Eating Disorders Treatments
Having an eating disorder means your life is on the line – but recovery is possible. Eating disorder treatment saves lives every day, bringing with it hope for a healthy, rewarding future.
Everyone who struggles with an eating disorder experiences the illness differently. This means that different therapies are effective for different people, depending on their unique background, circumstances and needs. In most cases, a comprehensive plan will be necessary to treat every facet of the eating disorder, including medical care, therapy, nutrition counseling and medication, when appropriate.
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Sometimes individuals with eating disorders have difficulty identifying or describing their thoughts and feelings. Art therapy allows people with eating disorders to express themselves in non-verbal ways, without the perceived pressure of one-on-one therapy. Art therapy can also be an outlet to explore body image and media messages, giving people with eating disorders a new perspective on their distorted self-image.
Art therapists use various materials and activities to appeal to patients' creative side, including:
- Colored Markers/Pencils
The artwork patients create becomes a journal of their journey toward eating disorder recovery, which they can look back on and see their progress.
Cognitive-behavioral therapy (CBT) is widely used in counseling for eating disorders to change the way patients think about their bodies and their relationship with food. Unlike some forms of therapy that focus on the past, CBT is an active and practical approach for solving problems and changing self-defeating thought patterns. With new skills, patients are able to reduce eating disorder symptoms, recognize triggers and avoid relapse.
Day-to-day life in recovery is likely going to involve preparing and eating meals, yet many patients feel uncomfortable in the kitchen or grocery store. In culinary therapy, patients may take cooking classes with a chef, plant crops in a garden, or go on grocery store and restaurant outings to help change their relationship with food. As patients begin to view food as a tool for achieving optimal health, they see mealtime as an opportunity rather than a threat.
Dialectical Behavior Therapy
One of the most effective therapies used to treat eating disorders is Dialectical Behavior Therapy, or DBT. This approach, originally developed by Marsha Linehan, Ph.D., is designed to teach patients new coping strategies to more effectively handle difficult emotions. Rather than turning to eating disorder behaviors, patients develop a set of life skills they can draw from for lasting recovery.
The four DBT skill sets are:
- Mindfulness – Staying present in the moment with a deep awareness of one’s thoughts, feelings and actions. Rather than judging a thought or feeling, mindfulness practice helps patients learn to accept whatever they are experiencing in a given moment. With greater awareness, patients are better able to regulate their thoughts and feelings and shift their attention in another direction when their thought pattern is becoming unproductive or unhealthy.
- Distress Tolerance – Learning to accept distress and other difficult emotions that are an inevitable part of life, rather than resorting to eating disorder behaviors. Part of distress tolerance is delaying gratification and avoiding impulsive behaviors, and finding healthier ways to cope such as self-soothing, distracting, and assessing pros and cons.
- Emotion Regulation – Identifying emotions and working to let go of painful feelings to make room for positive ones.
- Interpersonal Effectiveness – Improving interpersonal relationships by increasing assertiveness and communication skills. Some of the skills patients learn include asking for what they need, setting healthy boundaries, and coping with conflict effectively without hurting others or jeopardizing their self-respect.
Eating disorders affect the entire family, causing frustration and concern and drawing attention away from siblings. Recovery isn’t an isolated event – it is a process that unfolds each day, in the presence of family and friends.
Studies show that family involvement is essential for successful eating disorder recovery, particularly for teens. In family therapy, patients have the opportunity to discuss underlying issues and conflicts with their family in the presence of an objective therapist.
The goals of family therapy are to:
- Educate family members about eating disorders and the recovery process
- Instill new conflict resolution skills and communication strategies
- Prepare family members for the patient’s return home (if applicable)
- Help family members learn how to support their loved one’s recovery
- Connect with other families to share stories and support (multi-family therapy)
- Ensure that family members have a support network of their own and a healthy sense of self
With guidance, families can take care of their own needs while offering support and encouragement for their loved one.
Group therapy is a critical aspect of eating disorder treatment. For many people, hearing about the experiences of others and receiving honest feedback from people who are facing similar struggles is one of the most beneficial aspects of treatment.
In a safe, nurturing setting, patients share their pain and in doing so, realize that they are not alone. The camaraderie that develops in the group can build self-esteem and serve as a model for trusting, supportive relationships. The group setting is also a safe place to practice new communication skills and the art of acceptance of both self and others.
In group therapy, patients help one another identify and resolve problems with the guidance and expertise of a professional therapist. With a spirit of caring, they can question each other's distorted thoughts and destructive behaviors and facilitate the process of change. They also learn about nutrition, the process of recovery, relapse prevention, assertiveness techniques, coping skills and other important topics.
Although recovery happens while surrounded by family, friends and professionals, eating disorder treatment is essentially a journey of self-discovery. In individual therapy, patients have an opportunity to explore sensitive personal issues with feedback from a therapist. Common topics for discussion include childhood experiences, difficult emotions and relationship issues.
Depending on the patient's needs and preferences, therapists utilize a variety of approaches in individual therapy, including psychoanalysis, cognitive-behavioral therapy and an eclectic approach that combines a number of theories. Ultimately, one-on-one therapy creates an opportunity for healing by directly addressing the specific issues facing the individual patient.
Eating disorders exact a heavy toll on the body. The longer eating disorder behaviors take place, the more likely the patient is to experience serious, and sometimes life-threatening, health consequences.
Some of the medical complications that arise as a result of anorexia, bulimia and related eating disorders are:
- Heart Disease
- Irregular Menstrual Periods
- Bone Loss
- Digestive Problems
- Kidney Damage
- High or Low Blood Pressure
- Dental Damage
Some eating disorder treatment programs offer some form of movement therapy. While exercise can trigger or exacerbate eating disorder behaviors, movement therapy helps patients become more aware of their bodies and more comfortable in their own skin.
Some of the benefits of movement therapy include:
- A healthier body image and greater appreciation for one’s physical health
- A positive outlook brought on by the combination of movement and music
- Relaxation through breathing exercises
- Acceptance of self and others
Nutrition education and counseling is sometimes offered as part of a well-rounded eating disorder treatment program. Nutrition therapy is typically led by a registered dietitian who works with patients to normalize their food intake and develop a healthy relationship with food. The dietitian may begin with an assessment of the patient's eating patterns, weight, exercise habits, medical concerns and body image.
In a nutrition counseling session, patients may learn about:
- The different types of food, including carbohydrates, proteins and fats, and why the body needs foods from each category
- Portion sizes and eating a variety of foods in moderation
- The consequences of eating disorder behaviors
- Recognizing the body's hunger cues
- Creating balanced meal plans
- Eating in social settings
- Overcoming fears around certain foods
- Healthy exercise routines
- Nutritional supplements
Together, the dietitian and patient create achievable goals and begin working toward those goals with support, encouragement and understanding. Once the patient's basic nutritional needs are being met, they often find that they have more energy, sleep better, and feel happier and more grounded.
Psychiatrists work with patients to assess, diagnose and treat eating disorders. Other mental health issues, such as depression and anxiety, often accompany eating disorders and require dual diagnosis treatment from a team of nurses, doctors and therapists. When appropriate, psychiatrists may prescribe medications to aid in weight maintenance or to treat symptoms of co-occurring mental health issues.
Everyone suffering from an eating disorder needs support. For some, this may come from friends or family, but structured eating disorder support groups can also be beneficial. When combined with other forms of eating disorder treatment, support groups can help patients develop relationship skills and stay motivated in their recovery.
Some of the most well-known eating disorder support groups include:
- Overeaters Anonymous
- Anorexics and Bulimics Anonymous
- Eating Disorders Anonymous