Binge eating disorder is the most common eating disorder in the United States, affecting an estimated 3.5 percent of women and 2 percent of men, according to the National Comorbidity Replication survey, making it more prevalent than anorexia and bulimia combined.
As a clinical psychologist at the Women’s Center for Binge and Emotional Eating at Green Mountain at Fox Run in Ludlow, Vermont, Haica Rosenfeld, PsyD, is part of a team that treats women with binge eating disorder and emotional overeating. Established in 1973, Green Mountain is a mindfulness-based retreat for women who have health, weight and eating-behavior concerns that does not focus on dieting. Rosenfeld says the work is rewarding because she’s treating a condition few people understand.
“Our society doesn’t make it easy for people with this problem to seek help,” she says. “Binge eating disorder often carries a lot of shame, plus the stigma associated with overeating or having a larger body. When someone struggles with anorexia or bulimia, most people understand and want to help. When someone with binge eating disorder comes forward, the response is often, ‘Well, just stop eating so much. Go on a diet.’”
The Monitor asked Rosenfeld to talk about her work at Green Mountain and how she got her job.
What are your clients struggling with?
We see women who are frustrated with the weight cycling that arises from chronic dieting. They’re concerned about their physical and emotional health. They’re often highly successful professionals who are experiencing high levels of stress and have difficulty with self-care. We often hear, “I’m on top of everything in my life, except for eating. “
Our clients’ eating behaviors fall anywhere on the continuum from emotional eating, emotional overeating and some binge eating, up to the clinical diagnosis of binge eating disorder.
What does your role entail?
I’m one of the lead therapists for Pathway, the intensive clinical program designed to interrupt the binge cycle and jump-start meaningful change. I run both individual and group therapy sessions as well as embodied practices.
Another big part of my role is teaching behavioral classes at our retreat center on embracing whole health, including healthy eating and self-compassion.
What is Green Mountain’s approach?
Our core retreat program uses a blend of mindfulness, nondiet approaches, intuitive eating and Health at Every Size principles. We don’t focus on weight, but instead help women adopt attitudes and behaviors that support health, and by proxy, a healthy, natural weight. That’s the weight where the body settles when not restricting or overeating—when women eat normally and supportively, while moving their bodies for pleasure and well-being and effectively managing stress. It is a weight that is not defined by the body mass index but instead reflects genetics and other individual factors.
On the clinical side, the Pathway program dives deeper into the underlying root causes that drive the overeating. We help clients develop the self-regulation skills necessary to create a feeling of competence. It’s an eclectic clinical philosophy that combines mindfulness, cognitive-behavioral therapy, dialectical behavioral therapy, and acceptance and commitment therapy.
How did you decide to focus your psychology career on eating disorders?
I watched my father struggle with weight cycling and dieting—in hindsight I believe it was a binge eating behavior. I also dieted in my teens and had a negative body image. I first qualified as a licensed psychologist at the Universidad Católica Andrés Bello in my home country of Venezuela, then earned my master’s and doctorate in clinical psychology from the Institute for Graduate Clinical Psychology at Widener University in Chester, Pennsylvania, in 2008.
As part of my internship, I was exposed to people with eating disorders and I discovered a natural empathy for these clients. I was lucky to do my postdoctoral residency at the Renfrew Center of Florida, a residential facility for women with eating disorders. When I opened my private practice in Miami, I specialized in helping patients and their families struggling with these conditions.
How did you get your current job?
I’d been running my private practice for almost seven years and had noticed that more clients were presenting with emotional and binge eating issues. They wanted support groups and more intensive treatment. I felt a growing frustration at the lack of resources and treatment options available for this population. I wanted to connect them to more help beyond my therapy services, but there was nothing like that around me. I’d known about Green Mountain’s work for a couple of years because their approach was so unique. I was browsing their website looking for information for a client when I spotted a clinical therapist position. My first thought was, “Dream job!”
I applied right away, then it all happened very fast. After an initial phone chat, I flew to Vermont for an interview. They offered me the role the next day.
What do you enjoy about your role?
I always had a knack for guiding people through their difficulties. It’s a joy to pair that with my passion for helping those on the binge eating continuum. What makes Green Mountain special, beside the fantastic professionals we have, is the power of the participants coming together in a safe place. They can talk openly about what is often a dark secret in their lives and feel understood instead of judged. Seeing women come out the other side is a major source of satisfaction in my life.
What do you find challenging?
We live in a society that strongly encourages women to diet, and that considers them lazy or unhealthy if they don’t fit a certain body size. When professionals prescribe diets and restriction for larger-size people—the same problematic behavior that leads to a diagnosis of eating disorder in thin individuals—we know there is something profoundly wrong with our health-care system.
I have moments of thinking, how do we compete against a diet industry worth billions? How can a whisper become a roar? My hope is that by helping to change lives one at a time, we’ll create more noise, and eventually the message will be heard.
