Eating disorders in mountain towns are sometimes more hidden

Licensed Clinical Psychologist Laurie Crider, in private practice in Steamboat Springs, often includes her four-year-old golden retriever, Lucy, in therapy sessions. Lucy is the third golden retriever Crider has trained to help with therapy clients. Courtesy photo.

In a mountain valley replete with fitness enthusiasts, extreme competitors and top-notch athletes, intense exercise and strict eating routines become normalized. That also means local people struggling with eating disorders may find it easier to hide their conditions, said Licensed Clinical Psychologist Laurie Crider in private practice in Steamboat Springs.

“In mountain towns, it’s a problem that’s somewhat hidden, because a lot of intense exercise is really normalized here. I believe it’s a much bigger problem than we think,” Crider said of eating disorders locally. “Colorado ranked the slimmest state in nation; however, Colorado ranked 33rd in mental health.”

“There is a focus here on exercise, fitness and health, which contributes to the focus on body image, which can then become a hyper-focus to people vulnerable to developing eating disorders. Their eating disorder voice says, ‘This is perfect for me,'” Crider said.

After practicing for six years in Steamboat, 25 overall years of clinical experience and a focus on treating eating disorders through positions in other states, Crider is now offering specific services locally to treat eating disorders. Her work includes a team approach, with the assistance of the patient’s primary care physician and partnering registered dietitian Roxanne Hartman, who helps via virtual visits from her office in Lakewood.

Eating disorders are considered a mental health condition, often caused by underlying issues in life, and patients then focus too much on weight, body shape and food. Sufferers experience severe disturbances in their eating behaviors and related thoughts and emotions. Experts say among the various eating disorders, the most common are anorexia (a strong fear of gaining weight), bulimia (recurrent episodes of binge eating along with compensatory behavior) and binge-eating disorder.

Experts say all types of people with all body types can experience eating disorders, and only a small percentage of Americans suffering from eating disorders are medically underweight. That means eating disorders are often not noticeable, Crider said.

Although it is not officially listed in the Diagnostic and Statistical Manual of Mental Disorders, a guide for mental health providers, orthorexia is another condition that is a problem for local individuals, said Lana Jarosch, a registered dietitian at Minds in Motion integrative care clinic in Steamboat. Orthorexia is a fixation on healthy foods to the detriment of nutritional health. Jarosch said people may become fixated on eating too much kale or carrots, for example, or drinking too much juice or kombucha. That impairs the person from ingesting other key calories and protein.

Hartman said some people with orthorexia can take other dietary measures to the extreme so that it affects their overall lives and negatively impacts their ability to connect with others, such as clean eating, avoiding all processed foods, low-carb diets or avoiding dairy and meat.

The professionals agree that, unfortunately, eating disorder treatments are not well covered by medical insurance, unless it relates to newly diagnosed diabetes or chronic kidney disease. They know that eating disorders are a deeply emotional disorder that causes physical problems, yet they say eating disorders also can be treated successfully. They say the sooner an eating disorder is recognized, the easier it is to treat.

“When someone reports an eating disorder to me, it is often something they have battled for many years, and I am the first person they have told,” Crider said. “It’s hidden very well in this community, and more people are suffering than we are aware.”

Crider recommends that people who are concerned they may be developing eating issues conduct a short self-assessment survey on the National Eating Disorders Association, or NEDA, website at The online screening tool, for people age 13 and older, assesses warning signs. NEDA also offers a National Eating Disorders Helpline including phone, chat and text services for support, resources and treatment options.

Hartman said another good resource is the Denver-based nonprofit Eating Disorder Foundation that offers free virtual support groups.

Crider said her treatment team will work to determine underlying causes for eating disorders, which are complex disorders that mix genetic, environmental and personality factors. Hartman said some of the common co-occurring mental health issues that may pair with eating disorders include anxiety, depression, obsessive-compulsive disorder and post-traumatic stress disorder.

Laurie Crider

The psychologist said some risk factors for eating disorders include low self-esteem, families with eating disorders, chronic dieting, a personal history of trauma or abuse, cultural pressures to be thin and family dysfunction, including parents who live through the success of their child in a sport.

Crider noted eating disorders can be worse with athletes whose sport features endurance competition, emphasizes appearance or includes weight requirements.

“People develop eating disorders as a way to deal with underlying conflicts, pressures and stressors that feel out of their control,” she said.

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