I live in a town where eating disorder treatment is almost nonexistent. Feeling in danger of a relapse, I decided it was time to see a therapist. She was a licensed psychologist specializing in eating disorders and women’s issues. I went voluntarily, not expecting what I received.

Everything was booked and set via email. My choice. I hate calling people. She mailed me all the paperwork from her office to bring with me on my first visit. What I loved when I first met her was that she didn’t even want to look at the filled-out documents during session; she was eager to get down to talking. I was nervous being there, naturally, it’s sensitive material being shared with a stranger. I remember which chair I sat in and how she sat on the couch.

Eager. Ready.

There is a strong correlation between trauma and eating disorders. A number of studies have shown that people who struggle with eating disorders have a higher incidence of neglect and physical, emotional and sexual abuse. In particular, binge eating disorder is associated with emotional abuse while sexual abuse has been linked to eating disorders in males.

So what constitutes trauma?

Trauma comes in many forms, including childhood abuse or neglect, growing up in an alcoholic or dysfunctional home, environmental catastrophes such as Hurricane Katrina, a serious accident, loss of a loved one, and violent attacks such as rape and sexual assault. What all of these experiences have in common is that they leave the individual feeling helpless and out of control.

Trauma isn’t the same as having post-traumatic stress disorder (PTSD). PTSD is a specific diagnosis with distinct criteria, involving a serious or life-threatening experience that results in nightmares, flashbacks, attempts to avoid situations similar to those that led to the trauma and a hyperactive startle response, among other symptoms.

Recently I had the chance to ask Margarita Tartakovsky, an associate editor at Psych Central, a few questions about eating behavior.  She blogs regularly about eating and self-image issues on her blog Weightless.

Q. Why doesn’t the current model of treating obesity — only telling people what and how much to eat — work for most people?

A. Great question, because the current model definitely doesn’t work. I can’t remember who said it, but there’s a saying that if you want to gain weight, go on a diet. Diets have a failure rate of about 95 percent. People may lose weight initially but then they usually gain it back and then some.

So this model doesn’t work for many reasons. For one thing, genetics plays a prominent role in our weight. This is why you can have two people who eat the same foods in the same quantities look very different. One may be thin; the other may be considered “overweight.” Our bodies are more complicated than the “calories in, calories out” equation assumes.

Integrative medicine can be defined as “a healing-oriented discipline that takes into account the whole person — body, mind and spirit — including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of both conventional and alternative therapies.”

Complementary and alternative therapies used in integrative medicine can include acupuncture, chiropractic, herbal medicine, dietary supplements and others that give the clinician a wide array of treatments for difficult conditions. This is particularly true in the integrative medicine approach to eating disorders.

Eating disorders have been documented in adolescents and adults for many years. More recently, there is evidence that these disorders can also affect young children.

The cornerstones of an integrative medicine model for eating disorders includes some components that are found in every approach to the treatment of eating disorders, but may be used in a unique manner. Others are more specific to the use of complementary and alternative medicine (CAM) therapies. The most important difference in this model when compared to other treatment strategies is the philosophical underpinning of integrative medicine — that is, the belief in the self-healing nature of body, mind and spirit.

There’s a lucrative cottage industry in the U.S. for the residential treatment of almost anything you can imagine. Everything from “Internet addiction” and drug and alcohol problems, to eating and mood disorders. If you can treat it in an outpatient setting, the thinking goes, why not treat it in a “residential” setting for 30 or more days where you control every aspect of the patient’s life?

The “residential” treatment approach has long been available for eating disorders, since the treatment of these disorders tends to be long and complicated. Andrew Pollack writing for the New York Times notes how these kinds of programs have now become the focus of insurance companies looking to cut back on treatment options.

It’s no surprise, really. With the rollout of mental health parity — requiring that insurance companies can no longer discriminate against people with mental disorders for their treatment options — those companies are looking for other places they can cut costs. Residential treatment for eating disorders appears to be one obvious area.

So is residential treatment a legitimate modality for helping people with eating disorders? Should insurance companies cover the costs of such care?

6:05 am: You lie awake in your tiny bed, underneath the salmon covers, your neck sore from sleeping on one pillow (you asked for another but you’ll need a doctor’s order to have more than one.) Your sleep medicine has worn off and you are now once again a prisoner to your insomnia.

All there is to do now is listen to your roommate snore and mutter to herself in her sleep and the sounds of the nurses talking and phones ringing at the nurses station. You remember a Seroquel-induced nightmare you had previously in the night in which you were trapped in a house that was filling with water, drowning and gasping for air. You make a mental note to mention the dream to your doctor later on.

7:00 am: Morning checks. A tech bangs on your door just as you have started to drift off into a sweet sleep again and informs you that you must be up for breakfast in thirty minutes. You incoherently moan something that resembles an “OK,” roll over and close your eyes again.

Take a minute and answer this question: Is anyone really normal today?

I mean, even those who claim they are normal may, in fact, be the most neurotic among us, swimming with a nice pair of scuba fins down the river of Denial. Having my psychiatric file published online and in print for public viewing, I get to hear my share of dirty secrets—weird obsessions, family dysfunction, or disguised addiction—that are kept concealed from everyone but a self-professed neurotic and maybe a shrink.

“Why are there so many disorders today?” Those seven words, or a variation of them, surface a few times a week. And my take on this query is so complex that, to avoid sounding like my grad school professors making an erudite case that fails to communicate anything to average folks like me, I often shrug my shoulders and move on to a conversation about dessert. Now that I can talk about all day.

Here’s the abridged edition of my guess as to why we mark up more pages of the DSM-IV today than, say, a century ago (even though the DSM-IV had yet to be born).

This week is National Eating Disorders Awareness Week, which is sponsored by the National Eating Disorders Association (NEDA).

Like I said in my post on Weightless, I believe that awareness means spreading accurate information about eating disorders.

One of the biggest misconceptions is that parents cause eating disorders. They don’t!

In fact, many complex factors are involved in predisposing a person to an eating disorder. According to eating disorder specialist Sarah Ravin, Ph.D:

“…the development of an eating disorder is influenced very heavily by genetics, neurobiology, individual personality traits, and co-morbid disorders. Environment clearly plays a role in the development of eating disorders, but environment alone is not sufficient to cause them.”

(Check out her blog post for more.)

But while parents don’t cause eating disorders, they can make a difference in their child’s life by creating a safe, diet-free and nurturing environment.

As Kenneth L. Weiner, M.D., co-founder and CEO of the Eating Recovery Center, said recently:

“Because eating disorders are genetic, an individual who has a family history is much more likely to be sensitive to others’ words and actions surrounding food and body image. It’s important for families to talk about these deadly diseases and avoid behaviors and actions that could act as eating disorder triggers.”

Below Dr. Weiner and other eating disorder specialists from the Eating Recovery Center share some of the ways you can help your child. (I think these tips are relevant for all kids):

Ginger Emas has written an interesting piece about men and eating disorders. It piqued my interest because a friend of mine once asked me if she should be concerned about her son’s eating habits. He counted calories, stayed away from sweets, and was a tad obsessive about a healthy diet. I told her not to sweat it, buying into the cultural myth that boys don’t get eating disorders. Now I know they do. To get to Ginger’s original article on ShareWIK, click here. I have reprinted it with permission below.

Usually when we talk about body image issues, we’re talking about girls. But did you know that more than one million boys and men struggle with eating disorders? More than 80 percent of 10-year-olds are afraid of being fat. More than 10 percent of middle school boys have used steroids. These are boys who don’t understand why they should brush their teeth every night; how can they possibly understand the repercussions of starving or using steroids?

I fear that I’m giving my daughter an eating disorder with intentions of teaching her how to eat right. Which begs the question: which is more harmful — obesity (and diabetes) or an eating disorder?

I’ve implemented a “one-treat rule” in our home, which simply means that if my kids get ice-cream after school, they have already had their treat and don’t get dessert after dinner. I try to explain as delicately as I can that too many sweets and too much junk food makes you sick. Fat too, yes. But, more importantly, sick.

“What happens when you eat more than one treat?” my daughter asked me awhile back. And, well, I’m not proud of this, but I think I said, while my mind was somewhere else: “You blow up.”

So yesterday she had a snow cone at the pool. That was supposed to be her treat for the day. But when we went to a lacrosse party later that day, a fellow mom trained at Le Cordon Bleu made these amazing cupcakes with the team’s logo designed with butter cream icing. Katherine instinctively grabbed one, but then ran to me, asking, “Will I blow up if I eat this?”

Eating disorders affect five times as many people as schizophrenia, and twice as many people who have Alzheimer’s disease. And yet Alzheimer’s and schizophrenia …

Talking about our weight, the circumference of our thighs or our disastrous double chin is as natural (and hard to resist) as comparing ourselves to …