GETTING HELP FOR EATING DISORDERS

Millie said: "The struggle I had was with my grandparents and aunts and uncles. When I was anorexic I got to the point where doctors said I'd have two weeks to live, as my heart would fail. The doctors said to my parents they needed a support network as they couldn't handle it all. My dad's parents are all in India, whereas my mum's family is all here, so she told them, and the first thing they said was, 'It's because you spoilt her; whenever she asked for water, you gave her milk.' So basically, my grandmother visited me in hospital, and – bearing in mind I was so ill – they took me on a wheelchair and she said to me, 'We get it, you want attention, just snap out of it, we're giving you attention.' If I wanted attention I would streak in the middle of a football pitch; I wouldn't be doing this; I wouldn't be near death. So it was that sort of stigma I had to fight against."
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Stigma of eating disorders is one of the main barriers to getting help.  Some might laugh it off when you talk about having an eating disorder, saying "Don't complain that you are skinny!", or they might criticize you for a lack of self-control when you try to get support for binging behaviours "Just don't eat la!". You might even feel afraid of getting help because you don't want to be criticized for gaining weight.

Eating disorders are a serious mental health condition and is not due to a character flaw, weakness, being ungrateful, or just a lack of control. Because of the lack of awareness, and stigma, only a small minority of people with an eating disorder receive mental health treatment, with many cases going undetected by health care professionals. Consequently eating disorders often take a chronic course and resulting in serious physical health problems. 

Although the road to recovery may be long and tough, there are effective treatments available to help you to appreciate your body, and to a healthier way of living. You don't need to do this alone. The most effective and long-lasting treatment for an eating disorder is some form of psychotherapy, and the collaborative care of other health professionals at medical and nutritional needs.

Recommended care is provided by a multidisciplinary team including but not limited to a psychologist, psychiatrist, social worker, nutritionist, and/or primary care physician.

Medication is not the treatment of choice for eating disorders, although it may be used to treat co-occurring mental health conditions or medical conditions which may have resulted from the eating disorder.

 

Anorexia Nervosa

• Family-Based Treatment for anorexia nervosa is an outpatient intervention for patients who are medically stable, and consists of three phases: (1) parents take charge of the process of nutritional rehabilitation and weight restoration with the help of the therapist; (2) control over eating is returned to the adolescent in an age appropriate fashion; (3) issues of psychosocial development in the absence of an eating disorder are addressed. This form of treatment has been found to be particularly helpful for teenagers.
• Cognitive Behavioral Therapy for anorexia nervosa is designed to prevent relapse once a patient has gained weight in the context of inpatient treatment.

 

Bulimia Nervosa

• Cognitive Behavioral Therapy for bulimia nervosa directly targets the core features of this disorder, namely binge eating, inappropriate compensatory behaviours, and excessive concern with body shape and weight. This treatment focuses on how these symptoms cycle to perpetuate themselves in the present, as opposed to why they originally developed in the past.
• Interpersonal Psychotherapy for bulimia nervosa focuses on interpersonal difficulties in the patient’s life, particularly on interpersonal triggers of binge eating episodes.The therapist’s role involves keeping the patient aware of the time frame of treatment and focused on the problem areas, clarifying issues raised by the patient, and encouraging change.

 

Binge Eating Disorder

• Cognitive Behavioral Therapy for binge eating disorder focuses reducing dietary restraint through behavioural strategies (e.g., self-monitoring of behaviours, normalizing patterns of eating). The treatment also includes modifying dysfunctional thoughts and beliefs about one’s body shape and weight, which is also designed to reduce eating disorder pathology.
• Interpersonal Psychotherapy for binge eating disorder focuses on interpersonal difficulties in the patient’s life, particularly on interpersonal triggers of binge eating episodes.The therapist’s role involves keeping the patient aware of the time frame of treatment and focused on the problem areas, clarifying issues raised by the patient, and encouraging change.

 

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Here is a list of recommended laboratory tests for individuals suffering from an eating disorder:

Standard

• Complete Blood Count (CBC) with differential
• Urinalysis
• Complete Metabolic Profile: Sodium, Chloride, Potassium, Glucose, Blood Urea Nitrogen, Creatinine, Total Protein, Albumin, Globulin, Calcium, Carbon Dioxide, AST, Alkaline Phosphates, Total Bilirubin
• Serum magnesium
• Thyroid Screen (T3, T4, TSH) Electrocardiogram (ECG)

Special Circumstances

15% or more below ideal body weight (IBW)

• Chest X-Ray
• Complement 3 (C3)
• 24 Creatinine Clearance
• Uric Acid

20% or more below IBW or any neurological sign:

• Brain Scan

20% or more below IBW or sign of mitral valve prolapse:

• Echocardiogram

30% or more below IBW:

• Skin Testing for Immune Functioning

Weight loss 15% or more below IBW lasting 6 months or longer at any time during the course of eating disorder:

• Dual Energy X-Ray Absorptiometry (DEXA) to assess bone mineral density
• Estradiol Level (or testosterone in males)