How Calorie-Restrictive Eating Disorders Can Lead to an Underactive Thyroid

Thrive • January 2, 2022

By Thrive Reno’s Director of Primary Care Services Becky Barnett, PA-C

The Vital Role of the Thyroid in Your Health

The butterfly-shaped thyroid gland, located at the base of the throat, plays a crucial role in the body's endocrine system. Though small, this gland is responsible for regulating vital body functions by releasing hormones that impact nearly every cell, organ, and function within the body. The thyroid’s hormones are especially critical in managing metabolism, growth, and development, making it a powerhouse despite its size.

The Impact of Malnutrition on Thyroid Function

When a person experiences a calorie-restrictive eating disorder, such as anorexia nervosa, the body's response is to slow down thyroid function. This is a survival mechanism; the thyroid reduces the production and secretion of hormones to conserve energy in response to the lack of nourishment. However, this adaptive response can lead to significant health issues. Severe starvation can cause the thyroid gland to atrophy, or shrink, further weakening its function.

Recognizing the Symptoms of an Underactive Thyroid

Hypothyroidism, or low levels of thyroid hormones, can have wide-reaching effects on the body, particularly on metabolic processes. Below are some of the critical symptoms to be aware of:


Slowed Heart Rate: The lack of thyroid hormones can weaken the heart's ability to pump effectively, leading to a slower heart rate.


Elevated Cholesterol Levels: With a sluggish thyroid, the liver processes blood more slowly, potentially causing cholesterol to accumulate in the arteries.

 

Decreased Metabolic Rate: Low thyroid hormone levels can reduce the body's ability to convert food and drink into energy.

 

Lower Body Temperature: A slowed metabolism may result in a drop in core body temperature, often causing an individual to feel constantly cold.

 

Digestive Issues: Reduced metabolism can lead to constipation and other digestive problems.

 

Muscle Pain and Weakness: Insufficient thyroid hormones can cause muscles to feel weak, achy, and prone to cramping.

 

Cognitive Impairments: Hypothyroidism can manifest as "brain fog," characterized by forgetfulness, confusion, delayed reaction times, and difficulty concentrating.

 

Mood and Mental Health Symptoms: The overlap between hypothyroidism and depression symptoms is significant, with fatigue, social withdrawal, apathy, anxiety, and irritability being common in both conditions.

 

Given the overlap between the symptoms of hypothyroidism and eating disorders, it’s essential to have blood tests done to accurately diagnose low thyroid hormone levels.

Restoring Thyroid Health Through Recovery

The good news is that individuals in recovery from eating disorders can often restore healthy thyroid function. By gradually increasing caloric intake and working towards restoring a healthy body weight, the thyroid typically begins to normalize, as do many other bodily functions.

Thrive’s Comprehensive Eating Disorder Treatment

At Thrive, we understand the complex relationship between physical health and mental well-being. Our integrated approach to eating disorder treatment addresses the full spectrum of health—physical, mental, and emotional. Our expert-led team is here to help you on your recovery journey. Reach out to us to learn more about how we can support you in healing and reclaiming your life.

About the Author

Becky Barnett, PA-C — Thrive Reno Director of Primary Care Services

Becky Barnett, PA-C, has worked as a Physician Assistant for over 25 years with a primary focus on women’s health. She earned a bachelor’s degree from U.C. Riverside in 1991, and graduated from the College of Osteopathic Medicine of the Pacific (now Western University of Health Sciences) as a Physician Assistant in 1995. She has worked in various venues including community health centers, residential mental health facilities, large HMO settings and private practices as she moved throughout California and then into Nevada in 2001. She is proud to represent the medical team of Thrive Wellness of Reno, and is thrilled to be a part of such an authentic and passionate group.

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By Erin McGinty Fort, MS, MHA, CPC, LPC-S, CEDS-C December 18, 2025
Sometimes, people need more support, structure, and monitoring than the typical outpatient setting can provide. When this happens, the treatment team will usually recommend that someone be "stepped up" to a different level of care, or program, that can better meet their needs. I like to think of it as being similar to medication dosages; people need different strengths of medications, or dosages, to get better when they're sick. Stepping someone up to a higher level of care is like increasing the dosage of a medication to match the severity of their symptoms. How Are Higher Levels of Care Different from Standard Outpatient Care? At the core of differentiating higher levels of care from standard outpatient care is the intensity and structure of the treatment. Higher level of care programs tend to offer more days of treatment each week and more hours of treatment per day than in the outpatient setting. Those in higher level of care programs may also meet with their treatment team members more frequently each week. There are more staff present to support someone at or after meals and snacks, or to help those who are having urges to engage in compulsions or other harmful behaviors. Clients in our HLOC programs get access to an assortment of treatment modalities tailored to their individual needs, including personalized therapy sessions, group support, medication management, medical nutrition therapy with a dietitian, and check-ins with our primary care providers. We support clients with personalized treatment plans and regular assessments to monitor and tweak interventions as needed. Higher levels of care also offer increased peer interaction and support. Intensive programs incorporate additional group therapy sessions, which can help those in treatment feel less alone as well as create a greater sense of community. For some people, it can be difficult to devote the time and energy needed to recover while also balancing other responsibilities like school or work. Stepping up to more intensive levels of care allows people to fully dedicate themselves to recovery. As they get better and make progress, a person may be stepped back down to a less intensive level of care to start practicing their recovery in their usual home, school, or work settings while also receiving professional support from their treatment team. What Levels of Care are Available? At Thrive Wellness, we offer four different levels of care to help clients step up (or down) in their treatment when needed: -  Outpatient Treatment - weekly, bi-weekly, or monthly meetings with a therapist, psychiatrist, primary care provider, and/or dietitian. - Intensive Outpatient Program (IOP) - A minimum of three hours per day, three days per week. - Partial Hospitalization Program (PHP) - A minimum of six hours per day, five days per week. - Residential Treatment - Coming soon in 2026, The Greenhouse at Thrive will offer residential treatment for eating disorders, anxiety disorders, and obsessive-compulsive disorder. This level of care offers 24-hour support for those aged 12-24 living in our residential treatment center. How To Decide Which Level of Care is Right for You If you're unsure which option is right for you or your loved one, we offer a free assessment that can be completed with our admissions team. In this initial assessment, we'll gather information from you about what you're struggling with, speak with our team of providers, and then make a recommendation for what level of care we feel is the best fit for you and your needs. If you’re experiencing symptoms of an eating disorder, anxiety disorder, or other behavioral or mental health challenges, don’t hesitate to reach out. To get started with our intake process, give us a call at 775-525-8103 or fill out this form . We can’t wait to help you Thrive.
December 2, 2025
Like the fir tree, a symbol of endurance rooted in hope, our Family Inclusive Recovery (FIR) approach reflects the strength that grows when families face challenges together. At our new residential center “The Greenhouse”, FIR is more than a treatment model, it’s a philosophy of healing that places families at the heart of recovery for adolescents and young adults navigating eating disorders, anxiety disorders, and obsessive-compulsive disorder (OCD). We believe lasting healing doesn’t happen in isolation; it’s built with the support of families through perseverance, hope, and compassionate care. What Is Family Inclusive Recovery (FIR)? Family Intensive Recovery (FIR) is a specialized and immersive approach that actively engages caregivers as central agents in their child’s healing process. Rather than seeing families as contributors to a problem, we view them as essential partners in recovery. Drawing from two evidence-based frameworks, Supportive Parenting for Anxious Childhood Emotions (SPACE) and Family-Based Treatment (FBT), FIR helps families cultivate resilience, confidence, and connection throughout the journey to recovery. Grounded in SPACE and FBT Through the SPACE model, parents learn how to recognize and reduce well-intentioned but unhelpful behaviors known as accommodations that can reinforce anxiety and OCD symptoms. By shifting from rescuing to supporting and challenging, parents develop the confidence to guide their child through discomfort, helping them build distress tolerance and self-trust. Simultaneously, Family-Based Treatment (FBT) empowers families to take an active, compassionate role in their child’s nutritional and emotional recovery. Parents learn how to support weight and nutritional restoration, disrupt the eating disorder’s patterns, and reestablish boundaries that promote health and growing autonomy. Together, these approaches strengthen both the individual and family system, allowing recovery to take root within an environment of empathy and optimism. From Blame to Collaboration A cornerstone of the FIR model is removing blame. At Thrive, parents are not viewed as the cause of their child’s struggles, but rather as key partners in recovery. Treatment focuses on joining forces to create a safe, supportive environment where: Families learn to sit with their child's discomfort alongside them without rushing to fix or control it. Parents practice compassionate firmness, setting boundaries grounded in care and safety. Teens and caregivers rebuild trust through open, honest communication. This collaborative framework helps families reestablish a sense of connection and confidence, fostering long-term resilience and open communication that extends beyond the treatment setting. Why Family Matters in Recovery Recovery from eating disorders, OCD, or anxiety isn’t a one-person job, it requires integrated care including the family. When families learn to navigate challenges together, they can model emotional regulation, reinforce healthy boundaries, and create conditions for sustained recovery. Through FIR, we aim to strengthen attachment bonds, reshape family interactions, and empower every member of the family to grow. The result is not only symptom reduction but also a deeper sense of unity, hope, and shared endurance, just like the steadfast fir tree that stands resilient through every season. Moving Toward Hope Family Inclusive Recovery invites caregivers and loved ones to become active participants in change. It’s a journey of learning, letting go, and leaning into love and acceptance. Together, families and clinicians can cultivate the courage in clients to face uncertainty, and in doing so, help them discover that recovery is not just possible, but enduring. If you’d like to learn more about Family Intensive Recovery at The Greenhouse or how we support families in eating disorder and OCD treatment, reach out to our team today.
November 14, 2025
The Greenhouse at Thrive Wellness A New Chapter of Hope and Healing in Nevada On Friday, November 14 , we gathered with our partners at Molina Healthcare to share an important moment for our community. Together, we celebrated Molina’s generous $50,000 grant , an investment that is helping bring The Greenhouse to life. Their support is not only a financial contribution—it’s a statement of belief in the young people and families of Nevada who deserve access to compassionate, evidence-based mental healthcare close to home. This gathering marked the beginning of something we’ve dreamed about for years: a place designed specifically for adolescents and emerging adults to receive the care, connection, and support they need during some of the most vulnerable moments of their lives. Something New Is Growing In early 2026 , Thrive Wellness will open The Greenhouse , Nevada’s first residential treatment center devoted to adolescents and emerging adults navigating eating disorders, anxiety, and OCD . For too long, families have faced a heartbreaking dilemma—send their child far from home for treatment or go without the specialized care they need. The Greenhouse is our answer to that gap. It will be a place where young people can settle into an environment built for healing, where they are understood, supported, and surrounded by a team that believes in their capacity to recover. The Greenhouse represents a natural extension of our mission. It’s a living expression of our belief that recovery is possible—and that with the right support, families can find their footing again. 
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