Eating Disorders
According to the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V), eating disorders are characterized by severe disturbances in eating behavior.
Three of the commonly known types of eating disorders are:
- Anorexia Nervosa
The essential features of Anorexia Nervosa are the refusal to maintain a minimally normal body weight, an intense fear of gaining weight, and exhibiting a significant disturbance in the perception of one's body shape or size.
There are two subtypes of Anorexia Nervosa:- Restricting – while not engaging in binge eating (eating excessive amounts of food) and purging (vomiting, misuse of laxatives, diuretics, or enemas)
- Binge-Eating/Purging – regularly engaging in binge eating or purging behavior
- Bulimia Nervosa
The essential features of Bulimia Nervosa include binge eating and doing inappropriate interventions to prevent weight gain. - Binge Eating Disorder
The essential feature of this disorder is binging as described in Bulimia Nervosa, without the purging behaviors. An individual with this disorder will binge eat at least once per week for 3 months and have marked distress about the binge eating.
Treatment Options for Eating Disorders
Treatment options for individuals with eating disorders usually involve a team approach. Typical team members include a primary care physician, a psychiatrist, psychotherapist, and nutritional consultants. This team of professionals assists with medical monitoring, dietary coaching, and therapeutic interventions to change behaviors and distorted thoughts that accompany the illness.
Treatment can occur in a hospital setting, residential setting, or on an outpatient setting. An additional component to the team approach is family involvement in treatment.
Psychotherapy
Psychotherapy treatment involves counseling an individual to identify and challenge irrational thinking that distorts body image. Counseling helps the individual examine what is healthy and positive about their body size and shape, and develop healthier eating habits. Effective treatment modalities include cognitive behavior therapy, dialectical behavior therapy, acceptance, and commitment therapy. Most treatment plans involve family involvement to provide education to family members and build support for recovery.
Medication Management
Psychotropic medications are considered when co-occurring disorders such as depression complicate recovery from an eating disorder. Some psychotropic medications can help with common symptoms that occur with eating disorders, such as anxiety, poor self-esteem and compulsive thoughts. It is important to have a comprehensive physical exam and discussion with your treatment provider. Additionally, medical complications are common with eating disorders and must be addressed in the overall treatment plan. Some medical complications from eating disorders are so severe they become life threatening.
Treatment Settings
Treatment for eating disorders is provided in different types of settings determined by the individual's needs and medical stability. Inpatient hospitalization and residential treatment facilities are the most intense level of care and appropriate for individuals that require medical monitoring. Intensive outpatient and partial hospitalization offers day programing including therapy and some medical services.