Eating disorders can be treated with the following interventions:
Therapists can help you develop a healthier and more realistic self-image. They will help you find new ways to think about your body and yourself. Cognitive behavioral therapy (CBT) has been especially successful when used for people who have bulimia and, along with medicine, has proven to be the most effective treatment for this condition. If you have bulimia, CBT may help you normalize your eating patterns, end binging and purging, and teach you to eat small amounts of food more regularly.
Interpersonal therapy may help you understand and cope with concerns about your relationships. It may help you cope with anxiety and depression that may occur with your eating disorder. It is also useful in addressing social factors that influence your eating behavior.
Interpersonal therapy can help you express your feelings, develop a stronger sense of individuality, cope with change, and address past trauma that might have played a role in your eating disorder.
There are many different types of groups for people with eating disorders. Groups may be part of an inpatient or outpatient program, be led by a private therapist, or exist independently. A therapist, recovered person, or other individual may lead support groups for people with eating disorders. Topics may include coping strategies, body image, nutrition information, spirituality, family issues, art therapy, or a combination of topics. CBT can be effectively conducted in a group session.
Complex family behaviors and attitudes often play a role in eating disorders. Many people cannot recover unless their families recognize their roles in the problem and make changes. Close family members need to understand the disorder and support the patient. Family therapy can play an important part in the treatment plan.
If you have severe weight loss associated with anorexia nervosa, you may be hospitalized. In most cases, people with bulimia do not have to be hospitalized unless they develop anorexia, have nutritional deficiences, need medications to withdraw from purging, or have major depression with suicidal thoughts. A component of successful treatment is the desire and willingness to change.
Generally, hospitalization for anorexia may be necessary if:
Nutritional therapy is necessary for appropriate weight gain. The goal is to restore adequate nutrition, bring weight to a healthy level, and normalize eating patterns. This is done by:
If anorexia is severe enough or the person refuses to eat, life-saving interventions may be used. A feeding tube is used to deliver nutrition. Feeding tubes may include a nasogastric tube or in extreme cases, a jejunostomy (J-tube) or gastrostomy tube (G-tube).
Psychotherapy is more effective after weight loss and malnutrition has been corrected.
American Psychiatric Association. Practice guideline for the treatment of patients with eating disorders. National Guideline Clearinghouse website. Available at: http://www.guideline.gov/content.aspx?id=9318. Updated 2011. Accessed May 18, 2016.
Anorexia nervosa. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114614/Anorexia-nervosa. Updated November 19, 2015. Accessed October 6, 2016.
Bulimia nervosa. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114924/Bulimia-nervosa. Updated June 8, 2016. Accessed October 6, 2016.
Devlin MJ, Goldfein JA, Petkova E, et al. Cognitive behavioral therapy and fluoxetine as adjuncts to group behavioral therapy for binge eating disorder. Obes Res. 2005;13(6):1077-1088.
Eating disorders: About more than food. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml. Updated 2014. Accessed May 18, 2016.
Eating disorders in over 8s: management. National Institute for Health and Care Excellence website. Available at: https://www.nice.org.uk/guidance/cg9/chapter/1-Guidance. Updated January 2004. Accessed May 18, 2016.
Hall MN, Friedman RJ 2nd, Leach L. Treatment of bulimia nervosa. Am Fam Physician. 2008;77(11):1588,1592.
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4/29/2011 DynaMed Plus Systematic Literature Surveillance. http://www.dynamed.com/topics/dmp~AN~T114614/Anorexia-nervosa: Lock J, Le Grange D, Agras WS, Moye A, Bryson SW, Jo B. Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Arch Gen Psychiatry. 2010;67(10):1025-1032.
Last reviewed May 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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