Eating disorder therapy and nutrition counseling
Virtual eating disorder treatment in Massachusetts and Idaho for teens and adults navigating food, body image, anxiety, and recovery.
Actualize Counseling & Nutrition provides specialized outpatient support for anorexia, bulimia, binge eating disorder, ARFID, chronic dieting, compulsive exercise, body image distress, and disordered eating. Our therapists and registered dietitians work together so care feels coordinated, practical, and grounded in the whole person.
Recovery needs more than willpower.
Eating disorders affect the brain, body, emotions, relationships, and nervous system. Treatment should address all of it.
You do not have to wait until you feel “sick enough.”
If food, weight, exercise, body image, or shame is shrinking your life, support is appropriate now.
Signs an eating disorder may be taking over more of your life
Eating disorders are rarely just about food. They can affect thoughts, mood, energy, relationships, physical health, and daily functioning.
Food rules and behaviors
- Restricting meals or cutting out entire food groups
- Binge eating, purging, or feeling out of control around food
- Compulsive exercise or “earning” food
- Constant calorie tracking, body checking, or food negotiation
Body and health changes
- Dizziness, fatigue, fainting, or trouble concentrating
- Bloating, reflux, constipation, or GI discomfort
- Feeling cold, hair changes, brittle nails, or cycle disruption
- Difficulty trusting hunger, fullness, or body cues
Mental and relational impact
- Obsessive thoughts about food, weight, or shape
- High anxiety around eating or social events
- Body image distress, shame, or rigid thinking
- Isolation, irritability, or life shrinking around the disorder
Feeling stuck does not mean you are failing.
Many people feel deeply torn. Part of them wants freedom, while another part feels convinced the eating disorder is keeping them safe. We treat those stuck points with compassion and structure instead of shame.
Emotional flooding
Food can trigger panic, shutdown, or a fight-or-flight response.
Fear of body change
The wish to recover can coexist with intense fear and grief.
The famine response
Undernourishment can increase anxiety, rigidity, and obsession.
Protective behaviors
Symptoms can function like control, identity, relief, or protection.
Integrated treatment for the mind, brain, and body
We do not believe fragmented care serves people with eating disorders well. Therapy and nutrition counseling work together so treatment addresses nutritional rehabilitation, emotional pain, nervous-system regulation, body image distress, and daily recovery behaviors at the same time.
We coordinate with primary care providers when needed to help assess medical stability, labs, and next steps. If outpatient care is not the safest level of support, we help guide referrals to higher levels of care.
Emotional and psychological healing
Support for trauma, attachment wounds, body image distress, anxiety, perfectionism, shame, and behavior change using evidence-informed care.
Nutritional rehabilitation and flexibility
Support for meal structure, mechanical eating, GI restoration, fear-food work, and rebuilding a safer relationship with food and the body.
Trauma-informed and weight-inclusive
We treat eating disorders with compassion, not moral judgment, and work from a non-shaming, anti-diet perspective.
Outpatient when medically appropriate
We help determine whether outpatient eating disorder treatment is appropriate and support step-up referrals when more care is needed.
Types of eating disorders and eating concerns we treat
We support eating concerns that look highly visible and those that stay hidden behind “healthy eating,” overexercise, chronic dieting, or self-criticism.
Anorexia nervosa
Support for restrictive eating, intense fear of weight gain, body image distortion, and the emotional and physical impact of undernourishment.
Bulimia nervosa
Support for binge-purge cycles, shame, secrecy, food chaos, and the urge to compensate through vomiting, laxatives, or exercise.
Binge eating disorder
Support for recurrent binge eating, guilt, emotional eating, food preoccupation, and the aftermath of chronic restriction or dieting.
ARFID
Support for sensory-based food avoidance, low appetite, fear of aversive consequences, selective eating, and nutritional impact.
OSFED and disordered eating
Care for serious eating concerns that may not fit neatly into one diagnosis but still deserve specialized support.
Compulsive exercise and orthorexic patterns
Support for exercise compulsion, rigid “clean eating,” anxiety around flexibility, and perfectionistic health behaviors that become life-limiting.
Recovery is a process, not a single decision
Early recovery may feel structured and uncomfortable before it feels freeing. That does not mean it is not working.
Recognizing the cost
Moving from denial or ambivalence toward naming what the eating disorder is taking from you.
Strengthening the healthy self
Learning to separate your own voice from the eating disorder voice and choosing support over self-punishment.
Building structure
Using consistent eating, meal support, and practical skills to reduce chaos and improve regulation.
Moving toward flexibility
As the brain and body stabilize, recovery shifts toward trust, freedom, and a more peaceful relationship with food.
Virtual eating disorder care in Massachusetts and Idaho
Eating disorder therapy and nutrition counseling across Massachusetts
Online support for clients across Massachusetts, including Boston, Cambridge, Arlington, MetroWest, and surrounding communities.
- Eating disorder therapy
- Eating disorder nutrition counseling
- Virtual support for teens and adults
Eating disorder therapy and nutrition counseling in Boise and across Idaho
Online eating disorder support for clients in Boise and across Idaho, depending on clinical fit, provider availability, and licensure.
- Therapy + nutrition in one care model
- Support for food, body image, and anxiety
- Coordinated telehealth treatment
Work with providers who understand eating disorder recovery
Our team includes therapists and registered dietitians who can support eating disorders, disordered eating, body image concerns, trauma overlap, and nutrition rehabilitation.
Erica Carneglia
MS, RD, CPTSupports eating disorders, disordered eating, body image concerns, and sports nutrition.
Lisa Keovongsa
RDN, LDNSupports disordered eating, chronic food guilt, body image distress, and food flexibility.
Kevin Keovongsa
LICSWSupports trauma, shame, perfectionism, and deeper emotional patterns connected to eating concerns.
Questions people often have before starting eating disorder treatment
How do I know if I need eating disorder treatment?
Can I work with both a therapist and a dietitian?
Do you treat anorexia, bulimia, binge eating disorder, and ARFID?
How do you decide if outpatient treatment is appropriate?
Is virtual eating disorder treatment effective?
Do you offer eating disorder treatment in Massachusetts and Idaho?
What happens after I contact you?
You do not have to figure this out alone.
Whether you are ready to begin or still unsure what level of support you need, we can help you find a starting point that feels safe, thoughtful, and aligned with recovery.