that exercise too much. Let’s explore this as it relates to adolescents so parents can be aware of a healthy amount of exercise for their teens since we know that can positivity impact their mental health.


A person that does not exercise enough has an increased risk for certain physical health issues, but it can also contribute to depression and anxiety.


On the other extreme is someone who compulsively exercises. A compulsive exerciser or one that is addicted to exercising will miss out on obligations. If they do miss a workout, it can lead to feelings of guilt and/or sadness. Additionally, they may continue to exercise despite an injury or illness.


If your teen is not getting enough exercise, here are some ways to encourage them to begin an exercise program.


  • First, speak with your family doctor and make sure there are no special considerations to consider before beginning an exercise regimen.


  • Begin at a slow pace and gradually work up to more difficult activities.


  • Get someone like a friend or relative to join so that they can motivate and hold one another accountable.


If you have a teen that is a compulsive exerciser you can help them take control and get into a healthier workout regimen.


  • Change up workout routine to include less strenuous workouts or take days off from working out altogether.


  • Discuss healthy body types.


  • Make sure your teen is getting adequate nutrition from the food they are eating.


  • Don’t allow negative self-talk. For example, putting down their body type or thinking they are lazy.


  • Encourage a discussion about healthy exercise habits and ask your teen if they are struggling with what that is.


If your teen is struggling with either compulsive exercising or depression, know when to seek the help of a mental health professional.


Doorways LLC. is a faith-based counseling organization in Phoenix, Arizona, that provides comprehensive outpatient treatment focused exclusively on 13-25-year olds and their families specializing in treatment for eating disorders, mood disorders, anxiety/OCD, substance abuse, depression, ADD/ADHD, self-harm, suicide prevention, and family counseling.


Eating Clean and Dieting: What it Means for Eating Disorders

“Clean eating” is a buzz phrase that you may be hearing lately. What does that mean, though? According to the Mayo Clinic, “clean eating is, in essence, a diet — just a way of eating. But it is also a way of living that lends itself to improving one’s health and wellbeing.” They go on to explain that clean eating involves eating real foods that are not processed, eating for the purpose of nourishing the body, and eating safe food that is washed, cooked, and stored properly. While this doesn’t sound so bad, the National Eating Disorders Association suggests that clean eating is actually dieting, but just called something else.  Mental health experts have begun to see that the “clean eating” trend can impact those at risk for eating disorders negatively.

To begin with, the idea of labeling certain foods as “dirty” as opposed to “clean” can be a dangerous concept. If someone is eating anything other than vegetables, fruits, and lean proteins, does that mean that what they are eating is “dirty?” For those struggling with weight and diet issues, this can quickly turn into obsessing over everything that one consumes according to the Huffington Post. This could potentially lead to an eating disorder. If you notice that your teen has gotten caught up in the “clean eating” trend, here are some ideas on how you can encourage healthy eating habits instead.

  1. Everything in moderation.

While there are some foods that we know we shouldn’t eat all the time, like a box of cookies, the danger of labeling certain foods as off-limits it that it causes them to be more tempting to eat. Explain to your teen that it is perfectly okay to have a cookie occasionally. Everything in moderation.

  1. Don’t fall prey to the trends out there.

Between food bloggers, social media, etc. all new diet trends are put out there and largely discussed-particularly when they have been successful for weight loss. “Clean eating” might be all the rage right now, but down the road society will likely shift gears onto the next trend. Talk to your teen about the importance of not always following the crowd and evaluating what is right for them.

  1. Focus on the nutrients that your body needs.

As stated by the Huffington Post, nourishment isn’t just the physical, but also about the mental and emotional satisfaction that food can provide. Eating a salad with grilled chicken, and light dressing is a satisfying and healthy meal, but that doesn’t mean that your mom’s homemade pasta dish isn’t just as satisfying. There is a time for comfort foods. Remind your teen of that.

Encourage your teen to take cues from their body as to what nourishment they need and to be diligent about not obsessing about whether the foods they are eating are “clean” vs “dirty.” If you are concerned that your teen’s fixation with food is dangerous, please consult one our specialists here at Doorways.

Doorways offers individual and group programs for teens and young adults who are struggling with eating disorders. Our certified eating disorder experts are here to help your teen get their life back again.

Is Social Media Negatively Impacting Your Teen’s Body Image?

According to a recent report from Common Sense Media, teens are spending an average of about nine hours on social media daily and this does not include what they may be using at school.

Doorways Arizona Blog: Is Social Media Negatively Impacting Your Teen's Body Image?

Social media sites like Facebook, Instagram, and Snapchat have become an integral part of teenager’s lives, something that many teens feel they can’t live without. One of the more negative sides of social media use is how these media are serving to influence a teen’s personal body image.

Proud 2 Be Me, is an online community that was created by teens for teens.  Their goal is to promote positive body image. Proud2BeMe posed the question to their community of whether social media sites help or hurt self-esteem and body image.   The answers were enlightening:

Teens indicated that it’s all about getting the coveted “like” on social media.  Teens crave that positive attention. And the more likes the better. To get likes, teens, especially females, will often oversexualize themselves.  One teen said, “The less clothes you have on, the more popular you are.” –-Dayton, 17.

The problem is that the more of these oversexualized pictures the teens see, the more that look becomes the norm, rather than the exception. And teens start comparing themselves to these images that they are bombarded with, resulting in a false idea of what it is normal to look like.  In a way, social media is like an online beauty contest that never ends. And unfortunately, most teens feel like they can’t win this contest unless they do something drastic such as crash dieting to try to lose a lot of weight fast.

What is a parent to do about this? It’s not realistic to ban your teen from using social media.  You can help combat this negative influence by encouraging your teen to share what’s on their social media accounts with you.  Then you can discuss the pictures and the impact they have on our body image and self-esteem.

If your teen is struggling with body image and is engaging in unhealthy activities to alter their appearance such as extreme dieting, there is help.

At Doorways, we have caring, confidential, nutritionists and counselors on staff who are experts in teaching teens how to make healthy lifestyle choices.  We offer a free consultation to any parent seeking help. Just call us at 602-997-2880.



How to Survive Thanksgiving with an Eating Disorder

If your teen is struggling with body image, weight or food issues, the holidays make it so much more stressful. This is particularly true at Thanksgiving, which is a completely food centered holiday.

Doorways Arizona Blog: How to Survive Thanksgiving with an Eating Disorder

According to The Huffington Post, some 10 million Americans are fighting an eating disorder. For them, the amount of food around the holiday can be downright painful. For those with anorexia, the food at Thanksgiving can be scary since there is an expectation to eat the food and enjoy it. For those suffering with bulimia or a binge eating disorder, they may be having difficulty controlling their desire to purge being surrounded by so many triggers. However, there are ways that you can not only help your teen survive the holiday, but enjoy it.


While you may be busy cooking, cleaning, or visiting with family throughout the day, don’t forget to check in with your teen and see how they are doing. Additionally, you might suggest that they reach out to a friend that they can check in with throughout the day to give them an outlet to vent. Make sure they know that they are not alone.

Game Plan

The Huffington Post says that your teen should have a game plan. Encourage your teen to eat a healthy breakfast. Maybe they decide to avoid the pre-meal snacks so they can focus on the main meal. At the main meal, they can then make choices that are deliberate.

Ignore the Diet Talk

There is no avoiding the diet talk. As everyone is over indulging at the dinner table it is almost certain that someone will bring up how much they will need to exercise after the meal. Or how they are going to starve themselves after consuming a week’s worth of calories. It is important to talk to your teen about the possibility of this happening so that they can remind themselves that other people’s food issues are not also theirs. Encourage them to not feel guilty about what they are eating nor deprive themselves either.

Focus on Gratitude

While it may seem like it is all about the feast, it is really about thankfulness. Help redirect your teen’s focus from the feast to something or someone that they are thankful for. Maybe have everyone go around the table and say what they are grateful for to help further cement that focus.

Encourage your teen to enjoy their Thanksgiving meal and the special time with friends and family and most importantly, their thankfulness. If you find that your teen needs additional support, reach out to someone that specializes in eating disorders. Happy Thanksgiving!




How to Talk to Your Teen About Their Weight

During the adolescent years, teenagers become increasingly more aware of what shapes their identity, and they also begin to see and value how others view their appearance, skills, and achievements. For these reasons, teens are often much more susceptible to eating disorders and can easily develop an unhealthy relationship with food, which has the potential to severely impact their health and self-confidence.

How to Talk to Your Teen About Their Weight

As a guide in your teen’s healthy growth and development, it is especially important that you do not unintentionally do any harm while you are encouraging a healthy lifestyle for your teen. Here are four ways the National Eating Disorders Association recommends to positively reframe your conversations about weight and health with your teen:

When you talk about food, focus on health, strength, and nutrition rather than weight loss

The ways that you discuss food and exercise can definitely affect your teen’s eating habits and may also impact how they view their body. In fact, according to a study in the Journal of Adolescent Health, weight-related comments from parents or siblings were highly linked to disordered eating habits geared toward unhealthy, unsafe weight loss measures, particularly in teen girls.

Whether your teen is underweight, normal weight, or overweight, your words matter to them when speaking about their bodies. To ensure that you do not unintentionally harm your teen, you should focus on talking about health, strength, and nutrition rather than weight loss or diets. For example, saying, “Fresh fruits and vegetables help your body and mind stay healthy and strong.”, will be more helpful for your teen than saying, “You need to lose some weight, so eat all your vegetables”. The distinction of focusing on eating for health and strength will help your teen develop a better relationship with food and understand the importance it plays in a healthy lifestyle.

Ensure everyone in your family speaks the same way about health, food, and exercise

To make certain that your family practices healthy eating habits, and talks about food, weight, and exercise in positive ways, everyone needs to use the same language. You and your spouse, as well as any siblings in the household, need to all talk about these things in the same way.

Emphasize the importance of health over weight

When you want to talk about weight with your teen, pause and remember to speak about health instead. Speaking about the value of eating well for good health and energy to do all the things you enjoy, rather than the importance of being a particular weight will ultimately help your teen develop a more positive body image and relationship with healthy food.

Demonstrate your words in your body and life

Speaking positively about food, health, and exercise with your teen is very important. However, it is equally vital that you live the example of your words, and make sure you are not silently demonstrating unhealthy eating patterns or body image views to your teen.

If your teen is struggling with body image or an eating disorder, then speaking with a professional teen counselor can help you learn more ways to promote healthy eating and lifestyles in your home and your words.

4 Ways You Can Instill a Healthy Body Image in Your Teen Athlete

By the time your son or daughter reaches the teenage years, they will inevitably be involved and immersed in many interests as they explore their developing skills, talents, and passions. One of the most common pass times that teens typically enjoy at various degrees during adolescence and beyond is athletics.

Participating in athletics is a fantastic way for your teen to stay healthy and fit, while learning the value of teamwork, respect, and hard work. Playing sports can also build self-esteem and help your teen form healthy bonds of friendship as they learn how to handle success and defeat.

However, as you teen begins to develop athletic skills and pursuits, they will also become more aware of their bodies and how they compare to their peers and any athletic icons they look up to as role models and motivation.

Unfortunately, this heightened body scrutiny and comparison can give way to unhealthy body image issues and evolve into eating disorders very quickly if your teen is not equipped with a strong sense of what it means to be healthy, strong, and athletic. In fact, according to the National Mental Health Institute, 2.7 percent of teens age thirteen to eighteen have struggled with some type of eating disorder.

4 Ways You Can Instill a Healthy Body Image in Your Teen Athlete

According to the National Eating Disorders Association, here are four ways that you can help support a healthy body image in your teen athlete to protect them from developing dangerous, unhealthy eating or training habits:

Understand eating disorders and other body image issues your teen may face.

It is important to understand that eating disorders do not stem solely from eating or not eating in unhealthy manners. Eating disorders are a symptom of a much deeper mental, emotional, or psychological issue that may be plaguing the happiness and well-being of your teen. Make sure that you do the research on what different body image issues and eating disorders exist, and fully understand how they may impact your teen as they strive to excel in athletics.

Know how to identify if your teen is struggling with their body image or suffering from an eating disorder.

To keep your teen healthy and safe, know the warning signs and symptoms to look for that may provide you early warning into a potential problem. Most teenagers will not come forward openly with their body image or eating disorder problems, so you will need to begin the open, honest, supportive conversation if you witness the warnings. According to the Mayo Clinic, warnings of an eating disorder may include:

  • Abnormally low body weight
  • Fear of weight gain
  • Distorted body image
  • Expressions of self-hatred or loathing
  • Excessively limiting calories or food intake
  • Escaping to the rest room immediately after a meal
  • Refusing to eat
  • Vomiting after meals
  • Use of weight loss pills or laxatives

Talk to your teen about their athletic role models, and help them identify healthy bodies and training regimes.

As the Summer Olympics quickly approaches, your teens will be watching with added excitement and attention as the very best competitors in their favorite sports compete for medals. This is a great opportunity to point out healthy, strong bodies and talk to your teen about the best ways to accomplish their fitness goals in a safe manner.

Additionally, there are many athletes who have overcome eating disorders. Sharing these stories of triumph and success can help encourage your teen to open up and seek help if they have been experiencing issues with their body or are developing an unhealthy relationship with eating.

Intervene with support, positivity, and straightforward help when you suspect body image issues or eating disorders in your teen.

If your teen exhibits the warning signals of poor body image or a potential struggle with an eating disorder, you should intervene immediately. When you bring up this topic with your teen, do not speak in judgmental or negative terms. Be open, positive, and straightforward as you encourage your teen to speak openly while you listen. If your teen continues to display unhealthy behaviors after you’ve intervened, it can be immensely helpful to consult the advice of a professional teen counselor to help you reach your teen with tools for an active and healthy approach to athletics and life.

Is It a Diet or Is It an Eating Disorder? What Parents Need to Know

Eating disorders are a complex illness resulting from a variety of emotional and environmental factors and manifest in a variety of different ways. Often, they can go undetected, especially when unhealthy eating habits can look like a fad diet. Parents of teens may have a hard time recognizing when abnormal eating habits are leading to the detriment of their child’s health. Following are some tips that can help you spot the difference between symptoms of eating healthily while dieting and symptoms of an eating disorder.

Woman handcuffed by a tape measure

photo: bigstock

Your child on a diet:

  • Has a clear weight goal. Ask your child what their weight goal is and determine if it seems like a reasonable, healthy weight for their body.
  • Doesn’t completely cut out any food group. It’s normal to limit unhealthy or fatty foods, but part of eating healthily is eating a variety of nutrients and foods. If your child won’t touch a certain food at all, like bread or proteins, there may be a problem.
  • Limits portions, especially of unhealthy or fatty foods, but still enjoys eating. Most individuals on diets feel guilty after eating too much or too unhealthy, but not afraid. If your child seems afraid or anxious around food, especially eating in public, it may be a sign of a bigger problem.
  • Exercises because it helps them achieve their goals and feels good, not excessively or to punish themselves.

Your child with an eating disorder:

  • Doesn’t have a clear weight goal. Whatever the scale says, it won’t be low enough. They will always want to lose more and more weight.
  • Eats only certain types of foods. They seem disgusted or afraid of foods they used to like, which may be high in fat or sugar. They may also have strange eating rituals, such as cutting food into tiny pieces or rearranging it on the plate. They may also combine strange foods together, which they binge on in secret.
  • Limits portions to extreme degree of low calorie intake and skips meals. Individuals with eating disorders will often make excuses not to eat. Either they are not hungry, just ate with a friend, or are not feeling well.
  • Has an unhealthy body image. They complain about being fat regardless of how thin they are or how much weight they’ve lost. They seem repulsed by certain body parts or their body in general.
  • Suffers from depression and engages in self harm. Some individuals also abuse drugs, alcohol, or laxatives.

If your child shows signs of an eating disorder, getting help is essential. Eating disorders can lead to heart and kidney problems or even death, and often coincide with other emotional illnesses, which can be just as harmful mentally as they are physically. Treatment is available to help with the individual’s emotional, social, and body image problems that cause eating disorders. is a good place to get started in finding adequate treatment. There is hope in recovery. Your child can overcome his or her eating disorder.

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