Treatment Options for Eating Disorders

Getting Help: Treatment Options

Many complex factors lead millions of adolescents and adults to extreme dieting, many develop dangerous, and sometimes deadly, eating disorders. Eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorders are not simply about food and weight but are far more complex. Those with eating disorders desperately attempt to seek approval and acceptance, and may find it, temporarily, through the pursuit of thinness or the comfort of food. The eating disorder is merely a voice through which the body expresses itself and its unmet needs. Underlying issues, current stressors, and biochemical predispositions may cause one to turn to starving, bingeing, purging, or compulsively exercising as a means of coping.

Admitting you have an eating, exercise, or body image problem that requires treatment is a difficult step to take and getting the right help is essential! There are a variety of treatment options available: individual therapy, group therapy, nutritional support, psychiatric care, outpatient, inpatient, residential, etc. Please know that there are resources available to assist you and your loved ones!

You are not alone........

TREATMENT: There is Help Available!

It is generally accepted that the treatment of eating disorders must often involve clinicians from different health disciplines including psychotherapists, physicians, nutritionists, and nurses. Research on the treatment of eating disorders is exploring the various ways in which specific treatments can be matched to specific subtypes of these disorders. The consensus is that good treatment often requires a spectrum of treatment options. These options can range from basic psychoeducational interventions designed to teach nutritional and symptom management techniques to long term residential placements.

Most individuals with eating disorders are treated on an outpatient basis after a comprehensive evaluation. Those with medical complications due to severe weight loss or due to the effects of bingeing and purging may require inpatient treatment or hospitalization. Other individuals, for whom outpatient therapy has not been effective, may benefit from day-hospital treatment, hospitalization, or residential placement. Treatment is usually conducted in the least restrictive setting that can provide adequate safety for the individual. Many patients with eating disorders also have depression, anxiety disorders and other psychiatric problems requiring treatment along with the eating disorder.

Eating disorders are physically and emotionally destructive. People with eating disorders need to seek professional help immediately. Early diagnosis and intervention significantly enhance recovery. If not identified or treated in their early stages, eating disorders can become chronic, debilitating, and life threatening.

Overview- Initial Assessment, Diagnosis, Development of Treatment Plan:

The first step in establishing a diagnosis and treatment plan is the initial assessment. The initial assessment of eating disorder patient involves:

1. Review of patient's history.

2. Review of current symptoms presented.

3. Assessment of physical status.

4. Assessment of other psychiatric issues or disorders such as depression, anxiety, substance abuse, or personality issues.

What does treatment involve?

The most effective treatment for an eating disorder is psychotherapy or psychological counseling, along with medical and nutritional support and guidance. The treatment should be individually tailored. Treatment will vary depending on the severity of the disorder and the client's particular problems, needs, and strengths.

Psychological counseling needs to address both the eating disordered symptoms and the underlying psychological, interpersonal and cultural forces that contributed to the eating disorder.

-The individual needs to learn how to live peacefully and healthfully with themselves and food.

-Care should be coordinated and provided by a health professional with expertise and experience in dealing with eating disorders.

-Typically, care is provided by a licensed health professional, including but not limited to a psychologist, psychiatrist, nutritionist, and medical doctor.

Outpatient Care:

Many people with eating disorders respond very well to outpatient therapy. There are several types of outpatient psychotherapies with demonstrated effectiveness in treating patients with eating disorders. Cognitive-behavioral therapy, interpersonal psychotherapy, family therapy, and behavioral therapy have all shown promising results in treating eating disorder sufferers. Outpatient treatment for an eating disorder often involves a coordinated effort between the client, a psychotherapist, and a physician. Also, regular consultations with a registered dietician can be an effective means of support and information for patients who are regaining weight or normalize their eating. Patients with eating disorders are subject to a variety of physical and medical concerns, thus adequate medical monitoring is essential to effective outpatient treatment.

Psychopharmacology:

Psychiatric medications have a demonstrated role in the treatment of patients with eating disorders.

Intensive Outpatient Therapy (IOP):

IOP is a form of partial psychiatric hospitalization. IOP is more intense than weekly outpatient therapy and less intense than inpatient hospitalization. IOP clients come for therapy several days per week for several hours at a time. IOP is often done in groups. IOP treatments are shorter in duration than full Partial Hospitalization Programs known as PHPs.

Day Hospital Care:

Some clients may need more structure and contact than outpatient treatment can provide. These clients may benefit from the increased structure provided by a day-hospital treatment program. Day treatment programs provide structured eating situations and active treatment interventions while allowing the individual to live at home and in many continue to work or to attend school. PHP programs (see below) would fit into the day hospital care category.

Partial Hospital Program:

Partial Hospital Programs (PHPs) are more intense than IOP programs. They last longer (usually all day, i.e. 11am-7pm).

Inpatient Care:

Inpatient treatment provides a structured environment in which the client has access to clinical support 24-hours a day. Many programs are affiliated with day and outpatient programs that allow clients to step up or down to the appropriate level of care depending on their clinical needs.

Residential Care:

Residential programs provide long term treatment for those with eating disorders.

The treatment needs of each individual will vary. It is important for those struggling with an eating disorder to find a mental health care professional they trust to assist in developing and coordinating their treatment plan.

Sources:
American Psychiatric Association (1998), Eating Disorders.
Costin, Carolyn (1998), Monte Nido at www. montenido.com
Dept. of Health and Human Services (1987, 1995). Anorexia Nervosa and Bulimia.

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