Medical Management Of Eating Disorders

Greenlake Primary Care offers consultation and medical management of Eating Disorders with Tess Moore, MD and Melissa Holmes, PA-C. This service, which is separate from our primary care model, was created 10 years ago by Dr. Naomi Busch to provide personalized medical care for patients with disordered eating. She recognized that primary care physicians were rarely educated in the spectrum of disorders and needs for medical care of patients with eating disorders. We have become local experts in medical management of eating disorders including anorexia nervosa, bulimia nervosa, ARFID, and binge eating/compulsive overeating disorder.

Medical consultation involves assessment of eating disorder type and severity, recommendations for level of care, medical assessment and management of eating disorder related conditions such as electrolyte abnormalities and heart irregularities, monitoring for patients awaiting treatment or who are enrolled in day programs, and care for those who recently stepped down from treatment. We operate from a HAES® influenced, trauma informed lens. We recognize that eating disorders come in any body and each patient should be treated with compassion and autonomy.

Our treatment model is based on the understanding that individuals with eating disorders have unique and complex medical and psycho-social needs. The hope is that by improving communication between the various team members (dietician, therapist, psychiatrist, primary care or specialist), we ensure safe transitions and wraparound support through treatment. This increases success in treatment, maintains recovery, and prevents relapse. If a patient is a minor, parents are involved in medical concerns and treatments. At a teen’s request, parents are also involved in the mental illness aspect of care in conjunction with their psychiatric care providers.

In addition to their outpatient practice, Dr. Moore and Melissa provide medical consultation to several local eating disorder programs including Center for Discover, The Emily Program, Evidence Based Treatment Centers of Seattle, Opal: food and body wisdom, and other local experts. They have experience in levels of care from residential and partial hospitalization to outpatient. Dr. Moore also provides medication assisted treatment for substance use disorders.


Consultation service

New patients have an initial consultation with one of our medical eating disorder specialists to discuss their unique medical needs. During this initial visit, the medical provider conducts a full medical and eating disorder history, completes a physical exam, orders relevant blood work or other studies, and performs an EKG. If applicable, records and growth charts are reviewed. This, along with the patient’s medical story, will help her develop an individualized care plan that will include an assessment of the risk of medical complications and recommendations regarding exercise, vitamins, electrolyte replacement, and an appropriate level of care. Medical clearance for treatment can be completed at this time. They will share the care plan with the patient’s primary care physician (with appropriate release on file) and treatment team, and will be available for phone consult with the team immediately after consultation.

Ongoing care for eating disorders

Care at the clinic is individualized for each patient. If requested, our team can continue to manage medical needs. This may include vitals or ECG visits, regular visits as needed with their medical provider, and ongoing coordination with their team. Visits with our clinic for vital sign monitoring and labs are typically weekly to every other week during initial stabilization, then less frequently as appropriate. For patients who have difficulty getting to the office, we offer remote monitoring when it is medically safe.

Visit fees

***Greenlake Primary Care is Out-Of-Network with insurance companies. We provide an invoice and superbill that can be submitted by you to insurance or HSA/FSA plans for reimbursement. Labs can be billed directly to insurance. Payment is due at time of service. Typically new patient visits are $600 for a 90 minute visit and the coordination of care related to it. We collect a $250 deposit for new consultations.

We would be happy to discuss our program with you or your patients. Please call the clinic for more information or email us at