By JANET MARSHALL
By the end of next year, people struggling with eating disorders will be able to get help in Caroline County, at a residential center run by one of the country's leading treatment groups.
The center will be called Remuda East--an affiliate of Remuda Ranch Programs for Eating Disorders, which has treated more than 7,000 girls and women since opening in 1990 in Arizona.
Intractable and prevalent, eating disorders afflict more than 10 million women and girls, said Amy Spahr, the program's executive director of clinical services.
Remuda treats patients holistically, with therapy that takes their medical, spiritual, nutritional and psychological needs into account. The treatment team includes dietitians, medical doctors, psychologists, equine therapists and body image staff.
Together, the professionals and patients work to uncover and address the root causes of the disorder.
"It's not about what they eat," Spahr said of patients. "It's about what [they're] feeling."
People who seek treatment at Remuda spend from 45 to 60 days as inpatients, then transition into separate, residential housing where they receive support but ease back into independent lives.
Remuda tracks how its patients do after leaving. One of its surveys showed more than 90 percent of patients no longer met the criteria for an eating-disorder diagnosis a year after leaving.
Nancy Farrell, a local registered dietitian, said having a nationally recognized center in Caroline will provide local eating-disorder sufferers with a convenient treatment option.
Farrell said she's referred clients in the past to The Renfrew Center, another nationally known treatment facility, because it has centers in Pennsylvania. Farrell said she knew of no comparable facility closer.
"I think we're fortunate if the [Remuda] facility comes to this area," said Farrell, wellness dietitian for the Spotsylvania County schools.
Ferrell said she hadn't referred clients to Remuda in the past simply because of its Arizona location.
"I knew they were a great facility," Ferrell said. "And it was far away."
Family involvement is often critical to the recovery process, because family dynamics can be a factor in the disorder. So proximity to a center can be significant for patients and their families.
At Remuda, families spend a week at the center during family week, where they address family communication, nutrition and other issues.
The Caroline center will be based at the former Easter Seals camp, a 516-acre retreat not far from Bowling Green. The land has 30,000 square feet of building space already on it. The location, and the existing buildings, are a great match for Remuda, said Mark Bower, executive director of operations for Remuda East.
Remuda had been seeking an East Coast spot in a rural setting not far from major cities, he said. The Caroline facility will open sometime next year.
Remuda's first priority, in terms of new construction, likely will be building bigger housing for horses. Equine therapy is a large part of what Remuda does.
"Right now, there's a small barn on the property, but not really large enough," Bower said.
Grooming and riding horses is a significant part of Remuda's treatment approach.
Another hallmark of Remuda's care is its focus on spirituality. Remuda staff call their treatment approach scientifically driven and Biblically based.
Just as Alcoholics Anonymous has a spiritual component, so, too, does recovery at Remuda Ranch. The center's founders are Christian, and women and girls at Remuda are required to attend Christian chapel services daily. Whether patients participate in prayers or sit in the back and do crosswords is up to them, said Sandy Richardson, a former patient who now does marketing for Remuda.
"You are certainly free to believe whatever you want to believe," Richardson said.
But Richardson and other Remuda supporters say offering spiritual guidance can be critical to a patient's recovery.
"When someone comes [to Remuda], what they see are people who accept them completely and unconditionally and want to help them find a healthier way to cope with their life," Richardson said.
For Richardson, having staff address her worry that God was mad at her made a big difference in her recovery. It helped her feel less guilt and shame, and focus more on the issues that led to her disorder--things such as being sexually abused as a child.
She said her disorder began shortly after she got married. The relationship was loving--she and her husband are still married--but it gave rise to deep insecurity that led to disordered eating.
"I had sexual abuse, drug abuse, promiscuity, all kinds of things in my past. And I thought: 'If he finds out who I am, he will never love me. But if I'm pretty enough, I'll be OK,'" Richardson said. "Well, 'pretty' means 'thin.'"
Remuda patients are counseled on body-image issues, which are often exacerbated by pervasive images of rail-thin models. Richardson said disorders often begin with a seemingly benign desire to lose weight.
"I have never met anyone with an eating disorder who didn't have some sort of emotional root to their problem," Richardson said. "I've also never met someone with an eating disorder who didn't start with a diet."
For some patients, Remuda is a sort of last stop, a place they turn to after other treatment efforts have failed. For others, especially young patients, Remuda may be the place their parents send them right after detecting a disorder.
Remuda has treated patients as young as 8. The dominant age range is between 16 and 20. But Spahr said more and more patients are middle-aged women dealing with either a resurgence of an old problem or the emergence a disorder triggered by a life change such as a divorce or a child heading for college.
"That empty-nest syndrome--it plays a role in how they perceive their body," Spahr said.
Many patients have tried on their own to become healthier, thinking if they can latch on to a better eating style, life will improve. But a different diet isn't enough.
"That doesn't hit the underlying issues, which is why our treatment is 45 to 60 days plus transition care," Spahr said. "For a lot of them, perfectionism is part of who they are, and they need to learn how to deal with that."
Whatever a patient's age, entering a facility for treatment tends to feel "scary," Spahr said.
"But at the same time, most of them are sick and tired, and they're ready for a change."
For more information on Remuda Ranch, visit its Web site, remuda-ranch.com. To search for other treatment facilities, or to get more information about eating disorders, visit something-fishy .org.
To reach JANET MARSHALL:
Email: jmarshall@freelancestar.com