Addressing Eating Disorders: Treatment Options And Ways To Find Help
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Eating disorders can pose serious risks to an affected individual’s long-term health and well-being. However, with effective psychological treatment and medical care, it’s possible to recover from these dangerous conditions and much of the harm they cause. In this article, we’ll review the most effective types of eating disorder treatment and discuss how affected individuals can seek help.
Successfully treating eating disorders may require a combination of psychotherapy, medical management, and interpersonal support. A mental health professional can help clients rethink damaging ideas about weight and eating, as well as suggest strategies for modifying harmful behaviors. Meanwhile, doctors may prescribe medication and assist patients in returning to a healthy weight, while friends and family can help individuals stay motivated throughout their recovery journeys.
The risks of untreated eating disorders
While eating disorders may not receive as much public attention as more common mental health conditions like depression and anxiety, they can have devastating consequences. A 2020 study found that people with eating disorders generally had a risk of early death five to seven times higher than average, and they’re also at risk for many other devastating effects on health and well-being.
Specific effects may vary based on the kinds of disordered eating behavior.
Anorexia nervosa
Often known simply as anorexia, this condition is typically characterized by severe self-restriction of food consumption, which can lead to severe complications in virtually every system in the body. In the short term, this can include effects like weakness, dizziness, constipation, and brittle hair, nails, and bones. Over time, more serious effects can occur, including brain atrophy or failure of major organs like the heart and lungs.
Bulimia nervosa
Bulimia (as well as some forms of anorexia) usually involves eating large amounts of food in a short time, followed by “purging” behaviors intended to expel the food before it can be digested. This may cause many of the same malnutrition-related effects as anorexia. Purging can also directly cause ill effects like severe dehydration or damage to the throat and esophagus.
Binge eating disorder
This condition is normally marked by episodes of uncontrollable overeating, often to the point that the person feels uncomfortably or painfully full. This may contribute to concerns like obesity, metabolic syndrome, or diabetes. In some cases, binge eating can even cause intestinal rupture.
Untreated eating disorders and suicide
Along with health challenges directly related to restrictive food consumption, binge eating, and purging, eating disorders may carry an elevated risk of suicide. The pathology of these conditions often involves severe feelings of shame and a distorted self-image that can cause those affected to see themselves as unattractive, unlikeable, weak, or worthless.
Mental health treatment for eating disorders
Treatment for eating disorders can be lengthy and challenging, and not all individuals will respond equally well to any given treatment approach. However, research suggests that multiple forms of psychotherapy can effectively address the mental, emotional, and behavioral components of these illnesses. Here are a few potential evidence-based eating disorder treatments.
Cognitive behavioral therapy for bulimia, binge eating, and more
This treatment approach typically involves guiding a client to identify, confront, and reframe counterproductive mental patterns, such as a distorted self-image or an exaggerated fear of weight gain. The therapist may also assist the client in developing effective strategies for better regulating their behavior and emotions.
CBT is currently considered the first-line treatment for bulimia.
Studies indicate that it can also help with conditions like anorexia, binge eating disorder, and avoidant/restrictive food intake disorder (ARFID).
Enhanced cognitive behavioral therapy for eating disorders
Enhanced cognitive behavioral therapy, or CBT-E, is a modified form of CBT developed specifically for eating disorders. This four-stage process generally involves examining and overcoming the underlying causes for disordered eating behaviors, such as dysfunctional attitudes about weight and food.
According to a 2019 meta-analysis of existing studies, CBT-E can be an effective treatment for many types of eating disorders. However, it’s currently unclear whether it’s superior to traditional CBT.
Family-based treatment for adolescent anorexia
While CBT and other individual psychotherapies are often helpful in reducing anorexia symptoms, some research suggests that family-based treatment, or FBT, may be more effective for adolescents.
Rather than seeking to understand the cause of the illness, FBT usually focuses on educating and empowering family members to support their loved one’s journey to healthy eating behavior. By steering away from questions about the origins of eating disorders, this method may avoid counterproductive feelings of guilt while enhancing the family’s sense of confidence and self-efficacy.
Note that because FBT usually involves parents taking responsibility for their child’s eating-related decisions, it’s likely not a viable option for adult patients.
Dialectical behavior therapy for binge eating disorder and related conditions
Another potential eating disorder treatment is dialectical behavior therapy (DBT). Originally developed to address persistent suicidal behavior in people with personality disorders, this approach has been successfully adapted to reduce symptoms of several eating disorders, with the strongest evidence for binge eating disorder.
DBT usually involves helping clients accept themselves and let go of harshly self-critical attitudes, as well as coaching them on effective techniques of emotional self-regulation. This may help those whose disordered eating behaviors emerge from attempts to soothe challenging emotions like anxiety, self-loathing, or perceived helplessness.
Mindfulness-based treatments for eating disorders
Many emerging psychological treatments train patients to cultivate mindfulness, a type of non-judgmental self-awareness that may help individuals identify and let go of dysfunctional attitudes and habits. Emerging research suggests that increasing mindfulness may reduce eating disorder symptoms.
While evidence for the usefulness of specific mindfulness-based therapies in eating disorders is still limited, some studies have shown positive effects. For example, a 2020 paper reported that acceptance and commitment therapy (ACT) helped patients recover from lingering symptoms of eating disorders treated with other methods.
Another study found that mindfulness-based cognitive therapy (MBCT) helped decrease unhealthy eating behaviors in individuals with bulimia and binge eating disorder.
Can medication help with an eating disorder?
There are no known pharmacological treatments that can treat eating disorders on their own. However, some medications may enhance the effects of evidence-based psychotherapy when used as a supplemental treatment. Talk to your doctor to determine whether medication could be a helpful component of your treatment plan.
Medical supervision in eating disorder treatment
Because of the many medical risks associated with disordered eating, supervision and monitoring from a physician may be crucial for healthy recovery.
When patients with severe nutrient deficiencies begin working their way back to healthy eating habits, they may be at risk of refeeding syndrome, a type of severe electrolyte imbalance that can be damaging or even fatal. Proper supervision from qualified medical practitioners can prevent this reaction.
Even in less severe eating disorder cases, individuals may benefit from regular supervision from doctors who can monitor vital signs, body weight, and overall health. The National Eating Disorder Association (NEDA) also recommends nutritional counseling to help those in recovery ensure that they maintain proper eating habits.
Medical monitoring for eating disorders can take many forms:
- Inpatient care in a hospital generally involves round-the-clock monitoring and medically supervised refeeding. Inpatient treatment may be necessary to stabilize severely malnourished patients.
- Residential treatment centers can offer patients a stable, supportive environment with access to various forms of therapy and support. This approach can be costly, but research suggests it’s often associated with positive outcomes.
- Intensive outpatient or partial hospitalization programs typically involve close oversight from a dedicated care team but don’t require patients to stay overnight in a hospital or treatment center. This approach may improve outcomes for patients who are making limited progress with less intensive treatment.
- Standard outpatient care generally involves a combination of psychotherapy, medication, and social support, often involving regular checkups with a primary care doctor.
Finding treatment for an eating disorder
Talking with your primary care doctor may be a crucial first step in getting help for an eating disorder. They can assess you for malnutrition and medical complications and get you into treatment to help you avoid further negative health impacts. Your doctor may also be able to refer you to specialists like mental health professionals and registered dietitians.
Another option is to research treatment professionals or locations on your own. This may enable you to find eating disorder recovery specialists who fit your unique needs and preferences. Some resources that may help your search include the following:
- American Psychological Association (APA) Psychologist Locator
- National Eating Disorder Association (NEDA) treatment resource center
- National Alliance for Eating Disorders Treatment Center & Practitioner Directory
- Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline
- National Association of Anorexia Nervosa and Associated Disorders (ANAD) Treatment Directory
- EDReferral Eating Disorder Referral and Information Center
You may also want to consider reaching out to trusted friends and loved ones for support. Overcoming eating disorders is often easier with robust help and encouragement from those close to you.
Online mental health care for an eating disorder
Some patients may prefer the flexibility offered by online mental health treatment. Remote therapy often allows for easier scheduling, which can help when you’re trying to fit psychotherapy into a busy schedule that also includes doctor visits, nutrition counseling, meal planning, and other aspects of eating disorder recovery.
More research may be needed to confirm the effectiveness of online therapy for eating disorders, but the evidence so far suggests they can work well for many people. For instance, a systematic review and meta-analysis from 2023 found that internet-based cognitive behavioral therapy was “efficacious for the prevention, treatment, and relapse prevention of eating disorders.” Online care for eating disorders may need to be paired with in-person medical supervision to ensure a healthy recovery.
Takeaway
How do you treat an eating disorder?
Eating disorders are generally treated using therapy, medication, and residential treatment programs. These mental illnesses can be severe and lead to complex and life-threatening consequences. Treatment depends on the severity of one’s eating disorder symptoms and the type of eating disorder behaviors someone is living with. The most common therapeutic modalities for those who seek treatment for eating disorders are cognitive-behavioral therapy (CBT) and exposure and response prevention (ERP). A therapist may help clients improve body image and reduce intense fear of gaining weight. Therapy may also focus on improving physical health if done alongside a primary care provider and registered dietitian.
How can you help someone with an eating disorder?
If you have a loved one with an eating disorder, you might help them improve eating habits and seek support. However, if they deny having a mental illness, getting them to seek help might be difficult. In these cases, consider offering them resources from reputable organizations like the National Eating Disorders Association (NEDA). Although you can offer advice and support, it is not your fault if someone doesn’t accept or seek help for their eating patterns. If someone who is your dependant requires emergency support due to excessive weight loss, take them to emergency services for support with their physical and mental health.
How are eating disorders treated in adolescence?
Eating disorders in adolescents are treated in the same way as in adults. However, adolescents may benefit more from family therapy, allowing them to work on symptoms in evidence-based treatment alongside a trusted adult. Talk therapy can also be helpful for teens. For those experiencing severe symptoms of an eating disorder, inpatient treatment might be recommended so the teen’s mental and physical health can be monitored simultaneously by a team of providers to help them achieve recovery. The persons’s family may be included in treatment, and comorbid conditions, such as obsessive-compulsive disorder (OCD), may also be treated in the same place.
How can we prevent eating disorders?
Eating disorders may be prevented by noticing the risk factors and warning signs early and getting early treatment when eating patterns are impacted. Someone who starts frequently talking about a desire to lose weight may be showing signs of a desire to restrict or control food intake, which is a warning sign for eating disorders. Eating disorder prevention can also include spreading awareness about the signs of eating disorders and putting funding into more mental health resources nationwide.
How can I treat my own eating disorder?
Eating disorders are complex mental health conditions requiring professional support. Because the conditions often involve physically-impactful symptoms like excessive exercise and forced vomiting (which can cause acid reflux), they often require medical treatment as well as mental health support. You can take steps to reduce symptom impacts at home, such as by practicing coping techniques. However, for symptom remission, contacting your doctor, a therapist, or a nutritionist may be most effective.
What are treatments for binge eating disorder?
Binge eating disorder can be treated using multiple methods. One of the most effective options is cognitive-behavioral therapy (CBT), which looks at the causes behind the symptoms, beliefs one has about themselves, and ways to separate thoughts from behaviors. Exposure therapy, a subset of CBT, may also be helpful for BED.
What is the primary mental health prevention of eating disorders?
Education can be a powerful tool in preventing eating disorders, allowing more people to know about the symptoms of these conditions and the treatment options available for them. Early intervention may reduce the risk of serious consequences and might also lead to earlier symptom remission for people with eating disorders.
Why should we care about eating disorders?
Eating disorders can impact anyone, regardless of culture, background, class, sex, gender, sexuality, or identity. Even if you don’t know someone with an eating disorder, anyone you love could develop one. More understanding of mental illnesses can lead to improved awareness in communities, which can lead to earlier intervention and safer and more effective treatment.
How do you stop an eating disorder early?
One of the most effective ways to stop an eating disorder early is by getting early intervention from a therapist or doctor. If you notice symptoms of an eating disorder in yourself or others, seek treatment quickly. They will be able to help you form a treatment plan.
What treatments are used to help children with binge eating disorder?
Children with binge eating disorder and other eating disorders may respond well to cognitive-behavioral therapy, dialectical behavior therapy (DBT), or more intensive inpatient treatment. However, many types of treatments are used for eating disorders in children. Reach out to your child’s pediatrician or therapist to work on a treatment plan.
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