The fundamental goals of treating an eating disorder are to:
To be effective, treatment must identify and explore patients' distressing symptoms and determine how these symptoms help patients cope with their life circumstances. Treatment must also teach patients to manage symptoms themselves and suggest alternative, healthful ways to cope with them. This approach is based upon the belief that patients have the capacity to seek new paths while benefiting from knowledge gained from previous experiences.
Although eating disorder treatment varies from person to person, it tends to be most effective when it is addressed on multiple fronts. For example, a comprehensive treatment program might include:
Much is known about the treatment of eating disorders, and several treatments now have empirical support to substantiate their effectiveness. For example, treatment of adolescents with an eating disturbance should involve the parents, according to the Maudsley Method of Family Therapy, the treatment with the most supporting research.
The Maudsley Method requires that parents attend weekly family sessions and entrusts parents with the task of nourishing their children with anorexia nervosa back to health. Parents are to remain actively informed of the treatment process and goals and attend therapeutic sessions to the extent possible and advisable for their family's unique circumstances.
As much care and consideration should be given to choosing an eating disorders specialist as is given to selecting any healthcare provider or service. It is also important to give treatment some time before judging its effectiveness, as relationships and skills need time to develop.
Individuals seeking eating disorder treatment should ask if providers have been trained in therapeutic approaches that have research support.
For example, cognitive behavior therapy and interpersonal therapy have received preliminary support for the treatment of bulimia nervosa. And cognitive behavior therapy, interpersonal therapy, and dialectical behavior therapy have received support for treating binge eating disorder.
People who wish to seek treatment for disordered eating—for themselves or for a child—are advised to contact their insurance providers first. Those without insurance or whose insurance plan does not cover care for eating disorders are encouraged to discuss self-payment options with the specialist they would like to see, as some specialists are agreeable to establishing a payment plan.
The length of treatment necessary to successfully treat eating disorders varies greatly. For example, some reports indicate that adolescents with anorexia nervosa who are identified early in their illness trajectory may require as little as six months of treatment. In contrast, individuals with a prolonged course of eating disturbance may be in treatment for several years.
The issue of relapse is complex and is greatly influenced by an individual's expectations for treatment. Some people who felt they had lost control of their behavior and were at the mercy of their thinking patterns during their illnesses report complete recovery. With recovery, these people report that they have established a healthy relationship with food, as well as clearer insight into the difference between having certain dangerous thoughts and allowing those thoughts to dictate behavior. Effective treatment often permits a sense of calm distance between thinking and acting.
For others, concerns about eating and discomfort with body image remain as subtle background noise that they have learned to minimize so that it does not greatly impact their quality of life. Others continue to do the best they can to cope with the limitations imposed by their illness.
Last reviewed on 1/28/10
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