Eating disorders are learned behaviors developed over time. Hence the road to recovery from it can be challenging. Receiving the right treatment will allow the individual to unlearn these behaviors and recover from these conditions.
Understanding Eating Disorders
Eating disorders are serious mental illnesses characterized by a constant urge to eat and later engage in compensatory behaviors such as purging or laxatives. Some of the signs of eating disorders are obsessions with food, body weight, and appearance. These disorders can significantly impact a person’s physical and mental health and can even cause life-threatening conditions that may require medical attention. Treatment for eating disorders depends on the particular disorder and its associated symptoms. The treatment also includes addressing other underlying health problems that are caused by eating disorders. If left untreated, it may be life-threatening and have dire consequences.
It is essential to have an organized approach for treating eating disorders that will help you manage the associated symptoms. Some of the different types of eating disorders are:
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating Disorder
- Pica disorder
- Rumination disorder
Treatment Objectives For Eating Disorders
To control the urgency to eat can be challenging. Hence, establishing treatment objectives is crucial to recover from these conditions. Some of the goals that is established during the treatment process are:
- Identifying the sources of the disorder
- Learning coping mechanisms to manage stress
- Establishing healthy eating habits to respect the body’s needs
- Establishing a better relationship with their body
- Developing greater self-esteem
- Maintaining a healthy body weight
- Regaining a normal balance in life
Treatment Options For Eating Disorders
Recovering from an eating disorder can be challenging. You start believing that you’ll be happy when you reach that ideal weight, however, it is not necessarily so. This can be a distorted thought process that requires treatment. The primary step towards recovery is to admit that you have a problem. It is essential to be determined and stick to the treatment plan prescribed by the doctor. There are several treatment methods available for people suffering from these conditions. The treatment options are as follows:
Psychotherapy is a primary part of eating disorders. This allows a person to focus on developing healthy attitudes towards food. Some of therapy options include:
A. Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy is used to identify the thoughts and patterns that trigger negative eating behaviors and beliefs. These thoughts and beliefs can be associated with food, body weight or shape, or appearance. Once these thoughts are identified, they are replaced with positive thoughts to attain the desired goal. The psychologists may even teach them coping strategies in order to manage and help with their symptoms. A 2016 study 1 found that CBT can begin to improve the symptoms of eating disorders in just six sessions. According to a 2010 study 2 , “CBT is the treatment of choice for bulimia nervosa and for binge-eating disorder with the best results being obtained with the new ‘enhanced’ form of the treatment.” Early reduction in restrictive eating behaviors was also found in these patients.
B. Interpersonal Psychotherapy (IPT)
This therapy is used to treat eating disorders like binge eating disorder or bulimia. It is used to improve the quality of interpersonal relationships of the patient. IPT attempts to resolve issues within four key areas. They are:
- Interpersonal deficits such as social isolation or unfulfilled relationships
- Managing unresolved grief
- Difficult life transitions, such as divorce or retirement
- Interpersonal disputes arising from conflict of interest between partners, family members, or friends
A 2012 study pointed out that IPT is well suited for helping patients address interpersonal difficulties, thus facilitating their recovery.
C. Family Therapy
Family therapy is used to resolve conflicts and improve communication among family members. In this therapy, family members participate in the therapy session and attempt to resolve conflicts with the patients around appearance, body weight, abnormal eating behaviors. Family members are required to help the patient in the following aspects:
- Maintaining a healthy body weight
- Managing a healthy eating pattern
- Stopping unhealthy eating behaviors
A 2017 study 3 found that family therapy was efficacious in treating patients with bulimia and binge eating disorder. It was found that the patients had a steady weight gain after family therapy intervention.
D. Dialectical Behavior Therapy (DBT)
This therapy is a type of cognitive behavioral therapy. The primary goal of dialectical behavior therapy is to manage intense emotions. With this therapy, the patient will learn the skills that are required to change abnormal eating patterns. The skills that are taught in DBT are:
- Learning to live in the moment
- Improving relationships
- Managing emotions
- Improving interpersonal skills
- Coping with distress and anxiety
- Expressing emotions
- Developing flexibility and openness
A 2015 study 4 found that DBT proved efficient to treat patients with anorexia. It was found helpful in developing specific skills like flexibility, openness, and interpersonal skills.
There are no Food and Drug Administration (FDA) approved medications to treat eating disorders. For treating eating disorders, the primary aim of medications is to treat the conditions caused by these disorders. There is some evidence 5 that suggests the efficacy of pharmacological treatments for treating patients with bulimia and binge eating disorder. The doctor may prescribe Benzodiazepines before meals to reduce anxiety. A 2009 treatment study shows that Selective Serotonin Reuptake Inhibitors (SSRIs) are most effective when they are combined with psychotherapy.
Eating disorders may cause several life-threatening conditions such as bradycardia, hypothermia, severe weight gain or loss, and others. The primary goal of hospitalization is to attend to acute medical symptoms and stabilize the patient. There are several treatment programs in place for treating patients with eating disorders. They are:
A. Intensive Outpatient Care
In outpatient care, the patient can return home after treatment. The outpatient facility is used to attend to patients that don’t require daily supervision and who demonstrate progress in their recovery. Patients may require treatment once or twice per week.
B. Residential Program
Residential programs are specifically designed to address patients with eating disorders. This program is recommended for patients who require long-term care and who require daily supervision. The time spent in the residential program depends on the severity and intensity of the condition of the patient.
C. Day Hospital Programs
These programs are also known as partial hospitalization. In this program, the patient needs to be monitored regularly. Eating disorders impact the individual’s ability to function and can even stop them from performing activities such as purging or binge eating. The treatment sessions can last several hours and can occur for most days during the week.
D. Inpatient Hospitalisation
In this program, the patient can stay overnight at the hospital. The main goal of inpatient hospitalization is to stabilize the patient’s condition. Individuals with eating disorders who require medical attention usually opt for inpatient hospitalization. Such medical emergencies can include:
- Unstable vital signs
- Suicidal tendencies
- Severe weight loss
4. Nutritional Therapy
Eating disorders have the highest mortality rate of all mental illnesses. They can have a significant physical impact on the body such as constipation, weight gain or loss, missed menstrual cycles, cardiovascular issues, bradycardia, or weakened bones. Due to this, it is essential to seek nutritional counseling for people with eating disorders. Maintaining healthy body weight is an essential part of recovery. Hence, it is crucial to seek a professional nutritionist who can develop a meal plan and stabilize the normal body weight of the patient. This will allow the patient to avoid an abnormal eating pattern. A study 6 on nutrition intervention in the treatment of eating disorders found that a registered dietician is an essential component for treating patients with this condition to ensure a normal eating pattern and to reinstate the ideal body weight.
5. Self Help
Recovery from an eating disorder can be challenging. There are self-help resources that can be used to manage the urge of incessant eating. People with this condition can join support groups or read self-help books to try and tame their eating urges. However, in extreme cases, it is imperative to seek professional help. A 2012 study 7 found that pure self-help and guided self-help for eating disorders were effective for individuals with bulimia nervosa, binge eating disorder, and other specified feeding and eating disorders. Some of the self-help practices may include:
- Talking to a trusted friend or advisor
- Learning how to manage relapses
- Changing unhealthy eating patterns
- Practicing mindfulness
- Adopting relaxation techniques
- Learning to improve your mental well being
Recovery From Eating Disorders
Recovery from these disorders can be quite challenging. It is essential to attend and pay close attention to your thoughts around bodyweight, appearance, or eating habits. It is possible to avoid relapse by sticking to the treatment plan laid out by the doctor. This will enable you to maintain your quality of life and mental health.
- Turner, H., Marshall, E., Wood, F., Stopa, L., & Waller, G. (2016). CBT for eating disorders: The impact of early changes in eating pathology on later changes in personality pathology, anxiety and depression. Behaviour Research and Therapy, 77, 1-6. https://doi.org/10.1016/j.brat.2015.11.011
- Murphy, R., Straebler, S., Cooper, Z., & Fairburn, C. G. (2010). Cognitive behavioral therapy for eating disorders. The Psychiatric clinics of North America, 33(3), 611–627. https://doi.org/10.1016/j.psc.2010.04.004
- Rienecke R. D. (2017). Family-based treatment of eating disorders in adolescents: current insights. Adolescent health, medicine and therapeutics, 8, 69–79. https://doi.org/10.2147/AHMT.S115775
- Chen, E. Y., Segal, K., Weissman, J., Zeffiro, T. A., Gallop, R., Linehan, M. M., Bohus, M., & Lynch, T. R. (2015). Adapting dialectical behavior therapy for outpatient adult anorexia nervosa–a pilot study. The International journal of eating disorders, 48(1), 123–132. https://doi.org/10.1002/eat.22360
- McElroy, S. L., Guerdjikova, A. I., O’Melia, A. M., Mori, N., & Keck, P. E. (2010). Pharmacotherapy of the eating disorders. The Oxford Handbook of Eating Disorders, 416-451. https://doi.org/10.1093/oxfordhb/9780195373622.013.0024
- Ozier, A. D., & Henry, B. W. (2011). Position of the American dietetic association: Nutrition intervention in the treatment of eating disorders. Journal of the American Dietetic Association, 111(8), 1236-1241. https://doi.org/10.1016/j.jada.2011.06.016
- Wilson, G. T., & Zandberg, L. J. (2012). Cognitive–behavioral guided self-help for eating disorders: Effectiveness and scalability. Clinical Psychology Review, 32(4), 343-357. https://doi.org/10.1016/j.cpr.2012.03.001