There is no single treatment for eating disorders that works for every individual. Eating disorders are extremely complex, involving any number of underlying factors. A large body of research shows that a holistic and individualized approach to treatment is essential for successful long-term recovery.
A holistic approach addresses various issues of the body, mind and spirit through a variety of treatment therapies. In general, treatment will consist of a combination of therapies covering four areas: medical stabilization, nutritional rehab, pharmacotherapy and psychotherapy.
For individuals who are severely malnourished or dehydrated, treatment will start with medical care to restore stable health and address any other medical issues stemming from the eating disorder.
Nutritional rehabilitation is a major focus in eating disorder treatment. For people with anorexia, this begins with a process known as refeeding, which takes place in an inpatient program. During refeeding, health professionals supervise the process of reintroducing adequate nutrients into the diet. This is a slow process, because too many nutrients too fast can lead to serious medical problems.
Other nutritional services are typically provided by a registered dietitian and include:
- Nutritional evaluation
- Education about essential nutrition
- Risk assessments
- Individualized meal plans
- Strategies for good nutrition
- Weight monitoring
Pharmacotherapy is the use of medications to treat an illness. While no medications have been proven effective for treating anorexia nervosa, several have been approved by the U.S. Food and Drug Administration to treat bulimia and binge eating disorder. These include:
- Fluoxetine, a selective serotonin reuptake inhibitor, which is used to treat both bulimia and binge eating disorder by improving the function of serotonin, the neurotransmitter that controls mood and thinking.
- Topiramate, an anti-convulsant, which has been shown to reduce the urge to binge. It may also help some people lose weight.
- Trazodone, a tricyclic antidepressant, which helps to reduce binge and purge behaviors in people with bulimia. It’s not associated with weight gain, unlike many other antidepressants.
Pharmacotherapy for treating an eating disorder may also include medications to treat any underlying mental or medical illnesses.
Psychotherapy, or “talk therapy,” is the foundation of eating disorder treatment. Psychotherapy helps you:
- Identify and change faulty ideas, beliefs and ways of thinking and behaving
- Develop essential skills for coping with stress, urges and negative emotions
- Improve interpersonal relationships
- Address underlying issues like chronic stress or trauma
Research shows that the most effective psychotherapies for treating eating disorders include dialectical behavior therapy, interpersonal psychotherapy and Maudsley-approach family therapy.
Dialectical behavior therapy helps you address distorted ways of thinking about body image and eating, and it helps alter disordered behaviors surrounding food. It also helps you address other factors contributing to the eating disorder.
Interpersonal psychotherapy helps you learn to cope with the frustration and low emotional states related to dysfunctional relationships. It also helps you develop better communication skills for healthier relationships.
Maudsley approach family therapy is used to treat adolescent eating disorders. It’s based on the family systems theory, which holds that individuals can’t be fully understood in complete isolation, but rather as a part of their family, which is an emotional unit. The Maudsley approach helps families address a wide range of interpersonal issues. Restoring healthy functioning to the family system is crucial for adolescent recovery from an eating disorder.
Read part four of this series, Eating Disorders 101, Part IV: Tips for Long-Term Success, or download the entire series as an eBook.