GETTING HELP

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.

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)
References
  • http://www.div12.org/psychological-treatments/disorders/eating-disorders-and-obesity/
  • Fairburn, C. G., & Harrison, P. J. (2003). Eating disorders. The Lancet, 361(9355), 407-416.
  • https://www.nationaleatingdisorders.org/treatment
  • http://www.aedweb.org/downloads/Guide-English.pdf

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