Eating disorders are among the most serious psychiatric conditions I treat — not because they’re complicated to understand, but because they carry real physical risk and almost always develop alongside depression, anxiety, or trauma that goes unaddressed for years. Most people who come to see me have been struggling much longer than they’ve let on.
Types of Eating Disorders
Anorexia nervosa — severely restricted food intake, a distorted body image, and an intense fear of gaining weight. People with anorexia often believe they are overweight even when significantly underweight, and their self-worth is heavily tied to body shape and number on the scale. Medical complications can be serious: bone loss, cardiac arrhythmias, electrolyte imbalances, and in severe cases, organ failure. Despite the severity, most people with anorexia respond well to treatment when it begins early and includes both psychiatric and nutritional support.
Bulimia nervosa — cycles of binge eating followed by compensatory behaviors: purging, laxative use, excessive exercise, or fasting. People with bulimia typically maintain a relatively normal weight, which can make the disorder less visible to others and delay recognition. Intense shame around the behavior is common — bulimia is usually kept secret, sometimes for years — and that shame is often what keeps people from asking for help.
Binge eating disorder — recurrent episodes of eating large amounts of food in a short period, with a loss of control and significant distress afterward, but without the compensatory behaviors of bulimia. It’s the most prevalent eating disorder and is frequently associated with depression and anxiety. People with binge eating disorder often feel guilt and shame about their eating but feel unable to stop.
How Eating Disorders and Psychiatric Health Connect
Eating disorders rarely occur on their own. Depression, anxiety disorders, OCD, trauma (PTSD), and substance use disorders all commonly co-occur — and in many cases, one condition sustains or worsens the other. Treating only the eating behavior without addressing what’s driving it often produces limited results.
This is where a psychiatric evaluation matters. Understanding the full picture — the mood, the anxiety, the history, the patterns — is essential for building a treatment plan that actually holds over time.
How I Approach Eating Disorder Treatment
Eating disorders require a multidisciplinary approach. My role is the psychiatric dimension: accurate diagnosis, medication when it’s genuinely indicated (antidepressants and other medications play a meaningful role in several eating disorders), and close coordination with therapists, dietitians, and medical providers who are addressing other aspects of care.
I don’t treat eating disorders in isolation from everything else going on for a patient. If depression is driving the disordered eating, we address the depression. If there’s a history of trauma shaping someone’s relationship with food and their body, that belongs in the treatment. Getting the full picture right is what makes recovery durable.
I was also interviewed by Casey Becker of Mended Wing Counseling in Cambridge, MA on eating disorder treatment — you can listen to that interview here.
I’m Dr. David Brendel, MD, PhD — a Harvard-trained, board-certified private psychiatrist in Belmont, MA, with over 25 years in practice.
Why Choose Dr. Brendel for Eating Disorder Treatment?
- 25+ years treating eating disorders and co-occurring conditions in private practice in Belmont, MA
- Harvard-trained with an MD and PhD; board-certified by the American Board of Psychiatry and Neurology
- Addresses the full psychiatric picture — depression, anxiety, trauma, and OCD that commonly co-occur with eating disorders
- Medication management when indicated: antidepressants and other pharmacological approaches that support eating disorder recovery
- Multidisciplinary coordination: works alongside therapists, dietitians, and medical teams
- No judgment — a private, discreet practice where patients can speak honestly about what’s happening
- Located in Belmont, MA, serving Greater Boston, Cambridge, and surrounding communities
- Accepting new patients — book via ZocDoc or call (617) 932-1548
What I find in treating eating disorders is that the most important work often isn’t about food. It’s about what’s underneath — the depression that’s been there for years, the anxiety that spikes around eating, the trauma that’s quietly shaping someone’s relationship with their body.
People come to me having already worked with nutritionists and therapists, sometimes for a long time. What they often haven’t had is a psychiatrist who evaluates the full psychiatric picture — someone who can address the parts of it that medication, thorough diagnosis, and psychiatric expertise can genuinely help. That’s typically where I fit in.
Eating disorders can be life-threatening. I take them seriously. A thorough psychiatric evaluation — understanding what’s driving the pattern, not just managing the symptom — is where good treatment starts.
Ready to Take the First Step?
Dr. Brendel is accepting new patients in Belmont, MA. If you or someone you care about is struggling with an eating disorder, a thorough psychiatric evaluation is the right place to start.