Eating Disorder Treatment

Eating disorder treatment is very important, because without treatment, 20% of those with eating disorders die from their condition. Even with treatment, only 60% make a full recovery. Another 20% may be able to maintain a job and some superficial relationships, but continue to show some symptoms of an eating disorder. The other 20% don't respond to the treatment and continue to require medical care for their disorder. (Statistics from the National Eating Disorder Association.)

Eating disorder treatment must include three crucial components: medical care, mental health care, and nutritional counseling and education. If all of these components are not addressed, treatment is unlikely to be successful.

Many people with eating disorders require inpatient treatment at the beginning. While eating disorders can be treated in any general psychiatric unit, a facility that specializes in the treatment of eating disorders is recommended. Eating disorders are not really treated the same way that other psychological disorders, such as schizophrenia and bipolar disorder, are treated.

Medical care is the first item to be addressed. When a person with an eating disorder presents for treatment, they are often suffering from a host of medical problems. They will likely be dehydrated and malnourished. IV fluids may be necessary for rehydration, and in severe cases, tube feeding may also be required. They may have stomach ulcers. People with bulimia often have dental problems due to vomiting excessively; the stomach acid damages the teeth. If the eating disorder is very severe or has been going on for a long time, there may be heart and kidney damage. Nutritional deficiencies frequently exist and must be treated with vitamin and mineral supplementation.

Once the patient is medically stable, issues of mental health must be addressed. A combination of individual and group counseling is recommended. In counseling sessions, patients address issues of self-esteem, depression, anxiety, stress management, and coping skills. Individual sessions allow the patient to delve into personal history, trauma, and other issues that might not be appropriate for a group setting. Group sessions allow the patient to gain support from others in similar situation, to practice healthy ways of interacting with others, and to develop a sense of community.

In addition to counseling, individuals with eating disorders should receive a psychiatric evaluation to determine if there is a mental illness like major depression, post-traumatic stress disorder, borderline personality disorder, or any anxiety disorders. The patient should be evaluated to determine whether any psychotropic medications are indicated, such as antidepressants or mood stabilizers.

Finally, nutritional counseling and education is needed. This component is often not provided or available in general psychiatric units, which is one reason specialized care is recommended. Information about healthful eating can be provided in group educational sessions, but individual sessions with a registered dietician are also called for. In individual sessions, the dietician can help the patient develop a healthful meal plan based on the patient's individual nutritional needs and dietary preferences.

Inpatient treatment is not always necessary, but it often is. Most psychiatric hospitalizations these days are very brief, lasting maybe a week, two at most. However, successful treatment for eating disorders simply cannot take place in such a short period of time. Several weeks or even a few months of treatment is usually necessary. This is another reason that a specialized treatment center is recommended. A specialized treatment center will be prepared to offer a longer period of treatment that a general psychiatric unit will be accustomed to providing.

After a period of inpatient treatment, outpatient treatment will be necessary. Initially, a period of intensive outpatient treatment or partial hospitalization may be indicated. In such a program, the patient attends a treatment program for several hours each day, several hours each week. The treatment program should include medical monitoring, medication monitoring, individual and group counseling, and nutritional counseling and education. In addition, meals and snacks should be supervised while the patient is at the treatment center.

After a period of intensive outpatient treatment or partial hospitalization, ongoing outpatient services should include medical monitoring, psychiatric care if needed, individual counseling, and nutritional counseling as needed. Ongoing outpatient treatment may be needed for several months or longer.

Sources:

Women's Center for Healthy Living. http://www.edtreatmentcenters.com/eating-disorder-treatment.php. Eating Disorder Treatment.

National Eating Disorders Association. http://www.nationaleatingdisorders.org/information-resources/general-information.php#seeking-treatment. Seeking Treatment.

Alliance for Eating Disorders Awareness. http://www.eatingdisorderinfo.org/Resources/EatingDisordersStatistics/tabid/964/Default.aspx. Statistics.

Academy for Eating Disorders. http://www.aedweb.org/eating_disorders/treatment.cfm. Treatment.