Getting Help for Anorexia and Bulimia - Anorexia and Bulimia Treatment

Written by HealthyPlace.com Staff Writer

How effective is the treatment?

More than half of sufferers make a recovery, although they will on average be ill for five to six years. Full recovery can happen even after 20 years of severe anorexia nervosa. .Past studies of the most severe cases admitted to hospital have suggested that one in five of these may die. With up-to-date care, the death rate is much lower if the person stays in touch with medical care. .As long as the heart and other vital organs have not been damaged, most of the complications of starvation (even bone and fertility problems) seem to recover slowly, once a person is eating enough.

Bulimia:

Psychotherapy

Two kinds of psychotherapy have been shown to be effective in bulimia nervosa. They are both given in weekly sessions over about 20 weeks.

This is usually done with an individual therapist, but can be done with a self-help book, group sessions or even self-help CD-ROMs.CBT helps you to look at your thoughts and feelings in detail. You may need to keep a diary of your eating habits to help find out what triggers your binges. You can then work out better ways of thinking about, and dealing with these situations or feelings.

This is also usually done with an individual therapist, but concentrates more on your relationships with other people. You may have lost a friend, a loved one may have died, or you may have been through a big change in your life. It will help you to rebuild supportive relationships that can meet your emotional needs better than eating.

Eating advice

The aim is for you to get back to eating regularly, so you can maintain a steady weight without starving or vomiting. You may need to see a dietician for advice about a healthy, balanced diet. A guide such as "Getting Better BITE by BITE" (see references) can be helpful.

Even if you are not depressed, SSRI antidepressants can reduce the urge to binge eat. This can reduce your symptoms in 2-3 weeks, and provide a "kick start" to psychotherapy. Unfortunately, without the other forms of help, the benefits wear off after a while. Medication is useful, but not a complete or lasting answer.

• About half of sufferers recover, cutting their binge eating and purging by half. This is not a complete cure, but can enable someone to get back some control of their life, with less interference from their eating problem.
• The outcome is worse if you also have problems with drugs, alcohol or harming yourself.
• CBT and IPT work just as effectively over a year, although CBT seems to start to work a bit sooner.
• There is some evidence that a combination of medication and psychotherapy is more effective than either treatment on its own. .Recovery usually takes place slowly over a few months, or even years.
• Long-term complications include damaged teeth, heart burn, and indigestion. A small number of people will have epileptic fits.

The Royal College of Psychiatrists also produces mental health information for patients, carers and professionals including: Alcohol and Depression, Anxiety and Phobias, Bereavement, Depression, Depression in Older Adults, Manic Depression, Memory and Dementia, Men Behaving Sadly, Physical Illness and Mental Health, Postnatal Depression, Schizophrenia, Social Phobias, Surviving Adolescence and Tiredness.

The College also produces factsheets on treatments in psychiatry such as Antidepressants, and Cognitive Behavioural Therapy. All these can be downloaded from this website. For a catalogue of our materials for the general public, contact the Leaflets Department, Royal College of Psychiatrists, 17 Belgrave Square, London SW1X 8PG. Tel: 020 7235 2351 ext.259; Fax: 020 7235 1935; E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Organisations that can help

Eating Disorders Association, 103 Prince of Wales Road, Norwich NR1 1DW Helpline: 01603-621-414; Monday to Friday, 9.00 am to 6.30 pm Youth Helpline: 01603-765-050; Monday to Friday, 4.00 pm to 6.00 pm www.edauk.com. Provides information and help on all aspects of eating disorders, including anorexia nervosa, bulimia nervosa, binge eating and related eating disorders.

NHS Direct 0845 4647 www.nhsdirect.nhs.uk. Provides information and advice on all health topics.

Patient UK. www.patient.co.uk. Provides information on leaflets, support groups, and a directory of UK websites on all aspects of health and disease.

Young Minds, 102 - 108 Clerkenwell Rd, London EC1M 5SA; Parents Information Line: 0800 018 2138; www.youngminds.org.uk. Provides information and advice on child mental health issues.

Anorexia Nervosa and Related Eating Disorders, inc www.anred.com/slf_hlp.html. Website with information on eating disorders. 17

Books

Breaking free from Anorexia Nervosa: A Survival Guide for Families, Friends and Sufferers, Janet Treasure (Psychology Press)

Overcoming Anorexia Nervosa: A self-help guide using Cognitive Behavioural Techniques, Christopher Freeman and Peter Cooper (Constable & Robinson)

Bulimia Nervosa and Binge-eating: A guide to recovery, Peter Cooper and Christopher Fairburn (Constable & Robinson)

Overcoming Binge Eating, Christopher G Fairburn (Guildford Press)

Getting Better BITE by BITE: A Survival Kit for Sufferers of Bulimia Nervosa and Binge Eating Disorders, Ulrike Schmidt and Janet Treasure (Psychology Press)

References

Agras, W. S., Walsh, B.T., Fairburn, C. G., et al (2000) A multicentre comparison of cognitive-behavioural therapy and interpersonal psychotherapy for bulimia nervosa. Archives of General Psychiatry, 57, 459-466.

Bacaltchuk J., Hay P., Trefiglio R. Antidepressants versus psychological treatments and their combination for bulimia nervosa (Cochrane Review). In: The Cochrane Library, Issue 2 2003.

Eisler, I., Dare, C., Russell, G. F. M., et al (1997) Family and individual therapy in anorexia nervosa. Archives of General Psychiatry, 54, 1025-1030.

Eisler, I., Dare, C., Hodes, M., et al (2000) Family therapy for anorexia nervosa in adolescents: the results of a controlled comparison of two family interventions. Journal of Child Psychology and Psychiatry, 41,727-736.

Fairburn, C. G., Norman, P.A., Welch, S. L., et al (1995) A prospective study of outcome in bulimia nervosa and the long-term effects of three psychological treatments. Archives of General Psychiatry, 52, 304-312.

Hay, P. J., & Bacaltchuk, J. (2001) Psychotherapy for bulimia nervosa and bingeing (Cochrane Review) In The Cochrane Library Issue 1.

Lowe, B., Zipfel, S., Buchholz, C., Dupont, Y., Reas D.L. & Herzog W. (2001). Long-term outcome of anorexia nervosa in a prospective 21-year follow-up study. Psychological Medicine, 31, 881-890.

Theander, S. (1985) Outcome and prognosis in anorexia nervosa and bulimia. Some results of previous investigations compared with those of a Swedish long-term study. Journal of Psychiatric Research 19, 493-508.

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