Eating disorders don’t discriminate. Contrary to the once widely held belief, men and women from a wide array of socioeconomic , cultural, educational, religious, and medical backgrounds are diagnosed with eating disorders every year. Since its establishment in January 2011, Walden Behavioral Care’s Worcester clinic has seen a number of patients fearful that one of these factors may impede on their ability to receive treatment. For those who are struggling, barriers to treatment are easy to come by and need not include the aforementioned variables one cannot control. More often than not, accommodations can be made to ensure effective and meaningful treatment for all.


Earlier this year, a patient came into the Partial Hospitalization Program with a severe allergy to tap water.  She arrived with a doctor’s note in tow validating the allergy, apprehensive she would be told her allergy was a figment of her eating disorder and that she would be forced to drink the water or consume a product made with city water.  The patient suffered from petit grand mal seizures and she would go into anaphylactic shock if exposed to large quantities of city water or products containing city water which include a vast array of items ranging from milk to Ritz crackers, to the adhesive in band-aids.   Given the rarity of the allergy, the patient feared it may be too complex to accommodate.  However, modifications to the treatment protocol ended up being quite simple, given the patient packed a bagged breakfast and lunch for program. The program dietitian also created a list of water-free snack options and the patient was able to receive and engage in treatment just like her peers.

Religious Beliefs

Last year a patient in the Intensive Outpatient Program (IOP) approached her case manager and inquired about leaving IOP in order to abide by the rules of Ramadan, a month long Muslim observance that entails fasting from dawn until sunset. The patient was doing quite well in IOP and while enabling a fast can be challenging and counterintuitive in the eating disorder field, the interruption of treatment is also less than ideal.  With the patient’s motivation for treatment being high and medical status stable the simple postponement to the start of the patient’s therapeutic meal until after sunset, (i.e. during the last therapeutic group of the evening) was more than feasible.  The patient was grateful for the meal time adjustment and her peers in program were understanding.

Other Unique Populations

Patients with seemingly unique situations need not feel alone, either. Eating disorders are not limited to upper, middle class white teenagers and young adults. Patients as young as nine and as old as 67 have been enrolled in Walden programming. Likewise, patients whose home is a foster home, a convent, a group home, and a dorm room can and have all received treatment at the clinic. While there are evidence based treatment practices for eating disorders, patients often worry these treatment modalities leave little room accommodation and flexibility.  People with food allergies, those who are pregnant, have co-occurring substance use disorders, diabetes, or cognitive delays, as well as males and transgender patients are not uncommon in the clinic, but can be anxious about scheduling an intake.  Very few people meet the criteria for an eating disorder in the absence of any other medical or psychiatric symptoms.  Fortunately, for those struggling with an eating disorder, accepting the need for treatment can be challenging in and of itself and these pre-existing conditions need not stand in the way.

About The Author

Laura Roias is the Director at Walden Behavioral Care’s Worcester clinic. In this role, she is responsible for providing clinical, administrative, and fiscal oversight and development for the clinic. Formerly, she served as the Assistant Director of Walden’s Partial Hospitalization Program and Intensive Outpatient Program where she obtained extensive experience conducting individual, group, and family therapy. Ms. Roias employs a strengths-based perspective and utilizes a wide range of therapeutic modalities including cognitive behavioral, dialectical behavioral and interpersonal therapy. She received her master’s from the University of North Carolina.

For more information regarding the programs and services offered at Walden’s Worcester clinic, feel free to email Ms. Roias at