Perched in an overstuffed chair in The Moore Center's satellite office in Richland recently, Kimberly Cantley exuded warmth, energy and confidence.
She smiled and spoke with enthusiasm about her artwork -- painting flowers or decorating canvases by popping balloons filled with paint in bright, primary colors.
"I like to paint on big boards and see what comes out," she told the Herald.
The feelings she expresses through her work these days are happy, but there was a time when her work was darker and more sad.
There was a time the 25-year-old Kennewick woman couldn't look people in the eye and worked to hide what was to her a dark secret -- a longterm depression that resulted in an eating disorder that lasted nearly a dozen years.
"I never told my parents," she said.
And she did well while a student at Kennewick High School. She made honor roll, was her senior class president and captain of the swim team.
But living with anxiety, panic attacks and depression from the time she was 12 caught up with her in college. She said she flunked out of Washington State University and Eastern Washington University because she wasn't eating and was obsessed with exercising.
"It's all I would do," she said.
She realized about a year and a half ago that it was time to get help for the anorexia she had developed as a means of coping with the emotional pain she felt.
Cantley checked into The Moore Center in Bellevue in May 2011, and she credits the program with helping her find other ways to express her emotions than through restricting her intake of food.
"I found painting and drawing," she said. "It helped me get my feelings out -- to vocalize my feelings."
According to the National Eating Disorder Association, as many as 10 million girls and women in the United States and 1 million boys or men have an eating disorder such as anorexia or bulimia, and millions more have a binge eating disorder.
Katie Klute, community outreach coordinator for The Moore Center's satellite office in Richland, told the Herald that eating disorders typically are the result of underlying mental health issues.
Much as some people use alcohol or drugs to cope with depression, anxiety or other mental illnesses, some people use food or exercise as a way of feeling some measure of control over their lives.
"You can't control 99.9 percent of the things happening around you, but you can control what you put in and out of your mouth," Klute said.
When an eating disorder starts at a young age and goes unaddressed, it takes over the person's life.
"It is a controlling, addictive monster," Klute said.
Successful treatment involves addressing those underlying psychological issues and helping the patient replace disordered eating behaviors with other coping mechanisms, such as the way Cantley uses art.
The Moore Center offers one of the few options for eating disorder treatment in Washington. Its Richland satellite office is one of the only places in Eastern Washington where people can go for group therapy for eating disorders.
Tim Hoekstra, director of outpatient counseling at Lourdes Counseling Center in Richland, told the Herald that apart from individual counselors offering one-on-one outpatient counseling sessions, there are few resources in Eastern Washington for people who need treatment for an eating disorder.
The only inpatient treatment option in the state is the Center For Discovery in Edmonds, which takes only adolescents. Adults who need inpatient treatment have to leave the state, Hoekstra said.
The Moore Center's main clinic in Bellevue offers what Klute described as partial hospitalization program. It isn't truly an inpatient program, but requires patients to come to the clinic Monday through Friday for treatment. Local patients can continue to live at home with their families, or patients from outside the Puget Sound area can stay with their families in a Moore Center apartment.
The idea is to retain some sense of normalcy for the patients while they begin recovery, rather than have the somewhat abrupt transition from a purely clinical setting to living at home again, Klute said.
"Dr. Moore believes in having one foot in treatment and one foot at home," she said.
Cantley said the partial hospitalization approach allowed her parents to be with her on weekends while she went through treatment -- and to get a better idea of what she was going through.
"It helped them understand that they can't change me, but they can be there for me," Cantley said.
Once she progressed far enough, she was able to return home to the Tri-Cities on weekends, and eventually she moved back home and started attending group sessions at the Richland satellite office.
Klute said some people won't need the partial hospitalization and instead can start their treatment in Richland, but they are asked to connect with individual counselors in addition to group therapy.
"The groups are really meant to provide a place where people can go and be with other people who understand," she said.
The satellite office offers a group for teens 13 to 18, and another for adults 19 and older. While statistics show that most of the people diagnosed with eating disorders are young women, men also are affected -- and someone can develop an eating disorder at any stage of life. The oldest patient at the Richland satellite office is a woman in her 70s, Klute said.
The three main eating disorders are anorexia nervosa, which is characterized by restricting food and a preoccupation with weight, calories and dieting; bulimia nervosa, in which patients tend to binge eat and then purge to avoid putting on weight; and binge eating, in which people can consume unusually large amounts of food.
Anorexia and bulimia center around an unhealthy fixation on weight loss, dieting and control of food.
People who have anorexia often experience dramatic weight loss and may dress in layers to hide their weight loss, and may make frequent comments about being fat or overweight despite their weight loss.
People with bulimia may make frequent trips to the bathroom to purge their food and hoard food in strange places. Warning signs include the sound or smell of vomiting and the presence of laxative or diuretic wrappers, and calluses on the hands and knuckles and stained, discolored teeth from self-induced vomiting.
Signs of binge eating disorder include the disappearance of large amounts of food over a short time, hoarding food in strange places, and someone scheduling their life around food to make time for binge sessions.
All three disorders are characterized by the development of rituals surrounding food.
A fact sheet published by The Moore Center said that eating disorders are rooted in a combination of genetics, social factors, trauma and personal belief systems, and are not passing fads or phases teenagers go through.
Eating disorders can be fatal if not treated.
For information or to seek treatment, call Klute at 943-5329 or The Moore Center at 425-451-1134.
Online information is available at www.moorecenterclinic.com or ww.myneda.org.