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The treatment options for eating disorders


Eating disorders are a treatable illness. Treatment should commence as early as possible to promote recovery. The treatment of eating disorders involves a comprehensive approach including medical care, nutritional intervention and counseling, psychotherapy and medication if necessary.

Medical care

Eating disorders can cause a number of medical problems or medical complications. The affected person is required to undergo a comprehensive physical examination and laboratory tests. They can include the assessment of weight, height, menstrual patterns, dietary intake, hydration status, skin and hair condition, cardiac and pulmonary function, abdominal system, physical activity level, and blood tests for anaemia, electrolyte levels, nutritional deficiencies, liver function, and thyroid function. The physical health of the affected person will be monitored continuously by a medical doctor during the treatment process.

   

Nutritional intervention and counseling

These are provided by a dietician to improve the knowledge on nutritional needs of the person undergoing treatment, facilitate the development of a normal and healthy eating plan, manage obsessions about food and weight, and overcome bulimic behaviours(bingeing, purging, excessive exercise and dieting). Assessment will be performed on the patient to identify nutritional deficiencies. Guidance will be offered to the patient and his/ her family on meal planning to ensure that meals can meet his / her nutritional needs and is acceptable and tolerable. The patient will also be educated on how to use a food journal to record her/ his emotions related to food and eating.

   

Psychotherapy

It can be conducted on an individual basis or in a group with the aim to identify the psychological stresses underlying the development of eating disorders and an individual's current feelings about himself / herself and others. Patients will be helped to confront their concepts of body image, develop positive self-esteem and self confidence, and identify their resources that could help them overcome their difficulties.

Interpersonal therapy

  • The therapy was found to be effective for the treatment of bulimia nervosa and binge-eating disorder.
  • The therapy aims to help the patient resolve interpersonal problems that contribute to the cause of eating problems. The patient is helped to identify the problems, generate possible solutions, implement actions and monitor progress. It is conducted by a sympathetic and supportive therapist who the patient can trust.

Group therapy

  • In group therapy people with eating disorders are provided with the opportunity to interact with others in the same situation. They can share their feelings and learn about themselves, the illness and the recovery process. The group therapy is conducted by a health professional. Members in the group can develop support for each other.

Cognitive behavioral therapy

  • It is more effective for people with bulimia nervosa or binge-eating than for people with anorexia nervosa.
  • The therapy helps patients to explore thoughts and beliefs associated with their eating problems and to reestablish a regular and healthy eating pattern. They will learn how to eliminate their myths and distorted ideas about food, eating, shape and weight. They will be helped to increase self-esteem and reduce emphasis on physical appearance as an important personal attribute.

Family therapy

  • It is especially effective for treating young people (aged 18 or below) with anorexia nervosa lasting less than 3 years.
  • Eating disorders usually affect not only the suffering individual but also all members of the family when she/ he is still living at home. Thus all family members living with or very close to the family member with an eating disorder will be involved in the family therapy. The aims of the therapy are to identify any areas of stress in the family, find healthy ways to deal with stress, improve communication and trust, and recognize family strengths and resources that can be mobilized to fight the illness.

Medication

Antidepressant is commonly used to treat problems associated with eating disorders, such as depression, obsessive-compulsive symptoms or anxiety, or to help regulate eating and prevent relapse. It can take several weeks to be effective and its use would be most effective when combined with ongoing therapy.

Other forms of therapy

  • Self-help groups can offer mutual support and understanding, and information sharing to sufferers and their families. They are conducted by non professionals who have experience with eating disorders personally or indirectly.
  • Other useful therapies are movement therapy, body image therapy, aromatherapy, meditation, stress management and relaxation technique.

Treatment milieu

People with eating disorders can receive:

  1. outpatient treatment
  2. day hospital treatment
  3. inpatient treatment
  4. residential care

Outpatient treatment

  • It offers treatment in an outpatient setting in which the sufferer is required to attend regular follow-up(e.g. once a week or once every two weeks). This causes less disruption to the individual's normal routine. The treatment could include medical, psychological, pharmacological and nutritional care.

Day hospital treatment

  • It offers treatment in a structured environment in which the sufferer is required to attend a day hospital programme and return home to sleep at night. It is for sufferers needing a step-down programme after hospitalization, not responding to outpatient treatment or requiring regular supervision at meals.
  • It offers treatment in a hospital setting for those who are suffering from severe or rapid weight loss, severe medical complication, severe psychiatric complication, suicidal or homicidal thought or unsuccessful outpatient treatment.

Residential care

  • It offers a long-term treatment in a residential center in which the sufferer will have a longer time to stabilize her / his eating patterns and to address the underlying issues. There will be less monitoring and supervision on the person undergoing treatment than in an inpatient setting.
Reaching out for professional help


Finding professional help is an important step for the initiation of treatment. Professional help can be obtained from a multi-disciplinary team. The treatment team may include a number of specialists, such as a medical doctor, psychiatrist, psychologist, social worker, counselor, family therapist, dietitian, and nurse. Please look up the resources provided in this programme for the types of professional health services available. When choosing the specialists, you would need to consider their qualifications, experience, accessibility, service fee and ability in building up rapport. A second opinion should be obtained if you are not satisfied with the treatment that your family member is receiving.

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