Goodies Galore

Learning to focus less on dieting and more on overall health and wellness

Treatments for Eating Disorders

Since I’ve been researching this topic for my presentation, I figured I’d share  since many of you have deal with disordered eating. The information used was from a book by Mash and Barkley and an online source, http://www.aedweb.org/eating_disorders/treatment.cfm. Excuse the citations but it’s in APA format. Please note that there are many more treatments; these are simply the most popular/most researched.

Interventions for Eating Disorders

Regardless of whether one is seeking inpatient or outpatient treatment, it’s recommended that there be a multidisciplinary approach. This may include a psychiatrist, psychologist, social worker, dietician, and nursing staff/consulting team (if client is hospitalized.) If a multi-disciplinarian approach is not used, the treater should have access to outside referrals.

Inpatient/partial hospitalization

  • Inpatient treatment provides a structured and contained environment for clients, allowing clinical support around the clock.
  • Inpatient treatment is necessary for various reasons: when a person is non-responsive to outpatient treatment, if there are medical instabilities or metabolic abnormalities, if their weight is 15-25% below average or if there’s a psychiatric emergency (such as suicidal thoughts.)
  • Some programs are now affiliated with day hospital programs-this means that they can “step-up” and “step-down” to the appropriate level of care depending on their clinical needs.
  • Partial hospital programs are for clients who could benefit from more support than outpatient can provide, but do not want/need inpatient treatment. The program generally runs 3-8 hours daily, providing therapy sessions and scheduled eating.

Cognitive Behavioral Therapy

**Empirically supported treatment for BN, and a promising treatment for BED and AN (Mash and Barkley, 2006).

  • CBT techniques “combat distorted body image, erroneous beliefs and assumptions, and misinterpretations of environmental messages” (Mash & Barkley, 2006). Individuals with eating disorders often associate thinness with happiness and being overweight with weakness and failure. CBT techniques challenge incorrect beliefs, assumptions and ideas about body image.
  • Self-Monitoring-These techniques are helpful for people with BED and BN. Clients will be given a template to record parameters and context of their binge, including thoughts and feelings before and after a binge. Social Skills the goals of this training are to increase interpersonal communication, deficits in social competencies and assertiveness, and basic problem solving.
  • Weekly weigh-in and education about weight-to deter away from preoccupation with weighing self-daily.
  • Workbook

Interpersonal Psychotherapy

**Equally as effective as CBT but takes more time.

  • Helps the client recognize and alter maladaptive interpersonal interactions.
  • Individuals then learn how to cope with feelings of negative interpersonal interactions
  • Self confidence building

Family Therapy

**”Adolescents receiving family interventions for AN outperformed those receiving individual treatment on measures of maintained body weight at a 5-year follow up” (Mash & Barkley, 2006, p.801).

  • Family therapy can be used as sole treatment or as part of a mutlicomponent treatment package.
  • Ranges from supportive, informational counseling to more intensieve work focusing on changing family structures/patterns.
  • Depending on the family system, clients are encouraged to find age appropriate seperation from family., express personal needs and feelings clearly and enhance communication between parents (Mash & Barkley, 2006).

Pharmacology

  • Psychiatric medications have been found to be effective for some individuals with an eating disorder, specifically antidepressants (fluoxetine).
  • Found to be really effective when paired with CBT.

Nutritional Counseling

  • Help gain a fundamental understanding of nutrition
  • Conduct dietary counseling and eating plans.
  • Can be an effective source of support and information for clients who are regaining weight or who are trying to normalize their eating behavior.
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December 3, 2009 - Posted by | eating disorder, Graduate School

6 Comments »

  1. Hello!
    So my sister has been battling a severe case of bulimia for almost 5 years now. She is 24 years old and my family has tried EVERY treatment possible. Outpatient/Inpatient/Medications/Phychiatrists/Psychologists, you name it, we’ve tried it. We’ve tried fighting, intervention, not saying anything…nothing helps! My parents even had to 302 her (put her away against her will) and she was away for 2 months, the day she came home she binged and purged. It has completely torn our family to shreds watching her self destruct before our very eyes. Noone (even doctors) don’t know how to help her at this point. She has said she doesn’t want to get help because getting help means getting fat and to her she’d rather be dead. I know this an extreme case but any suggestions would be appreciated. I have even wrote to Oprah and Dr. Phil before because my family is broken and we don’t know what to do. I’ve barely even scratched the surface of her issues but that’s just a rough idea…On a positive note I LOVE your site and your sister’s 🙂 You’re both utterly adorable and I visit both your blogs daily!!

    Comment by Erin | December 3, 2009 | Reply

    • Hey Erin, So sorry about what’s going on with your family. I imagine that watching someone you love go down that path would be so painful. It sounds like your sisters beliefs and thoughts are so deeply embedded that she cannot see otherwise. For someone who hasn’t gone through something similar, it can be SO hard to even comprehend. I’m sorry to say that I have no advice for you. I wish I did. If I learn anything new tonight in class I’ll let you know. For now just give her love and support. Your family should also be seeking support and take extra efforts for self-care.

      Comment by lpskins | December 3, 2009 | Reply

      • THANKS! I know there is really nothing we can do until she wants help. I don’t even know how to act around her though. If we confront her its a fight, and if we say nothing, we begin to feel like we’re not doing enough. Its been a lose/lose battle for all of us. I really admire you bringing to light the struggles that SO many women have though, its not talked about nearly enough as it should be! Until an ED hit home with us, we didn’t even think they were real, we thought it was more of a phase or something…people need to be educated and know its truly another addiction just like drugs or alcohol! Keep up the great work!

        Comment by Erin | December 3, 2009 | Reply

        • Thank you and good luck to you and the fam.

          Comment by lpskins | December 3, 2009 | Reply

  2. DBT as well actually (which is Dialectical behavior therapy) which combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of mindful awareness, distress tolerance, and acceptance largely derived from Buddhist meditative practice.

    Comment by jessdownes | December 3, 2009 | Reply

    • Shit youre right! I totally forgot this for my presentation. Thanks jess.

      Comment by lpskins | December 3, 2009 | Reply


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