Keys to Effective Bulimia Treatment
Young girls and women who struggle with bulimia know how difficult it can be to overcome. Often, it isn't enough to simply stop the behavior binging and purging. It takes a change in their outlook, the way they see themselves, they way they interact with others and they way they interact with food.
Nutritional rehabilitation
Bulimia can cause significant and even permanent damage to the body if left unchecked. The first aim of a treatment program is to restore and maintain a healthy balance. Establishing a regular pattern of normal sized meals, improving attitudes related to bulimia, supporting healthy but not excessive exercise are all important steps to maintenance of healthy living. Another important aspect is resolving co-occurring conditions, like mood or anxiety disorders. Often, recognizing and working through what happens leading up to bulimic behavior can be vital in controlling those urges.
Counseling
Typically, both group and individual counseling is extremely helpful. Individual and group psychotherapy have proven to be effective ways to understand and change the underlying psychological causes of bulimia. Family or marital therapy can help the person maintain the changes when she returns home by making their family members more aware of their problem, and learning coping mechanisms.
New insights and experiences
An essential part of treatment is to learn to live with the positive changes after returning home. While some residential facilities do not allow the patients to leave during treatment, others encourage activities that mirror the ones they will experience after treatment has ended. Some treatment centers take their patients to movies, shopping, lake outings, horseback riding, and so on. These experiential outings help the girls and women to learn that they can stick to the changes they are making after they end treatment.
Making Eating an Enjoyable Experience
Feeling comfortable and happy eating is a very important part of life. Parents need to foster and create an enjoyable experience for their children that help to promote healthy living and good choices in the future.
Children go through many stages in their development and the types of food and ways in which they eat often change. For example, toddlers are classically known as picky eaters who find a few things that they like and then only want to eat those items. However, a few weeks or months later, those items then fall out of favor and may suddenly be "yucky" and a new food becomes the chosen favorite with the old favorites no longer being eaten at all. Older children may have other interests, such as friends or sports/hobbies, and don't want to make time to sit down and eat. Eating with family becomes a chore to be avoiding or simply tolerated.
These situations can often lead parents to feel frustration or be unsure how to get their children to eat properly. There are several ways that parents can work to create an enjoyable and healthy eating experience for their family, including:
- Atmosphere — create a fun and happy atmosphere in which mealtime becomes a family event that all want to participate it. It is a time to enjoy being a family and not a chore to be avoided.
- Making Meal Time Quality Time — when the family gathers for meals, it should be a time to talk and learn about each other's day and interests. Families should avoid turning on the television/radio, eating in front of the television, reading books, etc., and instead should be interacting and talking together.
- Making food colorful or exciting — for younger children or picky eaters, parents can try different techniques to make food colorful or different in ways that will intrigue the child. For example, food coloring can be added to mash potatoes to make them the child's favorite color or cookie cutters can be used to make "plain old peanut butter and jelly sandwiches" suddenly become the shape of the child's favorite character or a theme, such as a tree, star or stocking for the holidays. These techniques can make everyday food exciting and something new that the child wants to eat, instead of something that they have to eat.
- Having children help cook — children, even as young as preschool age, love to be helpful and be a "big kid." Parents can use this curiosity and desire to make food and mealtime fun. Children that are allowed to help in small ways, such as holding a measuring cup while you pour something into it or mixing up something in a bowl, feel ownership and a part of the experience. This will often create a level of excitement that causes the child to eat their meal because they had a part in creating it instead of it being something that is given to them and which they had no say in.
- Allowing choices whenever possible — children, especially young ones who are just beginning to learn that choices in life are possible love to have the opportunity to influence what is eaten. Parents can allow the child to do things like choosing which vegetable the family will eat for dinner out of a selection given to them or which of several options they want for a snack. Again, this sense of ownership and control over what they eat can lead to a more enjoyable experience.
- Trying different foods and menus — families can often get into a "rut" about what meals they eat. Busy parents are often struggling just to get a meal on the table after a long day and creativity can be lost. They rely on a list of meals that are eaten over and over and become a chore to the family to eat again. By trying new ethnic foods or buying a new cookbook and allow each child to choose a meal that appeals to them, the family can again create an excitement and enjoyment about eating together. Older children, such as teenagers, can even be given the responsibility to create and prepare the meal for an evening, which in addition to making an enjoyable family experience, can also give the busy parents a night off.
- Watching what you say — it is important for parents to be conscious of the messages that they may be passing on to their children through what they say. A simple comment like "you're eating all the time lately," or "you are fat/gaining weight/etc," or "you need to watch what you eat if you want to stay thin like you are now" can cause severe problems for the child. For a child who may already have a poor self-esteem level or that dislikes their appearance and behavior around food, these types of comments from parents or family members can influence the development of an eating disorder. If parents have concerns about the amount or way their child is eating, they need to approach it in constructive ways that reinforce their love for the child and may need to seek professional assistance if the child's behaviors or beliefs have become obsessive and control over food is being experienced.
Parents have an important role in creation of healthy eating habits in their children. By trying different techniques and strategies, they can make eating a family event and one that is enjoyable and fun for the whole family.
Bulimia Gone Bad
It's easy to shrug off eating disorders as something that happens to somebody else's kid. In fact, it's not unheard of for someone to think that having an eating disorder is somewhat 'glamorous', or that a person who has an eating disorder has amazing self-control and willpower. This type of misinformed thinking is not only wrong, but also dangerous! Most people who suffer from eating disorders do so quietly and often without anyone suspecting the pain and discouragement they are experiencing. The quest to be thin, feel beautiful, and be successful, is often accompanied by psychological issues due to stress, abuse or other external factors. These may contribute to many unacknowledged cases of Anorexia Nervosa, Bulimia and binge eating. There are many famous people who have suffered from eating disorders who share their struggles openly.
Among these are Mary-Kate Olson, Calista Flockhart, Kate Dillon and Paula Abdul. All have admitted to struggling with eating disorders. Paula Abdul is an official spokesperson for National Eating Disorders Association and shares her struggles with bulimia and negative body image from an early age. Paula wants young women to know it is one of the hardest things to talk about and deal with, but also important for them to realize bulimia is not about food, it is about feelings. Mary-Kate, after months of rumors about an eating disorder, finally checked herself into a treatment facility. She celebrated her recovery by donating thousands of dollars worth of designer clothing to a thrift store. Katherine McPhee, a finalist on American Idol in 2005, also checked herself into a treatment facility, Los Angeles Eating Disorder Center of California, where she learned how to eat appropriately. She learned that there are no 'bad' foods and that all foods eaten in moderation are okay. Two members of the former girl band Spice Girls have received treatment for eating disorders. One of these women, Geri Halliwell, emphasizes that there are many people who want to help. She is quoted as saying "I can honestly tell you from personal experience, that worrying about an eating disorder really can get you down. There's nothing to be ashamed about. You'll be amazed at the difference it'll make to your whole life if you tell someone you trust. There are lost of people who want to help and you really CAN'T fight this one on your own. It might be a hard decision to make, to tell people and to seek help but, trust me it's nowhere as hard as trying to deal with it on your own." Geri also wrote a book about her struggles entitled "Just For The Record". Calista Flockhart admitted, after years of denial, to an eating disorder. She finally admitted to over-exercising, under-eating and abusing her body. Kate Dillon struggled for years with trying to achieve the 'ideal' weight for her modeling career. As a top ranked print and runway model, photographers told her that she was too large even though she was already underweight. She took time off from modeling to work on her body image and, when returning to modeling, took work as a plus size model. She is now very proud of her healthy physique and the fact that she overcame her eating disorder and is successful on her own terms. Actress Kate Winslet has also become a success story in her struggle with eating disorders. She has been honest about her struggles with weight. She recalls being a bit heavy in high school and having classmates who called her "Blubber". This criticism led to depression and eating disorders. She was able to overcome the battle and today is healthy, happy, and satisfied with her curves. She says "I'm happy with the way I am... I'm naturally curvy. This is me, like it or lump it. People think that if a woman isn't rail-thin, then there must be something wrong with her - it's such nonsense".
Unfortunately, not all celebrities who suffer from eating disorders are lucky enough to overcome them. Just recently, in 2006, supermodel Ana Carolina Ruston died from complications of Anorexia Nervosa. Karen Carpenter died at the age of 32 after going on a water only diet to lose weight. She actually began to receive treatment and was recovering from her eating disorder at the time of her death. Unfortunately, her heart was weakened as a result of her eating disorder and she died in spite of her attempts to recover from her illness. Karen's death was partially responsible for bringing the struggles of an eating disorder into the public light.
Extreme dieting is not glamorous, it is not enviable, and it is not something to be dismissed lightly as a passing fad or a whim. Extreme dieting is an eating disorder, an illness, and one that has taken many famous and talented people from us. Increased awareness and the willingness of those who have recovered to share their struggles are a great blessing in the fight against eating disorders.
Equine Assisted Therapy for Eating Disorders
People suffering from eating disorders often need unconventional methods to assist them in changing their lives. Equine Assisted Therapy is one of these methods which is proving to be very effective.
Equine Assisted Therapy is using horses to help facilitate treatment of an illness or injury. In this case, horses assist people suffering from eating disorders. By providing a non-clinical, judgement-free environment where the eating disorder is not the primary issue. Additionally, working with the horses can give a sense of empowerment. People struggling with eating disorders have created a life with detrimental rules and structure. Working with the horses questions this structure and places focus on something other than the eating disorder.
There are different methods of Equine Assisted Therapy. Ability to ride a horse is not necessary to participate in Equine Assisted Therapy. In many programs the patients don't actually ride the horses. Rather, they try to relate to the horses and teach them to do various things such as running in a circle, jumping, or other activities in a coral. Generally non-verbal cues are used to try to instruct the horse to do what the patient wants. Problem solving, assertiveness, cooperation, and teamwork are skills that are enhanced and taught. Many of the tasks that they are trying to get the horse to do require concentration and perseverance. It is important for the patient to pay attention to the cues that the horse is picking up and that they are sending. Equine therapy gives participants a sense of accomplishment as they master new skills, overcome uncertainties and address fears. The idea behind Equine Assisted Therapy in relation to eating disorders is to help patients understand how they interact with others. It is also a very effective way to improve communication skills. Participants need to learn not only how to communicate effectively with the horse, but to communicate effectively with their teammates in a variety of activities.
After receiving training in Equine Assisted Therapy, two counselors at House of Hope, a drug treatment facility, made the following observation "There is something magical about the human-horse bond, about the energy levels involved. A lot of animals are used in therapy...but with horses, there's the respect factor. You can't bully them. If you give respect, you get respect." (eqgroup.com/library). By working with the horses, participants in Equine Assisted Therapy sessions learn things about themselves and their relationships which, after working with the horses, are then discussed. Feelings, behaviors and communication patterns are examined. One reason that horses are so effective in comparison to other animals is their sheer size. Overcoming possible fears and inhibitions as well as by learning to control such a large animal can translate quite effectively into overcoming fearful and challenging situations in other aspects of an individuals life. Like humans, horses are social animals. They have distinctive personalities, moods, likes and dislikes. Learning to gauge these moods and understand these characteristics are skills that can be incorporated into real life situations during and after recovery from an eating disorder.
One young girl who participated in an Equine Assisted Therapy program in conjunction with her treatment for Anorexia Nervosa made the observation "Horses aren't judgmental; they aren't looking to see what you're wearing or how big your thighs are. They don't care if you have a feeding tube in your nose.
Developing a relationship with a horse during treatment for eating disorders is a great way to engage in a healthy and beneficial relationship that doesn't focus on appearances. Another benefit is that due to the physical rigors of caring for and riding a horse, the participants become aware of how their body feels and functions. It becomes necessary to have health and vitality to engage in this physical activity.
Equine Assisted Therapy is a relatively new field of therapy. It is being used in many treatment centers for help with drug dependency, attention deficit disorders, self-mutilation, depression, emotional support and, of course, eating disorders. The results have been shown to be effective and beneficial both short and long term. Avalon Hills Residential Treatment Facility is one of the treatment centers which provides Equine Assisted Therapy for treatment of eating disorders. They have found much success with their program and have a well rounded treatment plan which involves the Equine Assisted Therapy as well as other animal assisted therapies. Their well trained staff of professional counselors, therapists, nutritionists and doctors provides a safe, effective environment for recovery from a variety of eating disorders including Anorexia, Bulimia, and Binge Eating Disorder.
Sources: eqgroup.com, alternativemedicine.com
