Eating Disorder Treatments and What Really Works

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When you look at the statistics on mortality rates over all mental disorders, statistics showing that Anorexia Nervosa has the highest mortality rate, it would be a reasonable assumption that it would have the highest funding for recovery treatment research. Unfortunately, this is nowhere near the case, and not only do they have the least recorded research, but one of the lowest rates of funding. It is important that psychologists reveal the quickest and most efficient recovery strategies for each eating disorder because of the extreme toll on the body and brain functions. Within this study we will go through each eating disorder and determine the best route for treatment, as each of these have very different root causes. The goal in the end is to reveal to the general public that these eating disorders are not solely about weight but also the individuals mental well being. Why certain people find their sense of control from past trauma or anxiety through food should be better understood.

Despite the rapid influx in disordered eating, for the past twenty years, they are still under funded. Recovery treatment covered by health insurance are almost nonexistent, and societal expectations to have the perfect body continue to diminish the self esteem of many. Even though eating disorders, according to physicians, tend to afflict girls ages 11 to 22 does leave men exempt from this mental disorder. Eating disorders are organized into a few categories which are as follows: anorexia nervosa, bulimia nervosa, night eating syndrome, binge eating disorder and eating disorder not otherwise specified (EDNOS).

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The more we can learn about the differences in each type of eating disorders, the better we can treat them. Whether some people with eating disorders have a higher recovery rate using cognitive behavioral therapy, others may do better with family therapy. Treatment cannot have a one size fits all approach, because this type of disease (like most) is far too complex and broad to ever have a single treatment option. It is extremely pertinent that physicians watch for common signs in every patient and use a screening method like SCOFF. SCOFF is a questionnaire consistent of five questions. If two are answered with a yes then there is a diagnosis of either anorexia nervosa or bulimia nervosa. It is important for physicians, especially pediatric physicians, have patients fill out this questionnaire if they show even the slightest sign of having an eating disorder.

Anorexia Nervosa is classified by obtaining thinness through starvation and other methods. This brings the result of a body weight way below the average range. The person has an emaciated appearance. Typically it will start to form in the adolescence years (majority of the time it will affect girls and young women). Unfortunately patients with AN not only are they extremely rare they are also extremely difficult when conducting trials because of the unwillingness to recover. Rutgers, Grilo, and Vitousek (2007) discovered that “throughout the past 20 years, only 15 comparative trials have been completed and published”(p.199). For adolescents, the best form of treatment is a “conjoint” format in which all family members are together. Once parental authority is established coaching the patient on rehabilitation becomes effective and in studies there was a 90% symptom free at 5 years after recovery (Rutgers et al., 2007). Unfortunately for those with a longer history or were older at onset of the disease, this method does not show to be effective and many patients fall out of treatment. For adults the “separated” format produced better results than the conjoint model.

According to Sim et al. (2010), “The most effective method of treatment for BN is a specific form of psychotherapy and cognitive behavioral therapy (CBT)”(p.748). Treatment should focus on maintaining control of binge eating behaviors and purging. Some research has shown that Fluoxetine (Dose of 60 mg/d), an antidepressant, can benefit the patient regardless of symptoms of depression. It should be noted that this drug contraindicates itself because of the high risk for seizure in patients with eating disorders. For BN, medication plays a huge role in reducing BN behaviors but only deemed effective when paired with some form of psychosocial treatment (Hay & Claudino,2011, p. 212). The best form of treatment for binge eating disorder (BED) is cognitive behavioral therapy (CBD). For patients without cardiovascular complications, Sibutramine has been shown to be the best form of medication to treat this disorder from the rates of recovery and weight loss in patients taking it. With the nature of this, disorder weight loss and nutritional guidance should be a portion of treatment focus along with a combination of psychotropic medications and psychotherapy (Hay & Claudino,2011, p. 212).

“Night-eating syndrome was initially described by Stunkard et al47 as early as the 1950s as a syndrome consisting of morning anorexia, evening hyperphagia, and insomnia” discovered by Sim et al.(2010). Physicians should encourage meals to be eaten earlier in the day to shift the late eating pattern. Seeing a dietician regularly has shown patient improvement as well for nutritional guidance. For those patients that are influenced by moods or stress, seeing a behavioral psychologist would be beneficial for recovery.

Most patients that show signs of an eating disorder but do not fit into a specific category may be labeled with an eating disorder not otherwise specified (EDNOS). For example, someone who shows all signs of having Anorexia Nervosa but still menstruates would be classified with EDNOS or someone with bulimia nervosa but only binge and purge twice a week would also be diagnosed with EDNOS. Even if these patients cannot be diagnosed with a known eating disorder treatment is still extremely necessary because most of these patients have some form of psychiatric illness symptoms.

With the little amount of research done on this topic and how fragile the participants can be, it is important to handle trials with the utmost of care. In this situation I would conduct a case study of each section of the eating disorder family. I would follow the treatment process of individuals going through it and gather as much data on what methods were used and the outcome of each. Each eating disorder would need to have multiple case studies to have the most accurate results.

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