5 levels of care

1. Out-patient treatment: Provided in The Hearth’s outpatient community counseling center, out-patient treatment is usually one hour per week with a therapist who specializes in eating disorders treatment. The therapy is for people of any age and can be the first point of entry when seeking evaluation for an eating disorder or it can be a step down from intensive out-patient treatment.

2. Intensive out-patient treatment: This is offered three nights a week for four hours a night. This level of care is for ages 8 and above who require more structure for weight restoration than community-based outpatient treatment. Group therapies and meal-based therapy are provided in this level of care.

3. Partial hospitalization: Partial hospitalization is usually a step down from residential treatment. This is for ages 8 and above who need all-day support and structure to continue their recovery process. Patients in this level enter a seven-day a week, 11-hour a day treatment program. These patients, like the ones in regular and intensive outpatient programs, live at home. But for partial hospitalization, The Hearth offers on-campus accommodations should this be needed.

4. Residential care: This highest level of care is for ages 8 to 21 with eating disorders who need 24-hour medical monitoring in combination with dietary, clinical and behavioral interventions.

5. Partnership care: The Hearth has created partnership treatment programs with the Palmetto Health hospital system, the University of South Carolina in Midlands, Greenville Hospital in the Upstate and the Medical University of South Carolina in the Lowcountry.

Source: The Hearth Center for Healing

About seven years ago, Jon Carpenter of Columbia went to his family doctor for a check-up and found out he had high cholesterol and blood pressure and was a tad overweight. The 6-foot, 1-inch man weighed a little over 200 pounds.

Knowing his family history of heart disease, he decided to make some lifestyle changes, such as cleaning up his diet and exercising.

Unlike most Americans who struggle to stay on a healthy path, Carpenter took it to the extreme. The school district finance officer became obsessed with it. He exercised intensely seven days a week and became “very restrictive” in his diet.

In a nutshell, his orthorexia, a recognized obsession with health, evolved into full-blown anorexia nervosa.

In late 2012, his weight bottomed out at 119 pounds. The 43-year-old father of two daughters had no energy, often felt physically cold, couldn’t concentrate and isolated himself socially. The stresses of the Christmas holiday finally broke him.

“On New Year’s Eve, I made a resolution to seek treatment. I knew I was suffering from anorexia, but I had to hear it to believe,” recalls Carpenter, adding that if didn’t get help, he feared that he would die within a year.

Hard path

But finding an intensive program, especially for males, proved difficult. At the time, there were none in South Carolina that offered full services dedicated to eating disorders.

The closest appropriate one was in New Orleans. Once he was there, however, his insurance dropped the coverage.

He had gained a mere six pounds and wasn’t considered sick enough. He couldn’t afford to pay $2,000 to $3,000 a day out-of-pocket for treatment. After a day, he flew back home.

“I was very surprised to be back on that plane that night,” recalls Carpenter. “I thought I understood health insurance until then.”

But he didn’t have to wait long for his luck to change.

In the late winter, South Carolina’s only full service, accredited center for eating disorders, The Hearth Center for Healing, opened on the campus of the Carolina Children’s Home in Columbia.

The Hearth offers outpatient treatment, intensive outpatient treatment, partial hospitalization and residential care for youths ages 8 to 21 who need 24-hour medical monitoring in combination with dietary, clinical and behavioral interventions, as well as outpatient services for adults.

Carpenter went with an intensive outpatient treatment, which takes place for four hours in the evenings Mondays, Wednesdays and Fridays and includes eating a meal with therapists.

While it’s not been a walk in the park, Carpenter, who is not allowed to exercise except to take his dogs on leisurely walks, is weighing in at 150 pounds. Ten more pounds and Carpenter says he’ll be allowed to do a little more exercise.

“Without this program, I would not, without a doubt, come as far as I have. It’s been a lifesaver,” he says.

Experts converge

Among those helping establish The Hearth has been a veteran eating disorders expert, Dr. Tim Brewerton of the Isle of Palms.

In 1987, Brewerton founded and directed the Eating Disorders Program at the Medical University of South Carolina. The program closed in November 2002.

Brewerton, who is the executive medical director at The Hearth, says the facility was a long time coming to the Palmetto State.

“It’s exciting to have it open,” says Brewerton, noting how he often had to send patients out-of-state for intensive programs in North Carolina, Florida, California and Colorado for help.

And while eating disorders remain a problem for young females, more cases are emerging from males and middle-aged women, says Brewerton.

He noted that while national data shows a 3-to-1 ratio of females to males for eating disorders, it’s more even, 60 percent to 40 percent, for binge eating.

One of his colleagues at The Hearth, outpatient therapist Sue Connelly-Nelson, agrees.

“There are a lot more males (with eating disorders) than care to come forward,” says Connelly-Nelson, who has been working in the eating disorders field for 20 years. “Still, it’s mostly in the female population, normally from age 12 to the 20s.”

Opening the center, Connelly-Nelson says, benefits many. Besides patients, it will save money and time for parents who often have had to empty retirement and college accounts, and/or refinance homes, to pay for sick children and cut costs for insurance companies.

A question she often heard from parents after Connelly-Nelson recommended intensive therapy in other states was, “What? How come there’s not anything in South Carolina.”

“They don’t have to be floored by that fact anymore.”

Reach David Quick at 937-5516 or dquick@postand courier.com.