On the outside, Clementine Twin Lakes looks no different from any of the massive brick McMansions that dot the Northern Virginia landscape.
For the teenagers and families who venture inside, however, the recently opened residential treatment center for eating disorders could be a lifesaver.
After officially opening the doors to its Clifton facility in October, Clementine Twin Lakes aims to establish itself in Fairfax County as a reliable place that young girls in particular can turn to if they are struggling with an eating disorder, including anorexia and bulima nervosa, binge eating disorder, and exercise addiction.
One of five such centers in the country, Fairfax County’s Clementine is part of a consortium of eating disorder treatment programs operated by the company Monte Nido and Affiliates, which started in 1996 with the first Monte Nido treatment facility in Malibu, Calif., before expanding with the Oliver-Pyatt and Clementine programs.
With the opening of Clementine Twin Lakes, Monte Nido and Affiliates now has 20 eating disorder treatment facilities in the U.S.
Unlike the Monte Nido and Oliver-Pyatt Centers, which focus on adults with the former offering day treatment to men as well as women, Clementine programs cater exclusively to adolescent girls ages 11 to 17.
“Clementine is specifically designed with the needs of the girls in mind,” Monte Nido and Affiliates medical director Dr. Molly McShane said. “It’s filled with light, decorated in warm colors, and intended to encourage girls to connect in the ways they enjoy. The Clementine environment…suggests hope, which helps with recovery.”
Part of what makes eating disorders challenging to address is that many people are simply not aware of how common they are, Clementine Twin Lakes medical director Dr. Elizabeth Weaver says.
The U.S. Centers for Disease Control and Prevention currently does not regularly collect data on eating disorders after the agency stopped tracking unhealthy weight control behaviors in 2015, according to the Strategic Training Initiative for the Prevention of Eating Disorders based at Harvard University’s School of Public Health and Boston Children’s Hospital.
However, according to the National Association of Anorexia Nervosa and Associated Disorders, the oldest U.S. nonprofit organization aimed at fighting eating disorders, at least 30 million Americans suffer from an eating disorder.
Binge eating is the most common eating disorder in the U.S. and one of the newest to be formally recognized as a clinical illness by the Diagnostic and Statistical Manuel of Mental Disorders, according to the National Eating Disorders Association.
Like any other eating disorder, anorexia nervosa, which is characterized by weight loss and a restriction of the number of calories and types of food consumed, can affect people of any age, but it frequently emerges during adolescence, ranking as the third most common chronic disease among young people behind asthma and type-1 diabetes.
The incidence of anorexia in women aged 15 to 24 has increased over the last 50 years, but men represent 25 percent of the individuals with the disease and are at a higher risk of dying, in part due to later diagnoses stemming from the assumption that men do not have eating disorders, according to NEDA.
Along with medical complications resulting from binge eating, starvation, and purging, eating disorders can lead to serious conditions like heart attacks, kidney failure, anemia, and bone diseases. Suicide is also common among individuals with eating disorders, according to NEDA.
In general, eating disorders have the highest mortality rate of any mental illness, with at least one person dying as a direct result every 62 minutes, according to the National Association of Anorexia Nervosa and Associated Disorders.
One in five anorexia deaths is by suicide, ANAD says.
The National Eating Disorders Association emphasizes that, contrary to widespread beliefs, eating disorders are not a choice or fad, but rather, complicated medical and psychiatric illnesses shaped by a variety of genetic, biological, environmental, and social factors.
While research suggests that genetics, biology, and neurochemistry influence the development of eating disorders, an individual’s temperament can play a role in whether someone has an eating disorder, which often co-occurs with other mental conditions like anxiety and depression, according to Weaver.
Social messaging and life stressors, such as physical illness or bullying, create an environment that may also contribute to a person’s vulnerability to developing an eating disorder.
“We’re seeing them increase with the increased presence of social media, increased pressure to follow a certain body type,” Weaver said. “…Not only are we seeing images in magazines like I did growing up or on television, but we’re just bombarded with social media and this false image of what a female body should look like.”
Given the multifaceted nature of eating disorders, Clementine has found that a multidisciplinary, holistic approach is needed to treat them, Weaver says.
In addition to offering individual and group therapy as well as other medical and psychiatric care, the residential treatment center works with patients to address their nutritional needs and develop a balanced, sustainable relationship with food.
Clementine Twin Lakes has on-site educators who help create personalized education plans so that the facility’s teenage clients can continue their academic studies while staying there. It also provides activities that develop life skills, such as hygiene, time management, communication, stress management, and decision-making.
“We work together to instill hope and trust, and heal the entire family,” McShane said. “Critical to residential treatment is preparing our adolescents for the real world. We want each girl to develop a full sense of self. We treat the whole girl, not just the disorder.”
For people worried someone they know might be struggling with an eating disorder, Weaver says signs to look out for include significant weight fluctuations, avoiding meals, playing with food without actually eating it, an extreme exercise regimen, and a fixation on food that can range from talking about food excessively to paying intense attention to calorie counts and food labels.
Shifts in behavior and mood, including increased isolation, depression, and anxiety, may also be indicators of an eating disorder.
Discussing eating disorders is difficult for many people because of general stigma around mental health issues as well as cultural attitudes around food and weight, according to Weaver.
For instance, people may inadvertently validate an acquaintance’s anorexic behavior by complimenting them for losing weight.
“There are a lot of resources out there in terms of how to talk to somebody about having an eating disorder,” Weaver said. “More than anything, I think confronting people and saying you love them and you’re concerned about them with the hopes of reaching them [is important].”