Experiences with Anorexia - Experiences with Anorexia Therapy

Written by HealthyPlace.com Staff Writer

Bob M: For those who want to know: what it is like when you check into the eating disorder treatment center? What is a typical day like?

Dr. Brandt: First, patients undergo a series of psychological and medical assessments. Then, they are engaged in a multi-modality treatment that entails efforts to block the primary symptoms of the disorder while trying intensively to understand the meaning of the symptoms. Most patients are in a combination of various groups, individual therapy, and nutritional counseling. Most are in family therapy as well. If indicated, medication is utilized.

Bob M: Here are some audience questions:

Heatsara: I have restricted my calorie intake to 100 calories a day...but am lucky if I eat 80. I am trying to get back to 88 pounds where I was a year ago. I am 5'8. The thing is I passed out and got a bloody nose at swim practice today. I am scared to death. I don't know what to do? No matter how hard I try, I cannot eat!!!

Dr. Brandt: You need rapid attention. There are serious medical manifestations of your ongoing starvation.

Julia: Whoever can answer, please help me. I have been having huge problems, and I haven't been able to eat right etc. I am afraid to talk to any of my doctors becasue they write everything down and they have threatened to admit me. I feel I can not trust anybody. I don't want to be admitted, but I want help. I am really scared.

Dr. Brandt: I suggest you try to get on the same "team" as your physicians. You have a serious problem and you need help.

Trina: Dr. Brandt - It seems like average inpatient or outpatient stays for ED treatment last 3 weeks - are there any actions to change this and force Insurance co's. to allow for longer-term treatment?

Dr. Brandt: The length of inpatient hospitalization can vary widely, but many of our patients are only inpatients for several days. They often then transfer into our partial hospitalization program for longer-term treatment.

Jenna: How difficult is it to get help when you don't fit any "clinical" definitions for eating disorders? I know I'm sick, but I'm afraid no one will help me. I'm not underweight, but I have lost 70pounds since this started last November.

Dr. Brandt: Your rapid loss of weight suggests that something is wrong even if you don't fit into any specific category. You deserve a thorough evaluation and appropriate treatment. No two people are alike.

Bob M: Is there like a cookie-cutter approach to treating someone with an eating disorder or does each person need a separate treatment plan?

Dr. Brandt: Because of the wide variability of symptoms and their origin, each patient needs an individualized treatment plan. Having said that, I would add that there are some common components of most treatment. In our program, we try to focus on providing structure for patients to block their starvation or bingeing and purging, and at the same time work in intensive psychological therapies. It is this approach that we have found to be most effective.

Bob M: I want to post a comment from an audience member. It was a followup to a question about how to let your family/friends know about your eating disorder:

Jenna: In response to UCLOBO...I was afraid of that too. But I was very honest when I told my best friend. I told him what was wrong and what I needed. Simply, I needed someone to listen and a shoulder to cry on. I didn't need someone to force feed me, or nag me...just someone to love me. I helped him get information on the disorder and I let him have a couple days to deal with the well of emotions that my confession brought forth. Let your friends be there for you...you'd be surprised how how strong they will be.

Donnna: Why is it that we always feel the need to fall back on the behavior rather than to deal with the real issues?

Dr. Brandt: We feel that the development of a healthy support network is an extremely important component of treatment for an eating disorder. The behaviors become a gratifying, soothing (but potentially deadly) way of dealing with underlying conflicts and issues.

Bob M: Let me go back to telling your family-- mom, dad, husband, wife---can you give us a step-by-step approach to telling your family and friends and how to ask for help? For many people that is a very scary thing!

Dr. Brandt: Yes indeed!!! I think open, honest communication is essential. We have found that it helps if a person with an eating disorder tries to communicate the underlying feelings...as opposed to engaging the family in an overfocus on meals, body weight, shape, appearance, calories etc. I have seen many patients receive a tremendous amount of appropriate support from family and close friends who truly want to help. If there is a lot of apparent conflict and power struggles, then the help of an objective outsider (a therapist) is usually necessary.

Bob M: What about people who are dealing with compulsive overeating? What is treatment like for them?

Dr. Brandt: Treatment for compulsive overeating starts with a complete assessment by a psychiatrist and a nutritionist. Often there are coexisting illnesses like depression or anxiety that require attention. Patients are usually treated in a combination of individual psychotherapy. Nutritional counseling that focuses on healthy, normal eating, and NOT on weight. and if binge eating is a part of the problem, medications might be utilized. We are opposed to the use of diet pills, fen-phen, and other weight loss agents. But we often utilize the proven anti-bulimic medications like the selective serotonin reuptake inhibitor drugs (Prozac, Zoloft, Paxil, etc.).

Julia: What are some of the signs of relapse?

Dr. Brandt: The signs of relapse are often the reemergence of old behaviors...social withdrawal...dieting...bingeing...overfocus on appearance and weight, etc.