Resident physician sees increasing awareness of a common mental disorder

Nicole Cifra, MD, shown in an Upstate cafeteria, is concerned with how may young women have unhealthy eating practices. (PHOTO BY WILLIAM MUELLER)


Upstate graduate Nicole Cifra, MD, trained with a mentor who told her of his early years as a doctor, some 35 years prior. When he heard a patient had anorexia, he had no idea what that was because he had never heard of the eating disorder in medical school or during residency training.

These days, people are more aware of eating disorders, and professionals no longer blame families or exclude loved ones when treating a young patient, Cifra says. She earned her medical and master of public health degrees at Upstate and is now a pediatric resident physician at the University of Rochester.

About one in 20 young women has an eating disorder, and “everybody knows somebody” who has had one, Cifra notes. Between 4 percent and 20 percent of young women practice unhealthy patterns of dieting, purging and/or binge eating.

At a recent talk at Upstate, Cifra explained that researchers are looking for the cause of anorexia and other eating disorders. Current thinking suggests a brain-based genetic illness.

She also spoke of challenges in diagnosing and treating patients, who may try to hide the disorder out of shame or guilt or whose obsessions with weight and food can seem commonplace. Since many health insurers do not cover the cost of treatment for eating disorders at the same level as for other mental disorders, families are liable to face high out-of-pocket costs. Finding appropriate care can be difficult, too.

Still, Cifra sees progress.

A medical care standards guide for eating disorders, which Cifra helped develop as a member of the Academy for Eating Disorders, offers information to care providers if no treatment is available nearby. Parents also use the guide to advocate for their children.

This article appears in the summer 2017 issue of Upstate Health magazine. For a 2016 essay Cifra wrote about eating disorders, click here. For  more information on eating disorders, visit the Academy for  Eating Disorders website.

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