Malnutrition and eating disorders have severely distortionary effects on the brain. For this reason many sufferers do not recognize that they are in need of treatment. Due to the long-term potential complications of maintaining a low body weight, it is crucial that families and friends do not wait for the sufferer to request treatment. The biggest and most important thing that you can do for a loved one that is suffering an eating disorder is help them get their body weight restored – even if they protest it! Eating disorders left unaddressed can be deadly, and the sooner you start treating eating disorders the better chances of full recovery are.
Some of the complications of a low body weight include; Dehydration, anemia, low levels of potassium and magnesium (which can lead to heart problems), hypotension, arrhythmia, kidney failure, liver disease, osteoporosis and many more.
If a person is malnourished this can have devastating long term effects. It is crucial that a low body weight is not endured and that sufferers get weight restored as soon as possible. The refeeding process can be difficult and complicated but thankfully there are programs and centers that focus solely on feeding people with eating disorders. This is not to say that treatment can start and end in a treatment facility, there is a lot of work to be done after the initial refeeding stage is taken care of, and this is where family therapy and outpatient programs are essential to prevent relapse.
Finding the right eating disorder treatment center can be difficult. Follow the link for more information about the process, to learn what good treatment looks like, and for questions to ask any center you are considering. You can also take a look at this article on navigating eating disorder treatment, and our treatment centers list.
Family Based Therapy/ Maudsley Approach
Recent research(1) on the Maudsley approach is positive in implying that family-based solutions are very effective at treating eating disorders(2). This approach utilizes parents as caregivers that are working with the sufferer around the clock to re-feed and restore a more normal body weight. The goal is to restore the sufferers weight and undo some of the neurological and biological effects of malnutrition.
Re-feeding a person with an eating disorder is difficult. The good news is that there are extensive resources for families that are interested in helping their loved one recover. The F.E.A.S.T. forum is a peer-based support forum that exists to give families a structured online resource.
Here is more on family-based treatment for adolescent anorexia.
This article discusses using family-based treatment on young adults with anorexia.
This article covers using family-based treatment for adolescent bulimia nervosa.
Here is more information on refeeding syndrome.
Eating disorders affect the sufferers perception of their own self and others, not to mention the relationship that they have with food. Therapy after weight is restored is most effective because the sufferer is in a better mental and physical state in order to deal with the emotional component to recovery.
Here is more on determining which type of psychological treatment is best for an individual.
Cognitive Behavioral Therapy (CBT)
The patient and therapist work together to identify irrational beliefs and thought patterns which are relevant to the eating disorder. Thoughts about food, body weight, calories and eating are worked on. The behavioral aspects of the disorder are addressed – binge eating, food restriction, dieting, purging and exercise. CBT has good results with bulimia and encouraging results in the latter part of treating anorexia after body weight is restored.
Follow this link for more information on Enhanced CBT for Eating Disorders.
Malnutrition plays a large part in any eating disorder. Nutritional rehabilitation is essential and once weight is restored, patients need to work on forming a structured and stable eating pattern in order to keep weight restored. Working with a dietitian is a good way for patients to garner an understanding about the role of nutrients in their bodies and how to keep themselves healthy and well. This is also a program that would be most effective after weight is restored initially.
Due to anorexia being a chronic disorder, treatment needs to look past the initial inpatient clinic or center. Family-based treatment centers such as the University of California, San Diego have Adult Intensive Family Therapy Programs that are specifically geared towards giving sufferers the support system that they need in order to make long term sustainable recovery possible.
There are plenty of online resources for a person that is living life after an eating disorder. Most of these are peer-based and should not be used instead of a professional or experienced treatment team. Recovered sufferers need to be wary of groups that promote any particular diet or restrictive way of eating as this could potentially trigger a relapse. Eating disorder advocacy groups such as MEAD Advocacy and Activism and IED International Eating Disorder Action work to eliminate triggering websites and erroneous information.
Eating disorders are complicated because they affect neurological and biological systems at the same time. Every sufferer will have their own path to recovery but one thing that is clear is that body weight has to be restored before the behavioral effects can be addressed. After weight restoration, a planned and structured continuation of eating disorder treatment must be maintained in order to prevent relapse and ensure that the individual continues into full long-term recovery.
Written by Tabitha Farrar – April, 2014
DBT Eating Disorder Treatment – How it works, case studies.
Acceptance and Commitment Therapy (ACT) in the Treatment of Eating Disorders
Anorexia Recovery for Orthodox Jews – Kosher Dietary Strategies
Exposure Therapy – How exposure therapy for eating disorders works, a look at the different methods.
“Eating with Your Anorexic” is a book written by Laura Collins (McGraw-Hill, 2005). Foreword by Dr. James Lock, Director of the Eating Disorders Program at Packard Children’s Hospital at Stanford.
“Anorexia and Other Eating Disorders: How to Help Your Child Eat Well and Be Well“, by Eva Musby – Practical solutions, compassionate communication tools and emotional support for parents of children and teenagers.
“Decoding Anorexia” A book written by Carrie Arnold that explains anorexia from a biological point of view.
“Help Your Teenager Beat an Eating Disorder“, James Lock and Daniel le Grange
Publisher: Guilford Publications, Inc.
1. Lock et al. (2010) Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa.
2. Keel et al (2008) Evidence-Based Psychosocial Treatments for Eating Problems and Eating Disorders