Koru Springs

Eating Disorder Recovery Center from Lakeview Health

It´s time to heal

Lakeview Health is excited to announce the opening of Koru Spring.
Taking patients April 2023


At Koru Spring, we offer a restorative environment for adult women of all identities to address and heal from the impacts of eating disorders.

High staff-to-resident ratios

Highly trained MD care team

Dual-diagnosis care

On-site, medically monitored detox care

24/7 medical care with nasogartic (NG) tubes

RTC, PHP, IOP, & Supported Living

Nutrition education:
wkly meal planning, meal exposure, & cooking experientials



Breakdown barries so that recovery is possible

Helpful Articles​

Deanna McMichael

An estimated 30 million people in the United States will experience an eating disorder at some point in their lives, with anorexia nervosa being one of the most prevalent disorders. It is important to note that eating disorders do not discriminate and affect individuals of all ages, genders, races, and socioeconomic backgrounds. 

Understanding anorexia statistics in America is not just about the numbers, but with this information we can better address this public health concern and provide appropriate support and treatment to those affected. In this piece, we will discuss the prevalence of anorexia in America, its impact on different demographic groups, access to treatment and the influence of the COVID-19 pandemic on these statistics. 

Prevalence of Anorexia in America  

Studies show that anorexia has the highest mortality rate of any psychiatric disorder. Anorexia is more commonly diagnosed in women with rates 3 times higher than men, making up 0.9% of the population for women versus 0.3% of the population for men. There are a lot of perceptions and stigmas surrounding anorexia, some of which have led to men being underdiagnosed. A 2019 case study reports that males represent 25% of people with anorexia but have a higher risk of death compared to females due to being diagnosed later.  

  • A 2007 study that combined eating disorder data from 2000-2006 reported that around 0.9% of women and 0.3% of men had a lifetime prevalence of anorexia. 
  • The risk of dying is 10 times higher in youth with anorexia between 15-24 than peers their same age who do not have an eating disorder. 
  • It is estimated that up to 20% of individuals with severe cases may die prematurely due to complications related to their eating disorder. 

Anorexia has the highest mortality rate of psychiatric disorders in America, with about 5% of individuals dying within 4 years of diagnosis. This highlights the urgent need for awareness, education, and support for those who are suffering. 

Anorexia in Different Demographic Groups  

Anorexia affects various demographic groups differently and is most diagnosed in adolescents and young adults. However, it is important to note that individuals of all ages can be affected by this condition.  

Adolescents: Anorexia often begins during adolescence and statistics show that lifetime prevalence is of cases diagnosed in this age group is 0.3% of the US population. The pressures of academic performance, social acceptance, and changing body image can contribute to the development of the disorder in teenagers. 

Adults: Contrary to common misconceptions, anorexia is not limited to young people. The lifetime prevalence of adults with anorexia is 0.6% of the population with some having struggled with the disorder since adolescence. 

Minority Communities: Studies have indicated that individuals from minority communities may experience unique challenges in seeking treatment for anorexia. Cultural factors, stigma, and a lack of culturally competent care can be barriers to diagnosis and treatment. 

Access to Treatment 

Access to appropriate treatment is critical for recovery. Many individuals with anorexia face barriers to seeking treatment, including stigma surrounding mental health and eating disorders, a lack of awareness about available resources, and difficulties accessing specialized care. 

Studies show that only 23% of individuals with eating disorders seek treatment, and among those who do, not all receive evidence-based treatments. Early intervention is key to improving outcomes in anorexia. The sooner individuals receive treatment, the better their chances of recovery. 

Another key part of treatment is considering the possible co-occurring disorders that people with anorexia might also need help with. A recent study of more than 2,400 hospitalized eating disorder patients found that 90% of these individuals were also being treated for a co-occurring mood disorder.   

Personality disorders are common in eating disorder patients, in patients with the restricting type of anorexia: 

  • 20% of patients also had obsessive-compulsive personality disorder  
  • 10% of patients had borderline personality disorder. 
  • In patients with the binge-purge type of anorexia: 
  • 12% of patients had obsessive-compulsive personality disorder 
  • 25% of patients had borderline personality disorder 

Recovery and Relapse Rates 

Recovery from anorexia is possible, a 22 year  follow up study on patients with anorexia and bulimia found that 62.8% of participants with anorexia fully recovered and many others experienced significant improvements in their health and well-being.  

Relapse is often part of the recovery journey and is quite common among anorexia patients. Studies show that relapse rates in the initial 18-month period after treatment are between 35% and 41%. There are numerous factors that can influence the risk of relapse, including stressors, societal pressures, and underlying psychological issues. Relapse prevention strategies are a crucial part of treatment. 

The support of family, friends, and treatment professionals plays an indispensable role in an individual's journey toward recovery. Having a dedicated support system can significantly improve the chances of maintaining recovery.  

Impact of COVID on Anorexia Statistics 

The COVID-19 pandemic has had significant effects on eating disorder statistics. A recent study, which looked at inpatient and outpatient care for eating disorders before and during the onset of the pandemic, found that there was a significant increase in eating disorder care numbers compared to pre-pandemic care. There is still much to investigate and look into for us to truly understand the impact that the pandemic has had on anorexia and eating disorders as a whole. 

Some potential factors include:  

  • Effects of the Pandemic: Factors such as increased social isolation, disruption of routines, and heightened stress have been linked to worsening anorexia symptoms.  
  • Changes in Treatment and Access to Care: The pandemic has also affected the delivery of healthcare services, including those related to eating disorders. Telehealth and online support have become more prevalent, but access to in-person care has been disrupted for some. 
  • Post-Pandemic Outlook: As we emerge from the pandemic, addressing the impact of COVID-19 on anorexia remains a priority. Increased awareness of mental health issues and improved access to virtual care may have lasting effects on how anorexia is diagnosed and treated. 

Understanding these statistics is crucial for raising awareness about anorexia and advocating for early intervention and effective treatment options. By recognizing the magnitude of this issue within our society, we can work towards providing better support systems for those affected by anorexia and strive for improved outcomes in terms of prevention, treatment, and recovery. 


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Deanna McMichael

People diagnosed with an eating disorder have an increased risk of experiencing other mental or physical health disorders. These are often referred to as “co-occurring conditions.” When a person seeks treatment for an eating disorder (ED), any co-occurring illnesses need to be considered and treated alongside the eating disorder, regardless of whether or not these co-occurring illnesses are linked to the eating disorder or exist independently. This can be extremely complex, but is a crucial part of an integrated and holistic treatment plan. 


Co-occurring Medical Illnesses and Physical Symptoms 

Eating disorders can be devastating for the body, with imbalances in nutrition and electrolytes being some of the most life-threatening repercussions. People with anorexia nervosa (AN) have a mortality rate that is 5 times higher than people who don’t have an eating disorder. Those with bulimia nervosa (BN) run a risk of premature death that is 50% higher than the average person. While these are not the only medical complications of eating disorders, these statistics emphasize the severity of an eating disorder diagnosis and the urgency of seeking treatment. 

Cause and effect are not always clear with co-occurring illnesses and sometimes both illnesses might be linked to other risk factors entirely. This makes treatment especially complex and research into these relationships crucial to help us enhance treatment efficacy. The following list gives examples of medical illnesses that are commonly found to co-occur with eating disorders, but it is important to remember that each person has their own experience and should discuss their symptoms with their medical care providers to get the most comprehensive care. 


Common medical illnesses or physical symptoms that co-occur with eating disorders: 

  • Gastrointestinal problems 
  • Headaches 
  • Menstrual disruptions  
  • Polycystic ovarian syndrome (PCOS) 
  • Osteopenia and osteoporosis 
  • Hair, skin and nail problems 
  • Type I and II diabetes 
  • Hypotension 
  • Joint pain 
  • Muscle weakness 

Mental Health Disorders that Co-occur with Eating Disorders 

Between 55-97% of those with an ED will meet the diagnostic criteria for another mental health disorder. The most common psychiatric disorders that co-occur with EDs include mood disorders, anxiety disorders, substance abuse disorders, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), some personality disorders, and self-harm. Researchers think that the high risk of co-occurring mental illness might be due to shared risk factors for the co-occurring disorders (such as trauma, emotional health, genetic predisposition, etc.). 

There may also be a link to personal traits and temperament. Some researchers have noted that those with bulimia and binge eating disorder tended to have greater co-occurrence with substance abuse disorder, self-harm and addiction, perhaps linked to impulsivity, novelty-seeking and emotional dysregulation within these individuals. This contrasted with the higher rates of anxiety disorders (related to compulsivity, control, social avoidance and risk aversion) in those with anorexia in this particular study.  

It is important to remember the risks that come with co-occurring mental disorders. Of women with an eating disorder diagnosis, 36.8% engage in regular self-harm. Death by suicide is 31 times higher in those with anorexia and 7.5 times higher in those with bulimia than in the general population.  Through trying to understand aspects of co-occurring mental illnesses, such as the order of onset, shared risk factors and unique interactions between certain disorders, the hope is to increase treatment efficacy and promote recovery for those diagnosed with co-occurring disorders.  

Below are some of the mental health disorders that most commonly co-occur with eating disorders: 



Anxiety disorders are a group of disorders that have the common symptom of pervasive and excessive fear in a non-threatening situation. This group includes phobias, social anxiety disorder, generalized anxiety disorder (GAD) and panic disorder. The National Comorbidity Survey Replication (NCS-R) found that, in the US, 47.9% of those with anorexia nervosa (AN), 80.6% of people with bulimia nervosa (BN) and 65.1% of those people with binge-eating disorder (BED) also have an anxiety disorder. Anxiety disorders can be present in 56% of people with an ED. 


Mood disorders 

Mood disorders have the common symptom of mood/emotional disruptions that can lead to extreme highs (mania) or lows (depression). Mood disorders can be broadly categorized into bipolar disorders and depressive disorders. There seems to be a widespread co-occurrence of mood disorders across all eating disorders, with one study finding that 94% of people admitted for an ED had a co-occurring mood disorder (most often major depression). Within the US, the NCS-R reports that 42.1% of those with AN, 70.7% of people with BN and 46.4% of those people with BED have been diagnosed with some mood disorder. Considering the elevated rates of suicide in those with an ED such as anorexia or bulimia, the treatment of co-occurring mood disorders simultaneously with eating disorders is crucial. 


Substance Use Disorders 

Substance use disorders are characterized by the repeated misuse of substances (such as alcohol) that has resulted in physical and psychological dependence. Often, substances are used to cope with overwhelming symptoms, sometimes caused by co-occurring mental illnesses. The NCS-R reports that, within the US, between 23% -36% of people diagnosed with anorexia, bulimia or binge-eating disorder also have a substance use disorder. The misuse of alcohol and other substances seems to vary across eating disorders. Substances such as caffeine, tobacco, diet pills and laxatives are commonly misused by individuals with symptoms of eating disorders. 



Experiencing a traumatic event (such as an assault, accident, military combat or a natural disaster) can have long-lasting effects. Short-term effects of life-threatening events are normal, but persistent symptoms may result in a post-traumatic stress disorder (PTSD) diagnosis. It has been reported that 23.1% of AN and 25.5% of BN participants with and ED also had a current diagnosis of PTSD. Cumulative traumatic experiences resulted in more severe symptoms. This emphasizes the need for trauma-informed care in the treatment of eating disorders. This study also highlights the need to treat co-occurring disorders simultaneously, as the disorders can interact and can exacerbate the symptoms of both.  


Finding Treatment for Eating Disorders and Co-occurring Mental Illnesses 

Treatment for co-occurring illnesses requires an experienced team of medical professionals who view recovery from a holistic perspective, such as our team at Koru Spring. There are many challenges to treating eating disorders and co-occurring mental illnesses, but treatment is available. Seeking urgent treatment for eating disorders is important for successful recovery, so if you or a loved one is experiencing an eating disorder, please contact the Koru Spring admissions team today.

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Masha Sardari MS, RD, LDN

The first thing to say about gentle nutrition? It is not a diet. If anything, it’s an anti-diet.

Second, though I’m a big believer in this way of eating and thinking about food, it’s not for everyone. I’m not going to tell you it’s the only way to go. That’s the kind of black and white thinking that can get us into trouble in the first place.

Enter gentle nutrition.

The concept comes out of the Intuitive Eating program first introduced in 1995 by nutrition experts Evelyn Tribole and Elyse Resch. Intuitive eating includes 10 principles, the final one being all about gentle nutrition.

Simply put, gentle nutrition encourages you to make food choices based on (1) a food’s nutritional value, and (2) your body’s innate cues regarding what it needs. Another way of saying it: Gentle nutrition, or GN, considers your desires along with your nutritional needs. Also, GN focuses on and is guided by self-care, not self-control.

Here are six things to know about gentle nutrition.

One: It’s important to understand some things before you start with GN.

Though GN becomes intuitive and in fact easy to do, you may need to learn some new ways of thinking about food and nutrition before that happens. It’s also best to be in a balanced overall health state before starting this way of eating.

For example, here at Koru Spring, we talk with our residents about the non-diet approach, essential nourishment, mindful eating, and honoring the body and mind through nutrition. We cover concepts like:

  • Food is not a way to manipulate or control.
  • Food has no underlying moral character—it is neither good or bad.
  • Food is a helpful, necessary, enjoyable thing.

We also try to move our residents away from the thinking that you’re bad because you enjoy food or certain types of food. Or you’re good because you only eat salads. That kind of moralizing about food is just not necessary or appropriate.

Suffice it to say, we cover a lot of ground before introducing our residents to GN. Which is why we always say it’s best to work with a dietician or nutritionist with expertise in GN before starting to eat this way, especially if you have a history of disordered eating or eating disorders.

Two: It’s about finding balance.

I mean this in several ways. Three, actually.

First, it’s important to be in a balanced state before starting your GN journey. In the eating disorder world, this means getting to a healthy, stable weight. Mentally, it means not approaching GN as a diet. Maybe above all, it’s about making peace with food.

Second, as I mentioned earlier, GN is about finding a balance of foods that you desire and that provide nutritional value. That includes eating foods simply because they are pleasurable.

Third, GN is about balancing and honoring your physical, mental, and emotional needs so they’re in alignment when you eat. For example, eating bland chicken breasts every day, even though you don’t like the taste, is putting yourself in an unbalanced state. Whereas eating seasoned, stir-fried vegetables that taste good and make you feel good—that’s balance.

Three: It’s open-minded.

I love working with our Koru Spring residents on food choices and meal preparation. When you hit your stride with gentle nutrition and things are clicking at the grocery store and in the kitchen, you act on pure curiosity.

What tastes good? What goes well with this type of meat? How about if I use that yummy herb with this vegetable? When this is happening, there are no moral attachments, no anxiety, and no negativity about food. It’s just pure, open-minded joy.

Four: It evolves as you evolve.

Gentle nutrition is always flexible, and never prescriptive. There are no rigid rules about numbers, percentages, or calorie counting.

Again, GN is about eating nutritious foods that taste good that you naturally gravitate to once your body is attuned to what it wants and needs.

And what it wants and needs will change over time. That’s fine! If you’re ready to incorporate more joyful movement in your days, for example, your GN way of eating will adjust to that and honor that.

For a person living with diabetes whose body requires support to process carbohydrates, you’ll naturally choose foods that align with that. If you become pregnant, your nutritional needs will be different, and your body will let you know which foods work best. And so on.

Five: It is wonderfully imperfect.

Many people, especially those with an eating disorder, chase perfection. The perfect diet. The perfect body. The perfect job or relationship. The perfect life.

But what happens is, even if you believe you have achieved that perfect body, diet, or life, in fact you often become the worst version of yourself. Or a warped version of yourself. Which isn’t healthy, it doesn’t make you happy, and regardless it isn’t sustainable.

GN has nothing to do with “perfection thinking.” It takes a lot of practice and patience at first, but the goal is never perfection. GN looks different for different people. There’s nothing strict or rigid about it. It’s about eating what you want, and enjoying it.

Six: It’s intuitive.

A caveat here. GN is not necessarily intuitive at first. That’s because many of us reach a point in life whereby our food and body perceptions—and even things like whether we’re hungry or not—become less clear. That’s when it’s time to make some adjustments, and begin to lean into your intuition.

The key with intuitive eating principles and GN is to tap into our body’s innate wisdom. On the biological level, your body has knowledge about the food/nutrition it wants and needs. You simply need to listen to it. Once you get comfortable doing that, gentle nutrition becomes second nature.

But back to hunger for a second. Many people with eating disorders lose the sense of what hunger means, or what to do about it.

With the residents I see who are dealing with this level of disorientation about hunger, I often make the analogy of getting tired. When we become tired, we know we need to nap, or go to bed for the night. Same thing with hunger. When you feel hunger, you need to eat. GN helps you do that. It guides you on what foods to reach for when you recognize that you’re hungry.

Final thoughts

Food can be so stressful these days. Which is crazy when you think about it. Food tastes good. It gives us pleasure. It brings people together at the table. It’s an amazing window into other cultures. And we need it to stay alive. How did all the negativity come into it?

I don’t know the complete answer to that, but the media (including social media) is a major culprit. The media is constantly fear-mongering food. It is constantly giving diet-culture advice that we don’t need.

Gentle nutrition helps you tune out all that chatter, stress, and negativity. It shows you how to look inward instead, to your own body and what it needs and desires. It allows you to get spontaneously joyful about food again.

It’s about time, don’t you think?

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