Eating Disorder Treatment
1. Anorexia Nervosa
2. Bulimia Nervosa
3. Binge Eating Disorder
4. Disorder Not Otherwise Specified
5. Eating Disorders Require Long-Term Care
6. Treatment Can Help
7. Cognitive Behavioral Therapy
8. Inpatient and Outpatient Settings
An eating disorder is a serious medical and psychological condition that can affect any family at any time. It does not discriminate based upon race, creed or socioeconomic demographics. Teens and adults, boys and girls, and men and women can suffer from one of the many eating disorders that have been identified. When an eating disorder develops within an individual, the entire family can suffer, but no one more than the victim.
In order to fully understand the best eating disorder treatment, it is necessary to know what an eating disorder is and the differences between the main categories of disorders. There are four main diagnoses for eating disorders:
- Anorexia nervosa
- Bulimia nervosa
- Binge eating disorder
- Eating disorder not otherwise specified
Anorexia nervosa is the most recognized eating disorder. This may be related to the characteristics that identify it. An individual who suffers from anorexia has an aversion to food and is terrified of gaining weight. In fact, one of the major symptoms or warning signs for anorexia is excessive weight loss and refusal to acknowledge the weight loss. Other symptoms include:
- Having a preoccupation with counting calories
- Developing a strict exercise routine with no margin for missing exercise for any reason
- Wearing baggy clothing
- Denial of hunger even at regular mealtimes
- Developing food rituals such as eating specific foods in a pre-established order or arranging food on the plate in a specific pattern
- Concerns about gaining weight or being “fat” despite continued and excessive weight loss
While 90 to 95 percent of those who suffer from anorexia are female, men and boys also suffer from the disorder. The disorder typically appears in early adolescence and can be treated successfully with proper care and diagnosis.
Unlike those who suffer from anorexia, the individual afflicted with bulimia nervosa will show very few outward signs of the disorder. For instance, they can very easily maintain a healthy body weight or be slightly overweight. This disorder will not cause the individual to have an aversion to food; rather the main characteristic of bulimia is the binging in private and subsequent evacuation of the food intake from the body. This can be accomplished in several ways:
- Excessive exercise
Because much of the food taken in will remain in the system despite efforts to remove it, the individual’s weight may not be affected. There are many other signs and symptoms for parents or others to watch for, however, that can indicate an individual is suffering from bulimia. These include:
- The unexplained disappearance of large amounts of food in a home or office setting
- A collection of wrappers or containers in a private or hidden location of a bedroom
- Excessive amounts of empty laxative or diuretic packaging in the trash or hidden in a secret location
- Purging signs, such as the smell of vomit after a bathroom visit with no other indication that someone has become ill, or frequent trips to the bathroom during a meal or immediately following a meal
- Swelling of the cheeks or jaw
- Bruising, scrapes or calluses on the hands and knuckles
- Excessive exercise and an obsessive need to burn calories
- Staining or discoloration of the teeth
The number of young people affected by bulimia is double that of anorexia, and approximately 80 percent of the victims are female. Boys who develop the disorder may be trying to “make weight” for sports-related activities; therefore, it is important not to assume that because someone is fit and athletic they cannot suffer from bulimia.
Binge Eating Disorder
Binge eating disorder shares one major symptom with bulimia. Both of these disorders are marked by the excessive binging on foods in a short period of time; however, the individual suffering from binge eating disorder is not concerned with expelling the food. Because of this significant difference, the individual may become mildly or morbidly obese.
The signs and symptoms of binge eating disorder mirror those of bulimia except for the indications of purging.
Eating Disorder Not Otherwise Specified (EDNOS)
EDNOS as a diagnosis for eating disorders was developed because very seldom does an individual’s eating disorder fall neatly into one of the three “types” listed here. An individual may suffer from pieces of each disorder; for instance an individual who suffers from anorexia may also binge occasionally and then punish herself later for what she sees as a transgression.
Because of the subtle nuances of diagnosis in the field of eating disorders, most of the diagnosis will fall into the EDNOS arena.
Eating Disorders Require Long-Term Care
When an individual suffers from an eating disorder, he or she is also suffering from an underlying psychological condition that has developed into a physical manifestation. The physical ramifications of an eating disorder are varied depending upon the type of disorder the individual develops. Health issues that occur with each condition are:
- Binge Eating Disorder: High blood pressure, heart disease, diabetes, gallbladder disease, high cholesterol, death
- Anorexia: Low blood pressure, premature osteoporosis, muscle loss, dehydration leading to kidney failure, fainting, malaise or overall weakness, lower body temperature, hair loss on the head while a fine “fur-like” hair grows all over the body in an attempt to keep the body warm, death
- Bulimia: Ruptured esophagus from excessive vomiting, tooth decay, chronic irregular bowel movements from abuse of laxatives, gastric rupture, dehydration, death
- EDNOS – When an individual suffers from more than one element of more than one disorder, the effects can be a mixture of all of the disorders
Treatment Can Help Those Who Suffer From an Eating Disorder
An individual who suffers from an eating disorder has a condition that is beyond their control. In lucid, logical moments, they may know and understand that they are harming themselves in sometimes irreparable ways. However, they are unable to stop their thought processes or actions and will continue to harm themselves until they are provided with the benefits of the best eating disorder treatment available.
There are several phases to treating an eating disorder. Depending upon the severity of the condition, the phases may overlap. The first and most obvious indicator to the type of treatment needed will be reflected in the individual’s body weight. If an individual is severely overweight or underweight, attention will be immediately placed upon regaining a healthy body weight.
The next phase of the process will focus on therapy to uncover the underlying causation of the disorder. Many of those who suffer from an eating disorder have a distorted body image. They believe they are unpleasantly shaped or sized. They also believe that if they were of “normal” body type, they would be more accepted by their peers, their parents or others of importance in their lives. Other types of mental disorders that could be at play are:
- Major depression
- Anxiety disorder
- Personality disorder
- Low self-esteem
Many people suffering from an eating disorder feel as though they have no control over their lives. It is imperative that the underlying mental condition be diagnosed and addressed in order to provide the correct medications, if needed and therapy for the individual to begin a path to recovery.
Cognitive Behavioral Therapy
In the past, therapy models for individual therapy focused on the method of treatment rather than the actual individual being treated. This process consisted of weekly or daily visits that could last for years. Cognitive Behavioral Therapy (CBT) was developed as a focused and more direct method to solve psychological issued in partnership with the patient.
The process consists of approximately 16 weeks of individual and group therapy, coupled with homework and self-assessment exercises, to help the individual learn to think more clearly (cognitive) and make better life choices (behavioral) in the future.
Inpatient and Outpatient Settings
The decision to be treated in an inpatient or residential setting for an eating disorder should be made with cooperation from all of the parties involved, including the treating physician, psychologist, family members or in the case of minor children, the parents, and the individual who is suffering from the disorder. This decision can be difficult to reach and several factors may come into play, including:
- Financial commitments if the patient is a breadwinner in the family
- Insurance plan coverage and benefits
- The willingness of the afflicted individual to seek treatment
- The overall health factors for the individual
In some cases, hospitalization is necessary to protect the immediate health needs of the individual. When this happens, a transfer can be arranged to a top treatment center once the acute issues have been resolved. Simply reestablishing a healthy weight through medical intervention will not solve the issue of high-risk behaviors and underlying psychological conditioning that caused the disorder to develop.
A top inpatient, residential facility can offer around-the-clock care to a resident who suffers from an eating disorder. In addition to this high-level of care, the patient will develop ongoing relationships with others who feel as they do – those who can understand how they feel about themselves. Many of the best treatment centers offer holistic and alternative therapies that can help the afflicted individual find new and better ways to express their feelings and regain control over their lives.
If the individual must meet employment or family obligations and their immediate health is not at acute risk, an outpatient program may be able to help them. Outpatient programs offer the same types of Cognitive Behavioral Therapy programs, alternative therapies and holistic nutrition classes that an inpatient program does, but they allow the individual to continue with those aspects of their lives that they cannot put on hold.
The most important aspect of eating disorder treatment is determining the best kind of care for each individual. Any eating disorder is a life-threatening condition that must be taken seriously.