Eating Disorder Treatment Differences
A 17 year old girl surveys herself in the mirror. At 89 pounds she is considered by the rest of the world to be thin and wispy. However, in her mind she is fat and getting fatter. Her personal self portrait reflects a girl who is spiraling toward imperfection and ultimately obesity. She is therefore so obsessed that she will go days without eating any substantial meals at all. Because of her eating disorder her life is in jeopardy due to problems with her cardiovascular system and heart function. She will also experience lowered brain function, mineral deficiency, and decreased bone density ultimately resulting in osteoporosis and arthritis. Her personal image of herself not only contributes to her poor health, but in 10-20% of cases like hers, she will die.
Obviously any eating disorder can be difficult to deal with, especially since most problems are complex involving psychological and physical components. Without question, the first line treatment for eating disorders is a regulation of diet and immediate weight gain. However, this will not last if the patient has not changed their habits mentally and emotionally in regards to how they see themselves. There are other external ways to help and eventually cure someone beset with an eating disorder.
- Treatment Centers — More than just a clinic, a treatment center is a wonderful solution for those seeking help with an eating disorder. Patients are surrounded not only by licensed therapists and counselors, but an entire staff of dieticians and friends who function as a support group and learning cohort. This option is ideal for eating disorders such as anorexia (deliberate starvation), and bulimia (binge eating and purging or throwing up). Though there is not "magic-bullet" approach to battling eating disorders, the multifaceted approach of a treatment center is excellent.
- Clinics — Much like a treatment center, a clinic combines some of the approaches to helping someone with an eating disorder. Depending on the clinic however, options may be limited. Clinics also tend to focus more on the medical solutions instead of a more holistic approach. When choosing a treatment source, the clinic or center should be thoroughly researched and the benefits weighed before deciding.
- Therapists — A recent study suggests that psychotherapy is an effective form of treatment and can lead to weight gain, improved psychological and social functioning, and overall better health compared to other less comprehensive programs.1 Individual and family counseling can be of great assistance in battling an eating disorder.
- Counselors — Much like therapists, counselors can individually and in groups talk patients through the specifics of there own self image and how they can change. Counselors also lead support groups and aid families in dealing with a loved one who needs help. Counselors may at times lack the amount of training that a trained therapists might have. However, a counselor often has more "real-world" experience with patients and can discuss as well as treat the problem on their level.
- Friends and Family — One of the single most important and powerful forces for change in the lifestyle of someone who has an eating disorder is those that love them. It is very helpful indeed for a patient suffering from an eating disorder to be supported and loved by those around them. Often, well meaning friends or relatives make comments that are incorrectly interpreted or lead the patient towards a relapse. For this reason the family support group should be counseled in understanding and helping their loved one through this difficult affliction.
- Self Education — It is so seldom that those with an eating disorder educate themselves on what a healthy person really should be. Often they believe only what they hear and see. This warped sense of reality can be righted with education. Because there is so much information that is unverified, his type of treatment is best done under the care of a trained therapist or counselor. Once someone is education at to the dangers of what they are doing to themselves, they will be more likely to change. Because the patient wants to be thin, self education most often neglected.
- Hospitalization — In particularly serious cases hospitalization may be required. In states where such legislation exists, it may be done even involuntarily. This is not the most ideal treatment option for the simple fact that those recovering from an eating disorder, who were forced against their will to undergo treatment, often harbor a true anger for those who they feel "robbed" them of their quest for perfection. They treasure their thinness so much that once away from the watchful eye of hospital staff they regress to their former state. For this reason, any medical treatment must be coupled with a comprehensive counseling program, and if possible self and family education.
- Drug Treatment — It has been common in the past for antidepressants to be prescribed with the intent of treat the anxiety or depression that accompanies most eating disorders. However, medication has not been found to be effective overall at treating anorexia specifically or preventing a relapse.2 Drugs such as Prozac have shown positive results in treating bulimia, however since the two disorders are so similar and often both displayed in the sufferer, drugs should be a last resort option.
1 Source: Hay P, Bacaltchuk J, Claudino A, Ben-Tovim D, Yong PY. (2003) Individual psychotherapy in the outpatient treatment of adults with anorexia nervosa. Cochrane Database Syst Rev, 4, CD003909. PMID 14583998.
2 Claudino AM, Hay P, Lima MS, Bacaltchuk J, Schmidt U, Treasure J. (2006) Antidepressants for anorexia nervosa. Cochrane Database Syst Rev, 1, CD004365. PMID 16437485. Walsh BT, Kaplan AS, Attia E, Olmsted M, Parides M, Carter JC, Pike KM, Devlin MJ, Woodside B, Roberto CA, Rockert W. (2006) Fluoxetine after weight restoration in anorexia nervosa: a randomized controlled trial. JAMA, 295(22), 2605-12. PMID 16772623.
Bulimia Treatment Facility Differences
The word bulimia in its Latin and Greek form means "ravenous hunger". This is a perfect description of what bulimia really is and how it feels to be afflicted by it. Sufferers report eating huge amounts of food in order to satisfy their cravings, and then, with a mixture of intense guilt at a never ending diet once again broken, and a hyperactive internal need to live up to an unrealistic overly thin body image, they regurgitate all the food they have just consumed. This cycle will repeat itself for years, and if left unchecked and untreated, might never end in the life of someone afflicted by it.
Several solutions exist where patients can get help and treatment for anorexia, bulimia, and any other eating disorder. Treatment options and approaches differ from one place to another, and those seeking help ought to make the decision that best enhances their chances for beating this complex psychological and physiological condition.
There are three main options for those seriously tormented by any eating disorder, and bulimia specifically. Each one has a purpose and a proper application, it is however important to understand each one and how they compare. In so doing sufferers of bulimia can make an educated choice on the road to recovery and ultimately be free of this insidious malady.
Eating Disorder Hospitals
Often thought of as the most serious and last option for someone who has bulimia, hospitals generally lean towards eating disorders with an array of medications and weight gain options. In extreme cases where death or severe medical trauma is highly probable, hospitalization may be necessary.
In states where the law permits it, admission of a patient against their will is also an option but should be done in the most extreme cases and only if necessary. It is common when a bulimic has been admitted to a hospital in such manner that they will develop a deep seated resentment and anger towards those that facilitated their admission and this will fuel a more severe relapse.
Hospital treatment for bulimia involves round the clock supervision where antidepressant drugs are administered intravenously as necessary. Vitamins and food supplements are also administered through an I.V. as well as a feeding tube if required. The immediate medical well being of the patient is considered first and foremost with the psychological well being of a patient being secondary. Upon release, the patient is refereed to a therapist or clinic where their disorder is treated further, but this is normally not done at a hospital.
Because hospitalization is not an effective long term solution it should only be considered when a person's life is in immediate danger. It is vital that a more holistic approach be sought to not only care for the physical well being of a loved one but the mental ability fitness as well. Only when a bulimic can see their own flaws, and the vicious and self destructive cycle that they are in, will they change.
Eating Disorder Clinics
Similar to hospitals, Clinics focus on the medical fitness of a bulimic and how what physical state they are in. Clinics use counseling to a certain extent, however the majority of clinics in the country focus on how the physical body is reacting and how to improve it through diet, exercise and medications.
Traditionally, antidepressants are prescribed and monitored at a clinic on an outpatient basis. Sufferers go to a clinic, are treated and examined, oft times they receive counsel for a few minutes, and then they are free to leave. Clinics also offer referrals to counseling groups and family therapists. This however therapy is not often followed up on by the practicing personal at the clinic, and is left to the patient to maintain.
Clinics serve as an excellent follow up to hospital visits. They are a way for a patient to check in and be accountable to someone. The doctor is also able to explain what medical dangers exist in an eating disorder and offer help and encouragement to their patient.
Eating Disorder Residential Treatment Centers
Because bulimia and all other eating disorders are so multi faceted, it is vitally important that the treatment be similar. Those with eating disorders are without question affected physically. However, it is often overlooked that they key to beating the bulimic battle is mostly psychological, and reflect a greater personal struggle with self worth and self control. When a patient can have an accurate picture of what healthy is, and is motivated to live so that they can be so, they will be on the road to recovery.
The most holistic and multifaceted approach to the treatment of eating disorders is Residential Treatment Centers. Patients are not only looked after medically, but are also cared for mentally where the true root of the problem is found. Residential treatment centers allow patients to live there for extended periods of time and undergo constant supervision and treatment. Foods are prepared and served as well and medications on an as needed basis.
Residential treatment centers are not as equipped for acute cases and major emergencies, but are a haven for recovery and education. Patients commonly are taught through activities, group therapy, workshops, and counseling, how to deal with their disorder and overcome it. This approach offers the most well rounded treatment and help for those suffering from bulimia.
Treatment centers also allow for family therapy to take place. This particular approach is highly useful in overcoming bulimia. The family provides a support group where the patient is able to grow and learned without judgment. This is another powerful tool to strengthen those with eating disorders.