How to Treat An Eating Disorder

The most effective and long-lasting treatment for an eating disorder is some form of psychotherapy or counseling, coupled with careful attention to medical and nutritional needs. Ideally, this treatment should be tailored to the individual and will vary according to both the severity of the disorder and the patient's individual problems, needs, and strengths.

Psychological counseling must address both the eating disordered symptoms and the underlying psychological, interpersonal, and cultural forces that contribute to, or maintain, the eating disorder.

• The individual needs to learn how to live peacefully and healthfully with food and with themselves.
• Typically care is provided by a licensed health professional, including but not limited to a psychologist, psychiatrist, social worker, nutritionist, and/or primary care physician.
• Care should be coordinated and provided by a health professional with expertise and experience in dealing with eating disorders.

Nutritional counseling is also necessary and should incorporate education about nutritional needs and planning for and monitoring rational choices of the individual patient.

Many people with eating disorders respond to outpatient therapy, including individual, group, or family therapy and medical management by their primary care provider. Support groups, nutritional counseling, and psychiatric medications under careful medical supervision have also proven helpful for some individuals.

Inpatient Care (including inpatient, partial hospitalization, intensive outpatient and/or residential care in an eating disorders specialty unit or facility) is necessary when an eating disorder has led to physical problems that may be life-threatening, or when an eating disorder has reached a level of severe psychological or behavioral problems. Inpatient stays typically require a period of outpatient follow-up and aftercare to address the underlying issues in the individual`s eating disorder.

The exact treatment needs of each individual will vary. It is important for individuals struggling with an eating disorder to find a health professional they trust to help coordinate and oversee their care.

Eating disorders arise from a variety of physical, emotional, social, and familial issues, all of which need to be addressed for effective prevention and treatment. Prevention is any systematic attempt to change the circumstances that promote, initiate, sustain, or intensify problems like eating disorders.

Primary prevention refers to programs or efforts that are designed to prevent the occurrence of eating disorders before they begin. Primary prevention is intended to help promote healthy development. Secondary prevention (sometimes called "targeted prevention") refers to programs or efforts that are designed to promote the early identification of an eating disorder---to recognize and treat an eating disorder before it spirals out of control. The earlier an eating disorder is discovered and addressed, the better the chance for recovery.

Basic Principles for the Prevention of Eating Disorders

1. Eating disorders are serious and complex problems. We need to be careful to avoid thinking of them in simplistic terms, like "anorexia is just a plea for attention," or "bulimia is just an addiction to food." Eating disorders arise from a variety of physical, emotional, social, and familial issues, all of which need to be addressed for effective prevention and treatment.
2. Eating disorders are not just a "woman`s problem" or "something for the girls." Males who are preoccupied with shape and weight can also develop eating disorders as well as dangerous shape control practices like steroid use. In addition, males play an important role in prevention. The objectification and other forms of mistreatment of women by others contribute directly to two underlying features of an eating disorder: obsession with appearance and shame about one`s body.
3. Prevention efforts will fail, or worse, inadvertently encourage disordered eating, if they concentrate solely on warning the public about the signs, symptoms, and dangers of eating disorders. Effective prevention programs must also address:
• Our cultural obsession with slenderness as a physical, psychological, and moral issue.
• The roles of men and women in our society.
• The development of people`s self-esteem and self-respect in a variety of areas (school, work, community service, hobbies) that transcend physical appearance.
4. Whenever possible, prevention programs for schools, community organizations, etc., should be coordinated withopportunities for participants to speak confidentially with a trained professional with expertise in the field of eating disorders, and, when appropriate, receive referrals to sources of competent, specialized care.

With a careful search, the provider you select will be helpful. But, if the first time you meet with him or her is awkward, don’t be discouraged. The first few appointments with any treatment provider are often challenging. It takes time to build up trust in someone with whom you are sharing highly personal information. If you continue to feel that you need a different therapeutic environment, you may need to consider other providers. Once you have chosen a treatment provider, you may want to consider asking these questions in your first meeting.

1. What is your experience and how long have you been treating eating disorders?
2. How are you licensed? What are your training credentials? Do you belong to the Academy for Eating Disorders (AED)? AED is a professional group that offers its members educational trainings every year. This doesn’t prove that individuals are up-to-date, but it does increase the chances.
3. What is your treatment style? Please note that there are many different types of treatment styles available. Different approaches to treatment may be more or less appropriate for you dependent upon your individual situation and needs.
4. Do you or your facility have a quality improvement program in place or regularly assess the outcome of the treatment provided?
5. Are you familiar with either the APA Guidelines or Britain’s NICE Criteria for the treatment of eating disorders?
6. What kind of evaluation process will be used in recommending a treatment plan?
7. What kind of medical information do you need? Will I need a medical evaluation before entering the program?
8. What is your appointment availability? Do you offer after-work or early morning appointments? How long do the appointments last? How often will we meet?
9. How long will the treatment process take? When will we know it’s time to stop treatment?
10. Are you reimbursable by my insurance? What if I don’t have insurance or mental health benefits under my health care plan? It is important for you to research your insurance coverage policy and what treatment alternatives are available in order for you and your treatment provider to design a treatment plan that suits your coverage.
11. Ask the facility to send information brochures, treatment plans, treatment prices, etc. The more information the facility is able to send in writing, the better informed you will be.

Support from parents and family is a crucial part of the treatment process. Below are some questions you can ask the treatment provider to assist you in providing the best support possible for your loved one. Remember you may need to be proactive to help ensure the communication process flows smoothly. And don’t forget to find support for you! As a parent, family member, or friend it is easy to overlook the self-care you need while you are focused on your loved one’s recovery.

1. How can I help to support my child during treatment? What is my role within the treatment?
2. How often will you talk to me about my child’s progress?
3. What if my child doesn’t want to participate in therapy?
4. How will the family be prepared for the patient to return home (if in a treatment center)?
5. What books, websites or other sources of information would you recommend?
6. How much weight gain should be expected in what time period if my loved one has anorexia nervosa? What can I do to support my family member during a time of weight gain?
7. How do family members determine if purge behavior is occurring in the home setting? What action should we take if we notice this behavior?
8. If my family member is being treated as an outpatient, how will the team decide if more intensive intervention is needed?
9. How do I assess if the treatment personnel are functioning as a team? Ask how often the team members communicate with each other. Remind and encourage the treatment team members to communicate with one another, which is especially important for those in separate locations such as in outpatient treatment. Even if the team doesn’t talk to each other, you can serve as a liaison to relay information.
10. If I become anxious about my family member or if problems are experienced, who should I call?

It is important to discuss with your children the dangers of trying to alter one’s body shape through dieting, the value of moderate exercise for health, and the importance of eating a variety of foods in well-balanced meals consumed at least three times a day. Help your children appreciate and resist the ways in which television, magazines, and other media distort the true diversity of human body types and imply that a slender body means power, excitement, popularity, or perfection.

101 Ways to Help Your Daughter Love Her Body offers suggestions for counteracting the media, fashion trends, the lure of Barbie and other cultural input that may negatively impact a girl's confidence and self-image. Mothers need to consider the detrimental messages sent when they criticize their own bodies, and fathers to focus on female attributes other than size and shape.

The best way to prevent your child from having an eating disorder is to do whatever you can to promote the self-esteem and self-respect of all of your child in intellectual, athletic, and social endeavors. Give boys and girls the same opportunities and encouragement. Be careful not to suggest that females are less important than males, e.g., by exempting males from housework or childcare. A well-rounded sense of self and solid self-esteem are perhaps the best antidotes to dieting and disordered eating.

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