Mental Health Help For Eating Disorders

Eating disorders can be dangerous mental illnesses that lead to significant impairment or death when left untreated. If you or someone you love is living with an eating disorder, finding help as soon as possible may be crucial for preventing severe long-term health impacts. 

Recovering from eating disorders may require a multifaceted approach. Talk therapy may help individuals let go of any distorted ideas about food, weight, and body image. Advice and supervision from medical professionals can assist them in restoring their bodies to a state of metabolic balance. Meanwhile, friends and family members may be able to provide motivation, accountability, and encouragement when affected individuals find eating disorder recovery difficult.

Types of eating disorders: anorexia, binge eating, and more

Although some people may think of an eating disorder (ED) mainly in terms of food restriction, clinical psychology has identified several different kinds of disordered eating. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), recognizes the following eating disorders:

1. Anorexia nervosa (commonly referred to as anorexia): A disorder in which individuals tend to severely limit their food consumption.
2. Bulimia nervosa (bulimia): A disorder in which an individual periodically binges (compulsively eating a lot of food) and engages in behaviors meant to compensate, such as forced vomiting or excessive exercise.
3. Binge eating disorder: A disorder marked by frequent binge eating without accompanying efforts to purge or compensate.
4. Avoidant/restrictive food intake disorder (ARFID): A disorder that typically leads people to avoid eating certain foods due to associated sensory discomfort or intense anxiety about vomiting or choking.
5. Other specified feeding and eating disorders: A category that includes people who meet some but not all of the criteria for diagnosis of other eating disorders.
6. Pica. A disorder that typically involves compulsively eating or swallowing non-food materials, such as sand, glass, wood, paper, or small inedible objects.
7. Rumination disorder. Also known as “rumination syndrome,” a rare condition in which someone reflexively regurgitates food after swallowing it. 

Risks of an untreated ED

Eating disorders can pose severe health risks. Some experts regard eating disorders as the most potentially deadly mental illnesses, with some estimates suggesting that they may lead to a risk of dying. Even when they aren’t fatal, eating disorders can cause major impairment and damage to the body.

Malnutrition due to the food restriction or purging that may accompany an eating disorder can deprive a person of key nutrients and energy. Resulting problems may include heart damage, diminished lung function, dizziness and weakness, electrolyte imbalance, and gastrointestinal difficulties.

Also, binge eating disorder can result in gaining weight at unhealthy rates. Obesity can be common in people with binge eating disorder and bulimia and can lead to a host of other negative health outcomes, including heart disease, diabetes, and cancer.

Eating disorders may also cause or reinforce other mental health conditions, such as anxiety, depression, and lack of self-esteem. This can have a significant impact on well-being, and the risk of suicidal behavior tends to be high in people with eating disorders. 

If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.

Mental health treatments and support

Successful recovery from eating disorders is possible. While some individuals may continue to need psychological support after getting eating disorders treated, many eventually resume beneficial eating behaviors and achieve a stable, healthy weight. According to Dr. Philip Mehler, the founder and executive medical director of the ACUTE Center for Eating Disorders, the body can recover from the damage done by these eating disorders given time and proper nutrition.

Psychotherapy for eating disorders

Eating disorders are often driven by attitudes about body weight, attractiveness, and self-worth. Successful eating disorder recovery typically involves working with a mental health professional who can help people overcome a distorted body image or feelings of shame and helplessness. Effective eating disorder therapies may also involve practicing behavioral control, emotion regulation, and interpersonal skills.

The right type of therapy may depend on the specific eating disorder a person experiences. Here are the current treatment recommendations for the most common and dangerous eating disorders:

Effective therapies for anorexia

Effective therapies to treat bulimia

Currently, the therapeutic strategy with the best evidence for effectiveness in bulimia is cognitive-behavioral therapy. For those who don’t respond well to this treatment, interpersonal therapy (IPT) may be an effective alternative, and there’s also some evidence supporting the use of dialectical behavior therapy (DBT) and integrative cognitive-affective therapy (ICAT). 

Effective therapies to treat binge eating disorder

Many of the recommended approaches for anorexia and bulimia have also been found helpful for binge eating disorder, including CBT, IPT, and DBT. There’s some evidence that CBT could be slightly more effective and it’s currently considered the treatment of choice for binge eating disorder.

Effective therapies to treat ARFID

Research into the treatment of avoidant/restrictive food intake disorder is still sparse since it hasn’t been a defined diagnosis for very long. However, both CBT and family-based treatment show promise for this eating disorder. 

Medical management options

In addition to talk therapy, effective eating disorder treatment often requires working with a physician. Otherwise, you may be at risk of refeeding syndrome—a life-threatening shift in electrolyte balance that can happen when a severely malnourished individual resumes normal eating. 

A doctor may also prescribe medications that could support your eating disorder recovery. Although pharmacological treatment by itself is often not considered as effective for these disorders, some evidence suggests that antidepressants like fluoxetine may help enhance the outcomes of psychotherapy for eating disorders. 

In addition to working with a physician, you might consult a dietitian or other expert for nutrition counseling and supervision. This may help alleviate fears about weight gain while helping you resume eating. 

How to talk to someone about getting help for eating disorders

Encouraging someone with an eating disorder to seek treatment could make a significant difference in their well-being. However, it can be a tricky subject to broach, since many people with eating disorders feel shame and distress around the subject. 

The conversation may go better if you use frequent “I statements,” highlighting your own concerns about their health and happiness. You may also want to focus on specific behaviors or health effects you’ve observed rather than stating outright that you think they may need help for an eating disorder. Avoiding comments about their appearance or weight may also be a good idea.

For example, you could try saying something like the following: “I’ve noticed that you’ve skipped some meals lately, and I’m concerned about your health. Do you need someone to talk to?”

Whether or not they’re receptive, it’s often best to emphasize that you’re happy to help them in any way you can, whether by offering a listening ear or assisting with practical health and wellness matters. Doing some research beforehand can prepare you to suggest possible eating disorder treatment resources if the person is interested in getting help. 

You may also want to mentally prepare for defensive reactions, such as anger and denial. It may take several discussions before the person is ready to admit they need assistance. 

Supporting someone in recovery

If someone you know is actively working to recover from an eating disorder, you might wonder what you can do to help. While every person’s recovery journey may be different, you may be able to support your friend or loved one with some of the following strategies:

• Educate yourself about eating disorders and treatment options.
• Be patient and understanding, even when it seems like their progress is slow.
• Give them opportunities to talk about negative feelings and sources of stress in their life.
• Provide praise and positive reinforcement for things other than their appearance, body, or eating behavior.
• Offer pragmatic assistance, such as driving them to therapy or helping them research ways to pay for treatment.
• Participate in family therapy with them (if applicable).
• Emphasize that you believe in them and offer encouragement when they’re having a difficult time with recovery.

There are a few areas of discussion that may be best avoided if you’re trying to assist someone in recovering from an eating disorder. The first is making comments about their appearance or weight. Even something that’s intended as positive might prompt feelings of insecurity. 

Also, it may be best to avoid urging the person to eat unless it’s part of an eating disorder treatment plan. Placing too much pressure on them could cause them to withdraw and become further isolated. Also, making assumptions about their feelings or trying to analyze the underlying causes of their eating disorder might also be counterproductive. Instead, you may want to focus on listening and providing nonjudgmental support.

Finding mental health support for eating disorders

When you’re seeking help with an eating disorder, talking to a doctor can be a useful first step. As noted above, having oversight from a physician can be vital for a safe recovery. A doctor might also be able to refer you or a loved one to a qualified mental health provider to help with the psychological aspects of an eating disorder. 

Various nonprofits and professional associations also offer tools to help you find a therapist with eating disorder-specific expertise, including:

• National Association of Anorexia Nervosa and Associated Disorders (ANAD) Treatment Directory
• National Alliance for Eating Disorders Treatment Center & Practitioner Directory
• LEAP AAPI Provider Directory (culturally sensitive care for Asian Americans and Pacific Islanders)
  

Online mental health care and help for eating disorders

Individuals can also receive mental health help for eating disorders over the internet. This option can let you or a loved one cast a wider net in your search for care than you could if you were limited to nearby providers. As a result, it may be easier to find a therapist who is a good fit. Also, online therapy can take place via audio, video, or live chat from the comfort of home or anywhere with an internet connection.

Eating disorder treatment online is a newer approach, but evidence is accumulating that it can provide valuable help for eating disorders. A 2020 review of the existing research reported that the majority of online interventions for eating disorders showed significant positive effects on a variety of eating disorder symptoms.