Eating Disorder Treatment
Treatment for anorexia nervosa and bulimia nervosa usually requires a team of professionals that works with the patient and family members. The team may include a physician, psychiatrist, psychotherapist, and nutritionist or dietitian. The approach involves a combination of medical management (e.g., antidepressants), psychotherapy (individual, family, and/or group therapy), and nutrition education. Severe cases require hospitalization.
Medical Management of Anorexia & Bulimia
Treatment of eating disorders with medication requires the guidance and monitoring of a psychiatrist or other health care professional who has specialized training in the treatment of eating disorders.
Bulimic patients may be treated successfully with antidepressant medications. The drugs improve mood and body image, reduce the obsessive focus on food and dieting, and reduce the frequency of binges. The long-term benefits of antidepressants are unclear; there is a high relapse rate (80 percent), and most patients who take antidepressants remain symptomatic. Anti-anxiety and, rarely, anti-psychotic drugs are also used. Studies are being done to determine the best course of medical management for bulimia.
Medication may help facilitate weight gain in anorexic patients.
Psychotherapy to Treat Anorexia & Bulimia
Several different types of psychotherapy may be included in the treatment plan:
- Cognitive therapy focuses on changing habits of negative thinking and behaving and on recognizing what triggers negative thoughts and behavior.
- Psychodynamic therapy focuses on understanding the underlying emotional problems and improving the patient's self-esteem.
- Family therapy is critical for patients who live at home, because family dynamics play an important causal role in eating disorders. It also helps in educating the parents about their child's illness.
- Group therapy, when the patient is ready, can be an important source of peer support and role models.
Nutritional Counseling for Patients with Anorexia & Bulimia
A professional nutritionist or dietitian can help patients learn how to manage their weight effectively. They can also help patients better understand how their eating disorders create serious medical problems.
Hospitalization to Treat Anorexia & Bulimia
Most patients with eating disorders can be treated on an outpatient basis, but anorexic patients with severe physical or psychological symptoms may require hospitalization. Inpatient treatment should be administered by a hospital staff that has specialized training in the treatment of eating disorders.
Treatment is aimed at increasing weight in order to relieve physical symptoms and at healing the underlying psychological problems. It typically involves the following:
- Rehydration and restoration of electrolyte balance: patients who are extremely underweight and/or resistant to treatment may need to be given a liquid food supplement or IV.
- Increasing the patient's weight: usually the patient's fluid and food intake and their weight are monitored daily, and caloric intake is gradually increased.
- Nutritional rehabilitation
It is essential that both patients and families be aware that hospitalizing and administering a feeding regimen to an anorexic patient is a life-saving act, not a punishment.