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Co-Occurring Disorders

Eating disorders often co-occur with depression, anxiety, OCD, self-harm, and substance use, requiring specialized treatment that addresses both the eating disorder and underlying mental health conditions for lasting recovery.

Treatment for co-occurring disorders at Aster Springs

Aster Springs offers comprehensive, evidence-based treatment for eating disorders and co-occurring conditions like anxiety, depression, and trauma. Our holistic approach treats the root causes — not just symptoms — through specialized therapies designed for lasting recovery. With expert, personalized care, we help individuals rebuild a healthier relationship with food, body, and mind.

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Why treatment is important

Kate Fisch, LCSW, CEDS, AVP of Clinical Operations, shares how professional treatment offers the structure, support, and healing essential for overcoming an eating disorder. Watch the video to learn more.

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About co-occurring conditions

  • Multiple conditions can complicate diagnosis and treatment, but when treated together, there is the best chance of long-term recovery.
  • An estimated 9% of the US population, or 28.8 million Americans, will develop an eating disorder in their lifetime, according to the National Eating Disorders Association (NEDA).
  • Substance misuse and eating disorders frequently co-occur, with up to 50% of individuals with eating disorders also using alcohol or illicit drugs, a rate five times higher than the general population.
  • Approximately 48% of adults with anorexia, 81% of adults with bulimia, and 65% of adults with binge eating disorder have at least one co-occurring anxiety disorder (National Comorbidity Survey).

Co-occurring conditions

FAQs

What are co-occurring conditions?

Co-occurring disorders — also known as dual diagnoses — occur when an individual experiences two or more mental health conditions simultaneously. Common examples include eating disorders with anxiety, depression, or substance use disorder. These conditions are often interconnected, with one disorder exacerbating the symptoms of the other. For instance, mood disorders can contribute to disordered eating behaviors, while malnutrition can worsen cognitive and emotional regulation. 

Co-occurring disorders can complicate diagnosis and treatment, requiring a nuanced understanding of their interactions. Research indicates that individuals with co-occurring disorders may face a higher risk of severe symptoms, relapse, and long-term health complications.

Substance use disorder is characterized by the excessive and frequent use of drugs or alcohol despite harmful consequences, often worsening the effects of co-occurring mental health conditions like eating disorders. Common signs and symptoms include: 

  • Increased tolerance requiring more significant amounts to achieve the same effect
  • Inability to reduce or control use, despite efforts to stop
  • Neglecting responsibilities at work, school, or home
  • Strained relationships due to mood changes, secrecy, or conflict
  • Excessive time spent obtaining, using, or recovering from substances
  • Risky behaviors, such as driving under the influence
  • Withdrawal symptoms, including anxiety, tremors, sweating, or insomnia

For individuals with eating disorders, substance use can heighten medical risks, worsening malnutrition, dehydration, and organ damage.

Our Treatment Approach

At Aster Springs, we address the underlying issues and experiences that contribute to eating disorders while simultaneously challenging the thoughts and behaviors that act as barriers to lasting recovery.

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Levels of Care

We’ll meet you where you are. Aster Springs offers a comprehensive continuum of care, bridging the gap between inpatient treatment and general outpatient therapy.

Virtual Intensive Outpatient Program (V-IOP)

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Intensive Outpatient Program (IOP)

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Residential Treatment

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Partial Hospitalization Program (PHP)

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Resources on
Co-occurring Disorders

Explore the links below to learn more about co-occurring disorders, including symptoms, treatment, recovery, and more.

Explore all resources
  • Blog

Why Eating Disorders + Depression Are So Closely Linked

  • Blog

Understanding the Link Between Adderall Abuse and Eating Disorders

Take the next step at Aster Springs.

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Outpatient

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Outpatient

In-network insurance

Ohio

  • Aetna
  • Anthem
  • Beacon
  • BlueCross BlueShield
  • Cigna
  • Medical Mutual
  • MultiPlan
  • Optum
  • Parkview Health
See location

Tennessee

  • Aetna
  • BlueCross BlueShield
  • Cigna
  • MultiPlan
See location

Virginia

  • Aetna
  • Anthem
  • BlueCross BlueShield
  • Multiplan
  • Optima Health
  • Optum
  • UMR
  • UnitedHealthcare
See location

Jeffersonville, IN

  • Ambetter
  • BlueCross BlueShield
  • CareSource
  • Multiplan
  • Optum
  • Parkview Health
  • PHP of Northern Indiana
  • UMR
See Location

Cincinnati, OH

  • Aetna
  • Anthem
  • Beacon
  • BlueCross BlueShield
  • Cigna/Evernorth
  • Front Path
  • Medical Mutual of Ohio
  • MultiPlan
  • Ohio Health Choice
  • Ohio State University Health Plan
  • Paramount
  • Physicians Health Plan of N. Indiana
  • Optum
  • UMR
  • UnitedHealthcare
See Location

Columbus, OH

  • Aetna
  • Anthem
  • Beacon
  • BlueCross BlueShield
  • Cigna/Evernorth
  • Front Path
  • Medical Mutual of Ohio
  • MultiPlan
  • Ohio Health Choice
  • Ohio State University Health Plan
  • Paramount
  • Physicians Health Plan of N. Indiana
  • Optum
  • UMR
  • UnitedHealthcare
See Location

Nashville, TN

  • Aetna
  • BlueCross BlueShield
  • Cigna
  • Optum
See Location

Richmond, VA

  • Out-of-network benefits
  • Self-pay
See Location

Executive Director, Ohio

Olivia Dunbar LISW-S

As the Executive Director for Aster Springs Ohio, Olivia is in charge of overseeing the operations of the facility and ensuring quality care for each and every patient who comes through the doors.

Olivia has a Master’s Degree in Social Work from the University of Michigan and received her Bachelor’s in Social Work from Michigan State University. Olivia comes to us with almost 7 years experience in the field and previously worked in addiction treatment and was the regional clinical director over 6 inpatient and outpatient facilities. Olivia’s passion is building and growing programs while ensuring the highest quality of care possible for all clients. When it comes to her work, Olivia is extremely invested and believes that every person should be given the opportunity to heal and grow in an environment that is safe and welcoming. The safety and satisfaction of clients and staff are at the forefront of her leadership style. Olivia is happily married to her husband Tyler and she is a proud dog mom to Dolly. In her free time, Olivia enjoys spending time on the lake with her family, traveling, and reading.

Let’s be honest about denial.

Denial keeps eating disorders alive. Eating disorders thrive in secrecy and denial. If you don’t believe you’re sick, why would you seek help? That’s precisely how eating disorders stay in control.

Let’s be honest about denial in parents.

Denial is a natural response — but delaying the proper care can prolong suffering. For many parents, accepting that their child needs eating disorder treatment is an overwhelming and emotional experience. But early, appropriate intervention is key to lasting recovery.

Let’s be honest about isolation.

Eating disorders thrive in isolation, convincing you that you’re better off alone. But the truth is, isolation only makes things worse. It shrinks your world and traps you in a cycle of self-doubt and despair.

Let’s be honest about change.

Change is hard, but so is staying stuck. Living with an eating disorder can feel like the only way to survive. Even when it causes chaos, it becomes familiar — making change feel overwhelming.

Let’s be honest about guilt + shame in parents.

As a parent, it’s heart-wrenching to make the decision to send your child to treatment, especially when that child doesn’t want to go.

Let’s be honest about guilt + shame.

Guilt and shame can trap you in the cycle of an eating disorder, making it challenging to seek the treatment you need.

Let’s be honest about fear in parents.

Deciding to seek treatment for your child is scary — but doing nothing is scarier.

Let’s be honest about fear.

You are stronger than your fears. Treatment is hard, but so is staying stuck in the cycle of an eating disorder. You can do hard things. And on the other side of fear? A life worth living.

Executive Director, Ohio

Olivia Dunbar LISW-S

As the Executive Director for Aster Springs Ohio, Olivia is in charge of overseeing the operations of the facility and ensuring quality care for each and every patient who comes through the doors.

Olivia has a Master’s Degree in Social Work from the University of Michigan and received her Bachelor’s in Social Work from Michigan State University. Olivia comes to us with almost 7 years experience in the field and previously worked in addiction treatment and was the regional clinical director over 6 inpatient and outpatient facilities. Olivia’s passion is building and growing programs while ensuring the highest quality of care possible for all clients. When it comes to her work, Olivia is extremely invested and believes that every person should be given the opportunity to heal and grow in an environment that is safe and welcoming. The safety and satisfaction of clients and staff are at the forefront of her leadership style. Olivia is happily married to her husband Tyler and she is a proud dog mom to Dolly. In her free time, Olivia enjoys spending time on the lake with her family, traveling, and reading.

Executive Director, Outpatient Cincinnati

Natalie Fausey RD, LD

As the Executive Director of Aster Springs Outpatient Cincinnati, Natalie provides both clinical and operational leadership to the team.

She holds a bachelor’s in human nutrition from The Ohio State University and has been a registered and licensed dietitian since 2018. Previously, Natalie served as the clinical dietitian at Aster Springs for three years. She is passionate about food’s multifaceted role in life, from nourishment and enjoyment to fostering connection, culture, and tradition.

Dedicated to empowering her team, Natalie ensures the highest standards of care for every client. Outside work, she enjoys spending time with loved ones, exploring new destinations, and discovering unique coffee shops and restaurants.

Executive Director, Aster Springs VA & Outpatient Richmond

Sara Berry LMHC, MBA

Sara joined Aster Springs Outpatient Jeffersonville as Executive Director in August 2023, bringing nearly 20 years of clinical and operational experience. She has worked in community mental health, inpatient and residential psychiatric treatment, and child welfare services.

She earned a bachelor of arts in psychology and a master’s of education in counseling psychology from the University of Louisville, followed by a master’s in healthcare management from the University of Southern Indiana. Since 2005, she has worked in behavioral health across Jeffersonville and surrounding communities.

In leadership since 2009, Sara has held key roles blending clinical and operational expertise. Her clinical interests include eating disorders, mood and anxiety disorders, trauma, and family systems. Passionate about helping others reach their full potential, she enjoys reading, family time, and the outdoors.

Executive Director, Aster Springs VA & Outpatient Richmond

Melanie Vann MA, LPC, NCC

Melanie holds a master’s in counseling psychology from Regent University and is a licensed mental health provider in Virginia.

She began her career treating eating disorders and specializes in trauma-based therapy, DBT, and experiential therapies. She became a certified equine-assisted therapist through EAGALA and a certified life coach through AACC to deepen her expertise. Melanie has worked in various mental health settings, including program development, nonprofits, podcasting, consulting, outreach, and education. She has held roles such as primary therapist, program director, clinical director, and executive director.

Melanie’s client-centered, strengths-focused approach reflects her belief that full recovery from an eating disorder is possible. Passionate about fostering hope, she helps individuals live confident, empowered, and authentic lives.

Executive Director, Aster Springs TN & Outpatient Nashville

Amber Lucchino LCSW, LADAC

Amber is a licensed clinical social worker and a licensed alcohol and drug abuse counselor with nearly 20 years of experience in the behavioral health field. With 22 years of recovery from an eating disorder, she brings a unique understanding and perspective to her role as a leader at Aster Springs.

Amber earned her bachelor’s in social work from Union University and her master’s from Columbia University in New York City. She has experience in outpatient and residential treatment settings, where she has held positions ranging from direct client care to program management and director roles focusing on staff development and organizational wellness. In addition to eating disorders, she has clinical experience in trauma and co-occurring disorders. She enjoys providing training within the community and has served as an adjunct professor in the department of social work for Belmont University in Nashville, Tennessee.

Amber is married and has four children. In her spare time, she can be found at the barn with horses or hiking on nearby trails. She loves cake decorating, spontaneous dance parties, and anything outdoors. Her motto is: “Pay attention to what brings you joy and do more of that.”

AVP of Eating Disorder Admissions

Stefan Glamp

Stefan is the National Director of Alum Services for Odyssey Behavioral Health, leading Aster Springs’ efforts to build compassionate, connected alum communities.

With extensive experience in addiction and mental health recovery, he specializes in fostering community partnerships and supporting clients in their unique recovery journeys, believing long-term recovery is achievable.

Stefan’s approach enhances treatment effectiveness by providing structured, ongoing support for all Aster Springs alums.

AVP of Eating Disorder Admissions

Alycia Aldieri LPC

As AVP of Admissions for Odyssey Behavioral Healthcare’s Eating Disorder Network, Alycia ensures a compassionate, responsive, and seamless admissions experience.

With a background in residential treatment for adults and adolescents with co-occurring disorders, Alycia holds a master’s in clinical psychology from Benedictine University and a bachelor’s in music therapy from East Carolina University. Her approach integrates clinical expertise, spiritual beliefs, and 12-step principles.

Committed to integrity, compassion, and ethics, Alycia believes recovery is possible for anyone willing to pursue it. She finds deep fulfillment in serving others and is dedicated to guiding clients and families with care and support through every step of the admissions journey.

National Director of Nutrition Programming

Tammy Beasley MS, RDN, CEDS-C

Tammy has over 35 years of experience in eating disorder recovery. She was the first dietitian certified as an eating disorder specialist (CEDS) by iaedp in 1993 and played a key role in securing certification approval for dietitians.

Tammy co-authored the Academy of Nutrition and Dietetics’ Standards of Practice for eating disorder RDNs and has developed nutrition programs nationwide. She mentors clinicians, serves as a media resource, and runs a private practice supporting clients and organizations.

Passionate about full recovery, Tammy’s guiding principle is “Do no shame.”

AVP of Clinical Operations

Kate Fisch LCSW, CEDS

As AVP of Clinical Operations for the Odyssey Behavioral Health Eating Disorder Network, Kate plays a key role in shaping Aster Springs’ exceptional clinical care across all levels.

With nearly two decades of experience in eating disorder treatment, Kate has provided direct client care at every level and is deeply committed to clinical supervision. Her passion lies in supporting and developing fellow treatment providers to enhance the quality of care in the field.

Kate earned a bachelor’s degree in psychology from Indiana University and a master’s in social work from Washington University in St. Louis, Missouri.

Medical Director

Dr. Tom Scales

Dr. Scales is the network medical director for Odyssey Behavioral Healthcare’s eating disorder network, including Aster Springs, where he provides psychiatric and medical care to clients.

He earned his undergraduate degree from Wheaton College, attended medical school at the University of Tennessee, Memphis, and completed his internal medicine and psychiatry residency at Rush Presbyterian St. Luke’s Medical Center in Chicago, Illinois. An advocate for eating disorder awareness, Dr. Scales has delivered community presentations, made media appearances, and hosted the web-based radio show Understanding Eating Disorders.

He is a diplomat on the American Board of Internal Medicine, the American Board of Psychiatry and Neurology, and addiction medicine through the American Board of Preventive Medicine. Most importantly, he is a husband and proud father of two children. 

Chief Executive Officer

Chrissy Hall LCSW

As Group CEO, Chrissy oversees operations, the executive leadership team, and clinical service delivery at Aster Springs.

With over 25 years in behavioral healthcare, she began as a direct care staff member and has since held executive roles in clinical and business development. Her experience spans residential treatment centers, acute care hospitals, outpatient centers, and military treatment programs. Chrissy specializes in clinical best practices, program development, staff education, and quality and compliance for startups.

Passionate about leading teams to provide exceptional care in safe, therapeutic environments, Chrissy holds a master’s in social work from Virginia Commonwealth University and is a licensed clinical social worker.

Connect with the Aster Springs admissions team to start the referral process.

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Connect today with the Aster Springs Virginia admissions team.

Connect with admissions at Aster Springs Outpatient Nashville.

Connect today with the Aster Springs Tennessee admissions team.

Connect today with the Aster Springs admissions team.

Aster Springs Richmond

Located in the heart of Richmond’s West End in Glen Allen, VA, Aster Springs Outpatient specializes in treating adults of all genders, ages 18 and older, who struggle with eating disorders.

Location

3957 Westerre Pkwy., Ste. 208, Richmond, VA 23233

Who We Treat

Adults (ages 18+) of all genders

Levels of Care

Partial hospitalization program (PHP), intensive outpatient program (IOP)

What We Treat

Anorexia, ARFID, binge eating disorder, bulimia, body dysmorphic disorder, OSFED

Aster Springs Outpatient Nashville

Located near the heart of downtown Nashville, Aster Springs Outpatient specializes in treating adults of all genders who are struggling with eating disorders. Our programs are LGBTQIA+-affirming and inclusive of all religious preferences.

Location

2900 Vanderbilt Pl., Ste. 200B, Nashville, TN 37212

Levels of Care

Partial hospitalization program (PHP), intensive outpatient program (IOP)

Who We Treat

Adults (ages 18+) of all genders

What We Treat

Anorexia, ARFID, binge eating disorder, bulimia, body dysmorphic disorder, OSFED

Aster Springs Outpatient Columbus

Located in the heart of Dublin, Aster Springs Outpatient Columbus offers a warm, sunlit environment that feels like home. We specialize in treating adolescents and adults of all genders — ages 12 and older — who struggle with eating disorders and co-occurring conditions.

Location

3530 Irwin Simpson Rd., Ste. B, Mason, OH 45040

Levels of Care

Partial hospitalization program (PHP), intensive outpatient program (IOP), evening virtual IOP

Who We Treat

Adults + adolescents (ages 16 & older) of all genders

What We Treat

Anorexia, ARFID, binge eating disorder, bulimia, body dysmorphic disorder, OSFED

Aster Springs Outpatient Cincinnati

Located just northeast of Cincinnati in Mason, Ohio, Aster Springs Outpatient in Cincinnati specializes in treating adolescents and adults of all genders, ages 16 and older, struggling with eating disorders.

Location

3530 Irwin Simpson Rd., Ste. B, Mason, OH 45040

Levels of Care

Partial hospitalization program (PHP), intensive outpatient program (IOP), evening virtual IOP

Who We Treat

Adults + adolescents (ages 16 & older) of all genders

What We Treat

Anorexia, ARFID, binge eating disorder, bulimia, body dysmorphic disorder, OSFED

Aster Springs Outpatient Jeffersonville

Minutes away from the heart of the Ohio River Valley, Aster Springs Outpatient in Jeffersonville provides compassionate, innovative eating disorder treatment that is inclusive of diverse populations and cultures.

Location

4500 Town Center Blvd., Ste. 103, Jeffersonville, IN 47130

Levels of Care

Partial hospitalization program (PHP), intensive outpatient program (IOP), evening virtual IOP

Who We Treat

Adults (ages 18+) | Adolescents (ages 13-17)

What We Treat

Anorexia, ARFID, binge eating disorder, bulimia, body dysmorphic disorder, OSFED

Aster Springs Virginia

Aster Springs Virginia is composed of two locations in Richmond, each offering exceptional, compassionate eating disorder treatment within peaceful, comforting environments.

Locations

Manakin-Sabot & Glen Allen

Levels of Care

Residential treatment, partial hospitalization program (PHP) with housing, intensive outpatient program (IOP)

Who We Treat

Adult women (Residential) | Adults of all genders (PHP + IOP)

What We Treat

Anorexia, ARFID, binge eating disorder, body dysmorphic disorder, bulimia, OSFED

Aster Springs Tennessee

Located just minutes away from downtown Music City, our multidisciplinary treatment team provides tailored treatment plans designed to meet the unique needs of each client. 

Location

7544 Old Harding Pike, Nashville, TN 37221

Levels of Care

Residential treatment, partial hospitalization program (PHP) with housing

Who We Treat

Adults (ages 18+) | All genders

What We Treat

Anorexia, ARFID, binge eating disorder, body dysmorphic disorder, bulimia, OSFED

Aster Springs Ohio

Located near a winding creek on a peaceful, private stretch of land in Toledo, Aster Springs Ohio combines evidence-based, whole-person eating disorder treatment with a tranquil, home-like setting. 

Location

5465 Main St, Sylvania, OH 43560

Levels of Care

Residential treatment, partial hospitalization program (PHP) with housing

Who We Treat

Adults (ages 18+) | Adolescents (ages 10-17)

What We Treat

Anorexia, binge eating disorder, bulimia, purging disorder, ARFID, co-occurring mental health conditions