WAIMEA — For a young woman struggling with an eating disorder, a typical day begins with stepping on the scale. She then vows to stay within an extremely low calorie count and not succumb to the pressures of any trigger foods that could derail this goal. She most likely will run or walk an unreasonable number of miles that day or take back-to-back exercise classes, sometimes at multiple gyms to deflect concern from the instructors.
WAIMEA — For a young woman struggling with an eating disorder, a typical day begins with stepping on the scale. She then vows to stay within an extremely low calorie count and not succumb to the pressures of any trigger foods that could derail this goal. She most likely will run or walk an unreasonable number of miles that day or take back-to-back exercise classes, sometimes at multiple gyms to deflect concern from the instructors.
People with eating disorders are typically high achievers, perfectionists even, and are thus able to maintain excellent grades or excel at a high-level job, despite not nourishing their bodies with adequate food. They can keep up the charade of being perfect while experiencing anxiety, shame, self-doubt and an aching desire to be normal again. Their brain is a calculator that computes nonstop all day — a human scanner which memorizes the calorie and fat count of every food item they see whether they intend to ingest it or not.
Eating disorders are not something someone willingly implements for attention or vanity. It may start out as a simple diet that spirals out of control, but eating disorders are rooted in anxiety and an individual in its throes has a complete inability to stop the behavior until they are ready. They may reach the point of needing to be hospitalized but will not be free of the eating disorder until they hit rock bottom and decide to seek help. This can happen when they realize that they have alienated their friends or family, or when they are simply tired of being enslaved by this disease. They can be free from the eating disorder permanently, but it takes dedicated work with a therapist and nutritionist to loosen the ties that bind them to this disordered behavior.
This was the personal story of a college student who suffered with an eating disorder for several years. In Hawaii alone, one in five people face this challenge each day.
Eating disorders impact all ages, both sexes, and is often misunderstood. To help patients face this challenge, Ai Pono Kamuela opened in October with an Intensive Outpatient Program (IOP) to treat patients struggling with anorexia nervosa, bulimia nervosa, binge eating disorders, orthorexia and other variations.
“An eating disorder is like a weed: if you cut it off at the top, given the right circumstances it can grow back. But if you go down and clear out its roots, it can be eradicated,” said Anita Johnston, PhD, an expert in this field who has helped thousands of patients as director of the Anorexia &Bulimia Center of Hawaii she co-founded in 1982. She is also clinical director and founder of the Ai Pono Intensive Out-Patient Eating Disorders Programs in Honolulu, Ai Pono Maui and the newest location on the Big Island.
Dr. Johnston is one of four partners at Ai Pono. Each bring 30 years or more experience to the team. Cathy Meyer-Uyehara has health care experience in administrative roles, holds her Fellowship in Health Care Administration and serves as CEO of Ai Pono in all Hawaii locations. COO Clayton Uyehara has an MBA and provides both financial and marketing expertise, and Dr. Steve Orenstein is the on-site therapist specializing in eating disorders, anxiety and depression.
“Ai Pono Maui opened its doors three years ago after three years of getting through the application process with the State Health Planning Department and Department of Health,” said Meyer-Uyehara. “As the only residential facility in Hawaii, we continue to look at ways that we can serve the residents of our island state. In 2016, we began the process of opening an IOP for the Big Island. Our Medical Director, Timothy Duerler, MD suggested we consider the Waimea area as a great location for the best access of our services. Another plus for Waimea was that we had two very talented therapy staff members: Marriage and Family Therapist Fabienne Bisaro and Nina Puckett, a soon-to-be licensed counselor.”
“I went to the Institute for Integrative Nutrition to become a health coach and then decided to go to Institute for Psychology of Eating to become a dynamic eating psychology coach. Once I did that, I realized I wanted to go further so I decided to go back and get my masters as a licensed mental health counselor,” Puckett said.
There is no set office for patients, as programs such as this are often held in home-like settings.
“The intention is to create a comfortable and secure setting for the program. The exact location is provided to patients or held private to assure patient privacy,” Meyer-Uyehara said.
Dr. Johnston provides weekly supervision to the program. They also have a registered dietician to support patients, and nurses who provide weekly clinical monitoring. Insurance is accepted.
“Our program is considered an IOP which consists of a 3-hour group program, 2-4 days per week for patients. In addition, they have individual sessions with a therapist and our dietician,” Meyer-Uyehara said.
To date, the Kamuela staff have reached out to the medical and therapeutic community, given talks at Tutu’s House and met with school counselors in the area to share the services now provided in North Hawaii.
“Typically, it’s not about food, it’s about their core belief which a lot of times boils down to not feeling good enough, not feeling like they fit in. The food is the just an external expression of an internal turmoil,” Puckett said.
Info: Call 313-0435 or go to www.aiponomaui.com