Treatments for Eating Disorders

People with eating disorders often do not recognize or admit that they are ill. As a result, they may strongly resist starting and staying in treatment. Family members or other trusted people can help to ensure that the person with an eating disorder receives needed care and rehabilitation. For some people, treatment may be long term.

Eating disorders can be successfully treated and a healthy weight restored. The sooner your disorder is diagnosed and treated, the better the outcomes are likely to be. Because of their complexity, eating disorders require a comprehensive treatment plan. Treatment involves medical care and monitoring, psychosocial interventions, nutrition counseling, and, when appropriate, medication management.

Treatment of anorexia calls for a specific program that involves three main phases:

  • Restoring you to a healthy weight and keeping you there
  • Treating psychological disturbances such as distortion of body image, low self-esteem, and interpersonal conflicts
  • Achieving long-term remission and rehabilitation or full recovery

Early diagnosis and treatment increase your chances of a positive outcome. Your healthcare provider may consider prescribing medication for you, but it may be started only after you have gained an appropriate amount of weight. A healthy weight is above 85%, but not necessarily as high as 100%, of your ideal weight. To achieve this weight, your intake of calories will be gradually increased.

If your weight loss is severe, care will likely be provided in an inpatient hospital setting in order to treat very serious or life-threatening physical conditions. In a hospital, healthcare providers will develop feeding plans to address your medical and nutrition needs. In some cases, a feeding tubeor nasogastric tube may be recommended. Once malnutrition has been corrected and weight gain has begun, you may receive psychotherapy (often cognitive-behavioral or interpersonal psychotherapy) to help you overcome low self-esteem and address distorted thought and behavior patterns. Families are often included in the therapeutic process.

General Treatment Guidelines for Bulimia Nervosa and Binge Eating Disorder

The primary goals of treatment for bulimia are:

  • To stop binging
  • To stop purging, in the case of bulimia
  • To provide education about healthy eating habits and nutrition
  • To focus self-esteem away from body image and shape

Bulimia and binge eating disorder are treated with nutrition rehabilitation, psychosocial intervention, and medication management strategies. Treatment is generally done on an out-patient basis. Treatment includes establishing a pattern of regular, non-binge meals, improving your attitude related to the eating disorder, and encouraging regular but not excessive exercise. Any co-occurring conditions, such as mood or anxiety disorders , should be treated as well. You may benefit from family or marital therapy.

Treatment of eating disorders involves the following:

Lifestyle changes
Medications
Alternative and complementary therapies
Other treatments


Currently, there are no surgical options for the treatment of eating disorders.

References:

American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html .

Anorexia Nervosa and Related Eating Disorders website. Available at: http://www.anred.com/ .

Eating disorders: facts about eating disorders and the search for solutions. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/publicat/eatingdisorders.cfm . Accessed April 8, 2007.

Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. Philadelphia: Elsevier Mosby; 2004.

National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/ .

Santucci P. A brief overview of therapies used in the treatment of eating disorders: a consumer's guide. Anorexia Nervosa and Related Eating Disorders website. Available at: http://www.anad.org/site/anadweb/content.php?type=1&id=6901 . Accessed April 10, 2007.

Yager J, Devlin MJ, Halmi KA, et al. Practice Guideline for the Treatment of Patients with Eating Disorders. 3rd ed. American Psychiatric Association; 2006. Available at: http://www.psych.org/psych_pract/treatg/pg/EatingDisorders3ePG_04-28-06.pdf . Accessed April 8, 2007.



Last reviewed April 2007 by Janet Greenhut, MD, MPH

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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