Initial Assessment: Dr. Shapiro will first meet with you and get to know you. She will gather information about your eating, activity, diets that you’ve tried in the past (what worked and what didn’t work), weight history, your social history (family, work, relationship, upbringing), the role that food and body played in your family, etc. She will then work with you to collaboratively put together a treatment plan.
Goals: Dr. Shapiro helps patients understand what is causing and maintaining their unhealthy relationship with food. Sometimes what caused the initial unhealthy relationship with food, eating, weight, or body image, a long time ago, is very different than what is maintaining the behavior. Dr. Shapiro will help you identify your current triggers and help you learn ways to reduce and/or replace your unhealthy relationship with food/weight/body image with the overall goals of helping you feel better. The focus is not on the past but rather it is on the present and what is maintaining this behavior/unhealthy eating pattern. This includes discussing the emotional and behavioral reasons for eating (or not eating, purging, etc) and learning different ways of managing these situations.
Length of Treatment: Typically, Dr. Shapiro meets with patients weekly (but is flexible upon the needs of each patient). As treatment progresses patients transition to every other week, and then monthly, until they graduate from treatment. The ultimate goal is for patients to manage their eating and weight alone and to feel better without Dr. Shapiro’s assistance.
Some examples of treatment targets include: If you binge eat or emotionally eat or feel out of control, we may discuss the specific triggers that lead to a binge eating episode. Then, you can learn to prevent the trigger if possible or learn alternative ways of managing it. Triggers can include events, isolation, relationships (positive or negative), feelings (stress, anxiety, boredom, loneliness, excitement), physical sensations (hunger, PMS, tired), unhealthy (and maybe untrue) thoughts.
If you tend to make unhealthy food choices, we may discuss why these choices are made, barriers to making healthier choices, and solutions to prevent this cycle from continuing.
If you sabotage yourself, we may identify the unhealthy self-talk that you might say to yourself and formulate healthier ways of thinking, feeling, and behaving: “I just blew it, I may as well get the extra large serving;” “I’ll never lose weight, what’s the point;” “Nobody is going to find me attractive like this!” “ I’ll start over on Monday.”
If you restrict your eating, we may look at your anxiety about eating and weight and take steps to challenge this.
If you purge or compensate for what you have eaten, we will identify the anxiety that triggers your purging and ways to resist it.
If you are underweight or malnourished, we will work to restore your weight in a healthy way.