As a psychotherapist how do you determine the severity of someone’s eating disorder is it diagnosed are there stages right you know so depending on the eating disorder I think you you want to see where they’re at physically so a lot of my clients when they come in without being the concern I have them if they don’t have a medical professional or someone that is evaluating them medically so we can get a base level of their lab work and see where they’re at so you would want to see severity meaning so where is their weight if weight is an issue right how severe that is it helps you to really determine are they’re in a place where since I’m in the outpatient community is this somebody that I can treat an outpatient or do I need to refer this person for a higher level of care so that I can stabilize medically so that is one of the main things you first see is where is it affecting them medically socially so in their in their in their life is this impacting their their their daily living are they not able to work are they not able to perform as a you know an age-appropriate level right now now I want to talk about the importance of the external support with family and friends and how important is it during this time and and it’s funny because one of the things you mentioned early in the show because a lot of us do it culturally and we are a culture many many cultures are attached to their food that’s so now you’re if someone doesn’t eat and becomes why aren’t you eating you shouldn’t eat this and it’s and it’s so much more than that so how do you get the family involved right so you know the family must be involved I don’t believe in working in particularly with the adolescents and young adults I see without the family that is their main source of support and so right off the bat I do explain to them your parents or your family is going to be involved in this work how do you work with them will you eat them and so you do get a sense of what are their what is their own relationship with food you want to see what the food culture what is going on in the home and get a good sense of that before you go and intervene you need to know what you’re dealing with you need to know what this particular person is also dealing with if you want to help them are there any mixed messages being sent at home then I would need to educate these parents where the dietician can also educate them to on you know introducing food or helping them so absolutely the family is is huge there is a form of therapy that’s called family based therapy and so in residential treatment centers maybe for adolescents you’ll see that the family is very involved and helping their child eat and helping their child’s you know get back to normal and be healthy you