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Eating Disorders: Treatments

 
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If you or a loved one has been diagnosed with an eating disorder, there are treatments and support services available to help you. Eating disorders are primarily thought to be caused by emotional problems such as over-expectation, low self-esteem and stress or depression.

The first line of defence against this is psychological therapy, such as counseling or family therapy if there are wider family issues involved in the development of the disorder or the affected person is a minor.

Joining a support group for people with eating disorders might also be suggested.
Cognitive Behavioral Therapy (CBT) has been shown to be helpful. A trained therapist will assist patients in changing the way they think and react in order to prevent starvation diets or binge eating.

This is done by:

• Describing meals as a way to gain control of their eating habits so that eating becomes a positive thing rather than a negative thing.

• Educating them on the risks of eating disorders so they know why they should participate in therapy.

• Encouraging behavioral experimentation so that they can see they won’t become overweight by having three healthy meals a day.

For instance, the therapist could ask them to agree to three meals a day for one week and see if they become overweight. When they don’t, the therapist could then suggest eating this way again for the second week.

• For patients with bulimia or binge eating, techniques such as learning what triggered the binge eating to help prevent future binge eating and finding new ways to cope with stress, like talking to friends or having a relaxing soak in the bath.

The UK government wrote:

"This (CBT) is a structured therapy based on the idea that our thoughts, feelings, behaviours and physical sensations interact. It involves challenging unhelpful thoughts and beliefs, thus reducing the negative emotions and problematic behaviours that accompany them. A specific form of CBT for eating disorders focuses on modifying unhealthy eating and weight control behaviours, and unhelpful ideas related to weight, shape and appearance."

Young children may prefer a therapy that is less based on talking and instead benefit more from modalities such as drama therapy or music therapy to release pent up negative emotions.

Medication

Some patients are offered antidepressant medication to treat the negative emotions and depression that may have triggered the disorder. In anorexia nervosa there is limited evidence that this actually helps, although antidepressant use has been shown to be assistive to patients with bulimia or binge eating.

The National Institute for Clinical Excellence in the UK wrote:

"Pharmacotherapy has not been the treatment of first choice for eating disorders, but it has been used as an adjunct to psychological therapies or to treat physical or co-morbid psychological problems. In anorexia nervosa, medication has to date been disappointing in influencing the core symptoms of the disorder, promoting weight gain or reducing associated mood disturbance (Treasure & Schmidt, 2001). Where modest improvements have been reported, consideration of unwanted effects (e.g. in prolonging the QT cardiac interval), have led researchers to conclude that drugs confer little advantage when added to standard treatment (e.g. Vandereycken, 1984)."

Hospital Care

If the patient is in a serious or life-threatening condition as a result of their eating disorder, they may be admitted to hospital to be given a drip of fluids and nutrients. Often patients who are starving themselves are resistant to drip feeding, so this is always a last resort.

Medical staff will try to work with a patient to help them in their recovery, but in some cases of life-threatening mental illness, the decision to drip feed can be made without patient consent.

Help and Support

You can obtain help and support for yourself or your loved one, at:

National Eating Disorders Association
165 West 46th Street
New York, NY 10036
Toll-free Information and Referral Helpline: 1-800-931-2237 (9am-5pm EST).
Email: [email protected]
Website: http://www.edap.org

Sources:

Anorexia Nervosa, Bupa. Web. 27 September 2011. http://www.bupa.co.uk/individuals/health-information/directory/a/anorexia

Eating Disorders, Net Doctor. Web. 27 September 2011. http://www.netdoctor.co.uk/diseases/facts/eatingdisorders.htm

CBT for Eating Disorders, by Lynn Mollick, Morris County Psychological Association. Web. 27 September 2011.
http://www.nj-act.org/eating.html

Eating Disorders, National Institute for Clinical Excellence (NICE) published 2004. http://www.nice.org.uk/nicemedia/live/10932/29220/29220.pdf

Eating Disorders, Postnote, Parliamentary Office of Science and Technology, July 2007, no. 287.
http://www.parliament.uk/documents/post/postpn287.pdf

Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting.

She is a mother of five who practised drug-free home birth, delayed cord clamping, full term breast feeding, co-sleeping, home schooling and flexi schooling and is an advocate of raising children on organic food.

Reviewed September 27, 2011
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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