Facts About Eating Disorders
Treatment
Strategies
Eating disorders can be treated
and a healthy weight restored. The sooner these disorders
are diagnosed and treated, the better the outcomes are likely
to be. Because of their complexity, eating disorders
require a comprehensive treatment plan involving medical care
and monitoring, psychosocial interventions, nutritional counseling
and, when appropriate, medication management. At the time
of diagnosis, the clinician must determine whether the person
is in immediate danger and requires hospitalization.
Treatment of anorexia calls for a specific
program that involves three main phases: (1) restoring weight
lost to severe dieting and purging; (2) treating psychological
disturbances such as distortion of body image, low self-esteem,
and interpersonal conflicts; and (3) achieving long-term remission
and rehabilitation, or full recovery. Early diagnosis and
treatment increases the treatment success rate. Use of psychotropic
medication in people with anorexia should be considered only
after weight gain has been established. Certain selective
serotonin reuptake inhibitors (SSRIs) have been shown to be
helpful for weight maintenance and for resolving mood and
anxiety symptoms associated with anorexia.
The acute management of severe weight loss
is usually provided in an inpatient hospital setting, where
feeding plans address the person's medical and nutritional
needs. In some cases, intravenous feeding is recommended.
Once malnutrition has been corrected and weight gain has begun,
psychotherapy (often cognitive-behavioral or interpersonal
psychotherapy) can help people with anorexia overcome low
self-esteem and address distorted thought and behavior patterns.
Families are sometimes included in the therapeutic process.
The primary goal of treatment for bulimia
is to reduce or eliminate binge eating and purging behavior.
To this end, nutritional rehabilitation, psychosocial intervention,
and medication management strategies are often employed. Establishment
of a pattern of regular, non-binge meals, improvement of attitudes
related to the eating disorder, encouragement of healthy but
not excessive exercise, and resolution of co-occurring conditions
such as mood or anxiety disorders are among the specific aims
of these strategies. Individual psychotherapy (especially
cognitive-behavioral or interpersonal psychotherapy), group
psychotherapy that uses a cognitive-behavioral approach, and
family or marital therapy have been reported to be effective.
Psychotropic medications, primarily antidepressants such as
the selective serotonin reuptake inhibitors (SSRIs), have
been found helpful for people with bulimia, particularly those
with significant symptoms of depression or anxiety, or those
who have not responded adequately to psychosocial treatment
alone. These medications also may help prevent relapse. The
treatment goals and strategies for binge-eating disorder are
similar to those for bulimia, and studies are currently evaluating
the effectiveness of various interventions.
People with eating disorders
often do not recognize or admit that they are ill. As a result,
they may strongly resist getting and staying in treatment.
Family members or other trusted individuals can be helpful
in ensuring that the person with an eating disorder receives
needed care and rehabilitation. For some people, treatment
may be long term.
| Eating
Disorders | Anorexia
Nervosa | Bulimia
Nervosa |
| Binge-Eating
Disorder | Treatment
Strategies |
source:
nimh.nih.gov
|
