Jan Hamilton , MS, PMHNP, 
Psychiatric Nurse Practitioner

Doorways LLC.

 1825 E. Northern Ave. 

Suite 200

Phoenix, AZ 85020


(602) 997-2880


Get Help Now  


A Note from Jan
Founder of Doorways 
Dear Friend of Doorways,

This month I wanted to let you know about a disturbing eating trend among teens and young adults.

It's called "extreme healthy eating," and it can lead to an eating disorder called "Orthorexia Nervosa."

Orthorexia Nervosa is not currently recognized as a clinical diagnosis in the DSM-5, but many teens and young adults are struggling with this phenomenon. The term literally means "fixation on righteous eating."

According to the National Eating Disorder Association,

"Orthorexia starts out as an innocent attempt to eat more healthfully, but people with orthorexia become fixated on food quality and purity. They become consumed with what and how much to eat, and how to deal with 'slip-ups.' 

An iron-clad will is needed to maintain this rigid eating style. Every day is a chance to eat right, be 'good,' rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts, and exercise). Self-esteem becomes wrapped up in the purity of orthorexics' diet and they sometimes feel superior to others, especially regarding food intake.

Eventually, food choices become so restrictive, in both variety and calories, that health suffers - an ironic twist for a person so completely dedicated to healthy eating.  Eventually, the obsession with healthy eating can crowd out other activities and interests, impair relationships, and become physically dangerous."

Symptoms of Orthorexia

Here are some questions from the National Eating Disorder Association that you can ask a loved one whom you suspect is taking healthy eating to the extreme. The more questions they respond "yes" to, the more likely they are dealing with orthorexia.
  • Do you wish that occasionally you could just eat and not worry about food quality?
  • Do you ever wish you could spend less time on food and more time living and loving?
  • Does it seem beyond your ability to eat a meal prepared with love by someone else - one single meal - and not try to control what is served?
  • Are you constantly looking for ways foods are unhealthy for you?
  • Do love, joy, play, and creativity take a back seat to following the perfect diet?
  • Do you feel guilt or self-loathing when you stray from your diet?
  • Do you feel in control when you stick to the "correct" diet?
  • Have you put yourself on a nutritional pedestal and wonder how others can possibly eat the foods they eat?
There is nothing wrong with following a healthy diet, however, when doing so becomes so consuming that it takes up an inordinate amount of time and attention or causes the person to stop doing what they used to enjoy, that is a good indicator of a problem.

Like I said in the beginning, at Doorways, we are seeing this type of extreme healthy eating more than ever, and we have several ways we can help. 

  • We have counselors who specialize in helping teens and young adults who have symptoms of eating disorders and are available for individual counseling.
  • We have dietitians who can help your young person learn about how to follow a nutritionally sound eating plan, and 
  • We have eating disorder groups where young people can learn about healthy eating in a group of their peers.  
We are here to help you when you need us,
Jan Hamilton, MS, PMHNP-BC
Psychiatric Nurse Practitioner


Openings Still Available!

Monthly Mental Wellness Tip

Provider Spotlight

Psychiatrist Joins Doorways
Dr. Brad Zehring, Psychiatrist 
Dr. Brad Zehring, Psychiatrist and Eating Disorder Specialist, is joining the team of providers at Doorways.

Dr. Zehring is a member of the Academy for Eating Disorders (AED) and is passionate about helping families who have loved ones with eating disorders.  He attended medical school at Midwestern University - Arizona College of Osteopathic Medicine. He completed his residency at Banner Good Samaritan Medical Center in Phoenix, Arizona.

During residency, Dr. Zehring was recognized by the University of Arizona College of Medicine with the House Officer of the Year Award in Psychiatry for 2013-2014 academic year for his enthusiasm, professionalism, and passion in teaching medical students.

Dr. Zehring is accepting new patients.  To find out more contact Doorways at 602-997-2880.

Calendar of Events
Open Groups at Doorways

Anxiety Disorders/OCD IOP 
The OCD/Anxiety Disorders Program is for males and females, ages 13 to 17. It is open enrollment, which means you may join at any time.
The Anxiety Disorders/OCD IOP meets Mondays, Tuesdays, and Thursdays from 4:00 to 7:00 pm 


DBT Skills IOP (Intensive Outpatient Program) for Teens ages 13-17 
The goal of this DBT Skills IOP program is to give teens the tools they need to have successful relationships and boundaries.  This is a highly interactive skills-based group program. It's not a program where you just sit.  Read more... 


Adolescent Eating Disorders IOP for ages 13-18
This ED IOP is 3 days per week, a total of 10 hours per week.  Open enrollment, join any time.


Summer 8 Week Young Adult (18-25)
Eating Disorder IOP
We will have snack and lunch (monitored by Registered Dietitians) and we'll offer various groups (DBT skills, Relapse Prevention, Body Image, Process Groups, Nutrition, COPE groups, etc)

We are also contracted with Aetna, Blue Cross Blue Shield, Cigna, and United Behavioral Healthcare for our IOP's. 
For more information about our IOPs, contact our IOP coordinator at 602-997-2880 or iop@doorwaysarizona.com. 

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