Treatment for Eating Disorders
According to the American Psychological Associations, Division 12, Society of Clinical Psychology,1 cognitive-behavioral therapy is a well established treatment for Bulimia Nervosa.2, 3 This treatment involves helping an individual use rational thinking skills to examine what is healthy and positive about their body size and shape, and develop healthier eating habits. Interpersonal therapy is another treatment that may be effective for treating Bulimia Nervosa.4 This treatment involves identifying and evaluating the interpersonal situations that are related to problematic eating behaviors. The focus of this treatment is not on eating habits or attitudes toward weight and shape.5
There is less evidence about the effective treatments recommended for Anorexia Nervosa compared to Bulimia Nervosa. Nutritional rehabilitation, which involves helping an individual slowly gain weight, is very important to a healthful recovery. Hospital-based programs should be considered when an individual is less than 75% of their ideal body weight.6 Unfortunately, patients suffering with an Eating Disorder often relapse after leaving the hospital. Cognitive-behavioral interventions through outpatient services can be effective in preventing a relapse. It is important to monitor physical health during treatment for an Eating Disorder, including monitoring a patient's weight, vital signs (blood pressure and pulse), electrocardiogram (ECG), and conducting routine laboratory tests. It is often useful to include nutritional counseling in the treatment protocol. For patients diagnosed with relatively recent onset Anorexia Nervosa, age 18 and under, family therapy may be helpful.7
For Anorexia Nervosa treatment, psychotropic medications should not be routinely used when someone is actively trying to gain weight. In addition, these medications should not be used as the sole or primary treatment for Anorexia Nervosa. Medications such as antidepressants maybe helpful in the prevention of a relapse among weight-restored patients or to treat associated features of Anorexia Nervosa, such as Depression or obsessive-compulsive problems.6
For Bulimia Nervosa treatment, antidepressant medications may reduce symptoms of binge eating and purging and may help prevent relapse among patients in remission.6
People who are suffering from an Eating Disorder may be experiencing other mental health problems, such as Depression or Anxiety. Medications can be helpful for treating co-occurring psychiatric problems. Not all medications work the same for all individuals. It is important to work with your provider to determine the right treatment plan.
1Chambless, D. L., Baker, M. J. Baucom, D. H., Beutler, L. E., Calhoun, K.S. Crits-Christoph, P., Daiuto, A. et al. (1998). Update on the Empirically Validated Therapies II. The Clinical Psychologist, 51, 1, 3-16.
2Agras, W.S., Schneider, J.A., Arnow, B., Raeburn, S.D. & Telch, C.F. (1989). Cognitive-behavioral and response-prevention treatments for bulimia nervosa. Journal of Consulting and Clinical Psychology, 57, 215-221.
3Thackwray, D.E., Smith, M.C., Bodfish, J.W., & Meyers, A.W. (1993). A comparison of behavioral and cognitive-behavioral interventions for bulimia nervosa. Journal of Consulting and Clinical Psychology, 61, 639-645.
4Fairburn, C. G., Jones, R., Peveler, R. C., Hope, R. A., O.Conner, M. (1993). Psychotherapy and bulimia nervosa: Longer-term effects of interpersonal psychotherapy, behavior therapy, and cognitive behavior therapy. Archives of General Psychiatry, 50, 419-428.
5Lock, J., & Schapman, A. M. (in press). Bulimia Nervosa. In J.E. Fisher & W. O’Donohue (Eds.), Practice Guidelines for Evidence Based Psychotherapy. New York: Kluwer Academic.
6American Psychiatric Association (2000). Practice Guideline for the Treatment of Patients With Eating Disorders, Second Edition. Accessed 5/30/06.
7Pike, K. M. & Walsh, B. T. (in press). Anorexia Nervosa. In J.E. Fisher & W. O’Donohue (Eds.), Practice Guidelines for Evidence Based Psychotherapy. New York: Kluwer Academic.