Anorexia treatment and therapy.

Anorexia treatment and therapy.

Since anorexia involves both mind and body, a team approach to treatment is often best. Those who may be involved in anorexia treatment include medical doctors, psychologists, counselors, and dieticians. The participation and support of family members also makes a big difference in treatment success. Having a team around you that you can trust and rely on will make recovery easier.

Treating anorexia involves three steps:

• Getting back to a healthy weight
• Starting to eat more food
• Changing how you think about yourself and food

Medical treatment for anorexia

The first priority in anorexia treatment is addressing and stabilizing any serious health issues. Hospitalization may be necessary if you are dangerously malnourished or so distressed that you no longer want to live. You may also need to be hospitalized until you reach a less critical weight. Outpatient treatment is an option when you’re not in immediate medical danger.

Nutritional treatment for anorexia

A second component of anorexia treatment is nutritional counseling. A nutritionist or dietician will teach you about healthy eating and proper nutrition. The nutritionist will also help you develop and follow meal plans that include enough calories to reach or maintain a normal, healthy weight.

Counseling and therapy for anorexia

Counseling is crucial to anorexia treatment. Its goal is to identify the negative thoughts and feelings that fuel your eating disorder and replace them with healthier, less distorted beliefs. Another important goal of counseling is to teach you how to deal with difficult emotions, relationship problems, and stress in a productive, rather than a self-destructive, way.

The biggest challenge in treating anorexia nervosa is helping the person recognize that he or she has an illness. Most people with anorexia deny that they have an eating disorder. People often enter treatment only once their condition is serious.

The goals of treatment are to restore normal body weight and eating habits. A weight gain of 1 - 3 pounds per week is considered a safe goal.

A number of different programs have been designed to treat anorexia. Sometimes the person can gain weight by:

• Increasing social activity
• Reducing the amount of physical activity
• Using schedules for eating

Many patients start with a short hospital stay and continue to follow-up with a day treatment program.

A longer hospital stay may be needed if:

• The person has lost a lot of weight (being below 70% of their ideal body weight for their age and height). For severe and life-threatening malnutrition, the person may need to be fed through a vein or stomach tube.
• Weight loss continues even with treatment
• Medical complications, such as heart problems, confusion, or low potassium levels develop
• The person has severe depression or thinks about committing suicide

Care providers who are usually involved in these programs include:

• Nurse practitioners
• Physicians
• Physician assistants
• Nutritionists or dietitians
• Mental health care providers

Treatment is often very difficult, and patients and their families must work hard. Many therapies may be tried until the patient overcomes this disorder.

Patients may drop out of programs if they have unrealistic hopes of being "cured" with therapy alone.

Different kinds of talk therapy are used to treat people with anorexia:

• Cognitive behavioral therapy (a type of talk therapy), group therapy, and family therapy have all been successful.
• The goal of therapy is to change patients' thoughts or behavior to encourage them to eat in a healthier way. This kind of therapy is more useful for treating younger patients who have not had anorexia for a long time.
• If the patient is young, therapy may involve the whole family. The family is seen as a part of the solution, instead of the cause of the eating disorder.
• Support groups may also be a part of treatment. In support groups, patients and families meet and share what they've been through.

Medications such as antidepressants, antipsychotics, and mood stabilizers may help some anorexic patients when given as part of a complete treatment program. Examples include:

• Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs)
• Olanzapine (Zyprexa, Zydis) or other antipsychotics

These medicines can help treat depression or anxiety.

Although these drugs may help, no medication has been proven to decrease the desire to lose weight.

Getting past your fear of gaining weight

Getting back to a normal weight is no easy task. The thought of gaining weight is probably extremely frightening—especially if you’re being forced—and you may be tempted to resist. But research shows that the closer your body weight is to normal at the end of treatment, the greater your chance of recovery, so getting to a healthy weight should be a top treatment goal.

Try to understand that your fear of gaining weight is a symptom of your anorexia. Reading about anorexia or talking to other people who have lived with it can help. It also helps to be honest about your feelings and fears—including your family and your treatment team. The better they understand what you’re going through, the better support you’ll receive.