That all changed when she joined the Eating Disorders Program at Linden Oaks at Edward hospital, where Maria Rago, PhD, is clinical director. Four years ago, Rago developed a novel treatment for the women at her clinic—feeding homeless people. Her patients create grocery lists, go shopping, and cook for what she called Real Meals night.
"Some people freak out," says Ari Carlson, 17, who participated in the program four years ago when she was being treated for anorexia and bulimia. "You're buying food for a large group, and that's overwhelming when you have a disorder. I was anxious. I had to remind myself that it was for people who were suffering."
Seeing real need up close shifts her patients' focus, Rago believes. "When they volunteer, they are powerfully engaged in making the world a better place. It boosts their sense of self-esteem and value."
The lessons go beyond feeding the hungry. Federici felt that sitting down and eating with the homeless was key to her recovery. "Here I was taking food for granted and denying myself, and there was this group of homeless people who needed food and couldn't get it," she says. "Once we were in the actual process of making the meals, it was suddenly like I didn't have an eating disorder. It became natural just to eat and talk with the others."
The concept for Real Meals is groundbreaking, says Frederic Luskin, PhD, senior fellow at the Stanford Center on Conflict and Negotiation. "If your identity is, 'I am a person with anorexia,' that's a very narrow focus," he says. "This program doesn't ignore that suffering, but it puts it into a much broader perspective. It starts to reverse the self-absorption and give people a positive purpose."
More than 400 patients have found success with Real Meals, Rago says. "This type of program doesn't have to be only for those with eating disorders," she says. "It can work for many mental health conditions—depression, anxiety, alcoholism. Everyone who is trying to recover can benefit from this type of volunteering."
Federici sees it this way: "When you give of yourself to others, there's healing. Me, being healthy now—I can't tell you what a feeling that is."