Tzvi Furer of Palm Tree Psychiatry PLLC On How To Support A Loved One Who Is Struggling With An Eating Disorder
Good help doesn’t judge: Regarding all aspects of mental health, I am generally a big fan of validation and ongoing support without any judgment. Recovery is difficult on its own, without feeling judged by the presence of symptoms, and feeling that they are alone in their road towards symptomatic improvement. Providing a safe and open environment may allow the individual to feel more open and honest about their recovery, which will provide the best basis for providing support & assistance. Patients that feel a pressure to improve may rush the recovery process, which often itself may be disastrous in terms of reoccurrence of symptoms. And like many recoveries, relapse can often be a part of the process, and this also needs to be viewed from a non-judgmental lens. Programs based on eating disorders understand that this is an ongoing process, and support should also be an ongoing process as well.
Eating disorders are complex mental health conditions that affect millions worldwide, transcending age, gender, and cultural boundaries. They are not simply about food but involve a range of psychological, physical, and social issues. Supporting a loved one through this struggle can be challenging, requiring understanding, patience, and knowledge of the right approaches to truly make a difference.
In this series, we aim to shed light on the most effective ways to offer support, understanding, and hope to those battling an eating disorder. We are talking to psychologists, nutritionists, doctors, therapists, and survivors, who can provide valuable perspectives on nurturing recovery, fostering resilience, and promoting healthy relationships with food and body image. As a part of this series, we had the pleasure of interviewing Dr. Tzvi Furer.
Dr. Tzvi Furer is a seasoned child & adult psychiatrist and owner of his concierge private practice, Palm Tree Psychiatry located in Jupiter, Florida. Dr. Furer has extensive mental health treatment experience- Dr. Furer is a former Unit Chief of Adolescent Inpatient Psychiatry at New York City’s Bellevue Hospital, former Associate Program Director for New York University Langone Health’s Child & Adolescent Psychiatry Fellowship Program, and former undergraduate professor at New York University in class topics including narrative medicine, sleep, and love. Dr. Furer has also been awarded the status of Fellow through the American Psychiatric Association and Distinguished Fellow by the American Academy of Child & Adolescent Psychiatry, given for significant contributions in the field of psychiatry.
Thank you so much for joining us in this interview series. Before we dive into our discussion, our readers would love to “get to know you” a bit better. Can you share with us the backstory about what brought you to your specific career path?
My name is Dr. Tzvi Furer, and I have always been fascinated with the human brain. In fact, I knew I wanted to be a doctor since I was four years old! I have always wanted to help others and found a calling in psychiatry. After finishing college and medical school, I completed Adult Psychiatry Residency at SUNY Downstate Medical Center/ Kings County Hospital Center in Brooklyn NY where I served as Chief Resident. I then completed a Child Psychiatry Fellowship at NYU Medical Center / Bellevue Hospital Center in Manhattan NY, where I stayed on as faculty for several years after graduation. I previously served as Unit Chief for Inpatient Adolescent Psychiatry for several years, and previously served as the Associate Program Director for NYU’s Child Psychiatry Fellowship. I now live in Florida with my wife, children, and dog.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
My favorite “Life Lesson Quote” is to treat people the way that you want to be treated yourself. I have found this immensely helpful both personally as well as professionally. In my career, I have often found myself in the position of identifying and empathizing with the struggles of my patients. I believe this outlook has allowed me to look at the issues and concerns of patients with a perspective that strictly isn’t limited to the medical model of prescribing medication. I have found myself open to hearing about the experiences and journeys of others and have learned just as much from others as they have learned from me. It has been one of the reasons that I have had an interest in narrative medicine, and often explore “out of the box” treatment options for my patients that may include a holistic or natural approach as well.
Are you working on any exciting new projects now? How do you think that will help people?
I own and operate my own concierge private psychiatry practice, Palm Tree Psychiatry, in Jupiter, Florida that services both Florida & New York with treatment for children, adolescent, and adults. I launched this practice in January 2024, and have been able to service in-person in Jupiter, FL as well as virtually across Florida and New York. I have been able to help patients and families by providing direct concierge care.
More specifically related to our topic, I have also had the privilege of collaborating with various professionals specifically in the realm of treating eating disorders. By doing this, I have been able to provide appropriate therapeutic and medication support for these patients and allowed my patients to begin the process of recovery.
According to this study cited by the National Association of Anorexia Nervosa and Associated Disorders, at least 30 million people in the U.S. of all ages and genders suffer from an eating disorder. Can you suggest 3–5 reasons why this has become such a critical issue recently?
It is tragic to see the rise of eating and intake-related disorders across the United States. Even in my own clinical practice, I have seen eating disorders play a larger issue than earlier in my career, with many different mental health conditions featuring impaired eating or the presence of compensatory behaviors. Social media since its inception in the early 2000s has made a noticeable impact on the perception of “perfection.” Social media provides a self-promoted and manufactured glimpse into a false reality, with many images and pictures being the product of careful digital manipulation, heavy editing, and the use of “filters” to wash away any perceived imperfections. What has resulted is that a very susceptible population, teenagers and young adults, now believe that their own growing and developing bodies are not reaching a specific ideal of “perfect.” As it is impossible to achieve these standards, it is leading to increased symptoms of eating disordered behaviors, as well as depression, anxiety, and self-harm / suicidal behaviors. Youth are now attempting to live up to an impossible ideal, which has created excessive frustration, disappointment, and dangerous attempts at dieting or exercising that have lasting impacts on the body.
The other major impact on the rate of eating disorders was the COVID-19 pandemic. The COVID-19 pandemic left lasting impacts on the field of mental health, and eating disorders were especially affected. As many were quarantined and worried about the debilitating effects of a pandemic virus, it exacerbated poor eating habits and patterns as most were quarantined and only communicated through social media & online platforms such as Zoom. Social isolation and the stress of the pandemic led to an overall increase in symptoms of various mental health disorders such as anxiety and depression. This itself contributed to a rise in symptoms of eating disorders.
Based on your insight, what can concrete steps can a) individuals, b) corporations, c) communities and d) leaders do to address the core issues that are leading to this problem?
Recognition and normalization of eating-related disorders is the first step towards recovery. The proliferation of skewed views of self-image through social media requires a course correction- more specifically, the normalization of individuals having various body types. Societal views of various eating disorders relegate it to a disorder that is either highly stigmatized or entirely minimized. Proper awareness of the visible signs of somebody suffering from eating disorder should be known by any support systems. Too often, these signs and symptoms are either missed or ignored altogether. Destigmatizing interventions such as support groups or individual therapies can play a huge role in recovery. Likening it to recovering from other forms of addiction, eating disorders are often not held to the same standard as other forms of recovery which can often make individuals feel isolated or ineffectual in their journey.
As you know, one of the challenges of an eating disorder is the harmful,and dismissive sentiment of “why can’t you just control yourself”. What do you think needs to be done to make it apparent that an eating disorder is an illness just like heart disease or schizophrenia?
Stigma and the societal perception of eating disordered symptoms needs to be addressed to allow for effective interventions. Any additional support and treatment modalities, be it educational sessions or even campaigns to target the family, friends and supports of those with eating disorders, will allow for the most effective forms of recovery. This brand of education should approach eating disorders as a form of addiction-related behaviors, which would veer it away from a volitional choice. Education should also support the medical aspects of eating disorders, including severe nutritional deficiencies, muscle wasting and atrophy, or even bone wasting that can occur with severe forms of eating disorders. Reconceptualizing this illness as an addictive process that is not under self-control may allow others to recognize its importance, and not that it is something to “outgrow” or simply a form of dieting. Support should also be given towards psychoeducation of healthy dieting, and that radical weight changes are indicative of eating disorder-related behaviors.
Here is the main question of our interview. Can you please share with our readers 5 ways to support a loved one who is struggling with an eating disorder? If you can, can you share an example from your own experience?
1 . It is a marathon, not a sprint: Professionals treating eating disorders are aware that road to recovery for eating disorders, regardless of type of symptoms, usually is not completed overnight. That is not to say that there aren’t options for treatment or that treatment is effective, recovery from eating disordered symptoms usually requires a comprehensive approach tackling medical, psychological, and interpersonal factors. For adolescents struggling with these symptoms, therapies involving family systems and dynamics are often highly recommended as there is a risk of relapse with many of these conditions. In my own clinical experience, I have seen more sustained improvement of symptoms and recovery with individuals that are aware that maintenance of symptoms is also vastly important. This includes attending recovery meetings, that often can occur for years after completion of programs. Unfortunately, some individuals and families might believe that recovery ends after a single medication trial, or one treatment experience at a higher level of care. Awareness of triggers and ongoing steps to recovery help create the best possible outcomes.
2 . Try to avoid discussing food: While open and honest discussion about eating-related intrusive thoughts, cognitive beliefs, and feelings are crucial in the acute treatment phase, discussion about food can be a difficult subject while in ongoing recovery. Often, family members and supports may be on “high alert” to notice any changes or concerns about eating habits, however I would recommend not commenting on food quality, portion sizes, or meal intakes directly. I would still highly recommend supporting overall and validating progress and recovery, however individuals may find these comments to be triggering and help to bring up misperceptions and old cognitive distortions about themselves that they worked on in recovery. It may be helpful to consult with a therapist about the best way to approach check-ins, and perhaps setting up either a color-coded or number-based system so that individuals may be helpful sharing any concerns they are experiencing.
3 . Avoid comments about physical appearance- positive or negative!: A focus on an individual’s appearance may often have been the catalyst for eating disordered related symptoms, and comments, regardless of the intention, have the possibility of being harmful. Patients recovering from any eating disorders may find themselves either gaining or losing weight, and often having to cope with a previous trigger often can be a source of great anxiety. Drawing attention to very normal changes that may occur during recovery may itself cause a worsening of symptoms, and may run the risk of a possible relapse of symptoms. Drawing attention to physical symptoms may run the potential to substantiate or validate previous cognitive distortions about appearance, and instead it would be better to validate overall experience and progress.
4 . Support and validate! It goes without saying but those with eating disordered symptoms need all the support they can get! Multiple research studies and clinical outcomes have demonstrated that having the support of loved ones can be crucial in recovery, and it is important that individuals feel supported throughout their journey. Patients with these types of symptoms may feel alone, and having support constantly, despite what is occurring, is important. Often, eating recovery is misjudged as being treatable only briefly with medication and therapy, when instead, a higher level of support such as groups, treatment programs, or even residential campus admissions may be warranted for the best chance of recovery. Validation should go together with honest, open communication, which is important in helping these patients feel that they are not alone at all. The ups and downs of recovery should not be glamorized or judged, and instead, constant support is linked with the best chances at relieving symptoms permanently.
5 . Good help doesn’t judge: Regarding all aspects of mental health, I am generally a big fan of validation and ongoing support without any judgment. Recovery is difficult on its own, without feeling judged by the presence of symptoms, and feeling that they are alone in their road towards symptomatic improvement. Providing a safe and open environment may allow the individual to feel more open and honest about their recovery, which will provide the best basis for providing support & assistance. Patients that feel a pressure to improve may rush the recovery process, which often itself may be disastrous in terms of reoccurrence of symptoms. And like many recoveries, relapse can often be a part of the process, and this also needs to be viewed from a non-judgmental lens. Programs based on eating disorders understand that this is an ongoing process, and support should also be an ongoing process as well.
How do you navigate the balance between offering support and respecting the autonomy of a loved one with an eating disorder?
This is often a difficult tight rope walk, however, can be managed with an appropriate mindset and approach for treatment. Individuals with eating disordered-related symptoms may often feel an array of emotions including frustration, shame, embarrassment, anxiety, guilt, and sadness over experiencing symptoms. It is important to have open and honest communication about support for their condition, but also discuss ways that indicate that they are having a tough time. Often, these individuals may not feel comfortable discussing these symptoms directly for fear of judgment. It is important to highlight, that checking in too frequently or constantly questioning symptoms may lead to difficulties in being honest and open. The most important thing is to set expectations, and often a type of “safety plan” may be useful in identifying triggering or concerning statements, actions, or objective signs that indicate that there is concern over symptoms. This type of open communication style will allow those with symptoms to feel less judged, and seek out the appropriate held if the need arises.
Is there a message you would like to tell someone who may be reading this, who is currently struggling with an eating disorder?
There is hope. I have worked with numerous individuals with symptoms of eating-disordered related behaviors, in several settings both inside and outside of the hospital. What I would emphasize is that while there is not a one-size-fits-all approach to eating disorder treatment, the most important part is recognition that there is an issue. There are several different forms of care, and that an appropriate evaluation of symptoms and behaviors is necessary to provide the best recommendation for treatment. Eating Disorder Specialists have consistently been some of the most nonjudgment and supportive providers that I have seen in mental health, and so I would wholeheartedly recommend committing to the process for the best chances at full recovery.
In your experience, what are the most effective strategies for building resilience and a positive self-image in individuals recovering from an eating disorder?
Trusting and embracing the process is often the most difficult initial strategy for targeting symptoms of eating disorders. Often, critical work will be necessary in terms of negative cognitions, automatic thoughts, and connections between feelings, thoughts, and behaviors. I think taking a slow approach towards recovery is best, as often an attempt to rush through recovery and get immediate improvement can be a set-up for long term difficulties or even relapse of symptoms. Self-esteem can be built up by working on negative self-talk and conceptualization of self, and this often includes work in group and family therapy systems as well. Recovery can be gradual but becomes more substantial as time goes on, which includes a significant improvement in the resilience. Expectations can also be important about the road to recovery, which as with many addiction-related behaviors, may include relapses as part of the recovery process. Having validation and support therapeutically as well as personally can be immense in terms of building overall resilience.
What are your favorite books, podcasts, or resources that have helped people with this struggle? Can you explain why you like them?
I would recommend the following books as they have been helpful in connecting with my patients:
– Eating With Your Anorexic, by Laura Collins
– The Overcoming Bulimia Workbook, by Randi McCabe, Tracy McFarlane, Marion Olmstead
– Eating Mindfully, by Susan Albers
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the largest amount of people, what would that be? You never know what your ie ddea can trigger. 🙂
While there have been an amazing number of resources and organizations that have been helpful in assessing and treating eating disorders, I would like to create an open, non-judgmental space for clinicians of all types. I have often come across various mental health professionals that will specifically highlight their lack of comfort in treating eating disorders. This has made me wonder whether there is a larger need for more specific training during medical training, and I believe would also be crucial from a sociological perspective as well. The stigma towards eating disorders have been substantial, and too often individuals on social media or any public platform will mention it without seriously bringing it to light. There needs to be a push towards recognizing not only how important eating disorders are, but also how pervasive and the seriously dangerous complications that can occur when left ignored and/or untreated. I would like to push towards more providers, even those not specifically in psychiatry, to be aware of signs and symptoms of eating disorders, as it can often be missed in several environments and recognized years after concerning patterns have been in place.
How can our readers continue to follow your work online?
Please visit my website at www.palmtreepsychiatry.com! I am also available on various social media platforms including Facebook, X, Instagram, LinkedIn, and Threads- @palmtreepsychiatry.
Thank you so much for these insights! This was so inspiring!
It was my pleasure, thank you for the opportunity.
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