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Treating Eating Disorders: Anorexia, Bulimia, Bingeing

Treatment works for at least 60 percent of people with eating disorders. They can return to and maintain healthy weights and eat normally. They can develop healthy relationships with people, raise families, and build careers.

But despite often-intense treatment, about 20 percent of people suffering from eating disorders don’t recover fully. These people remain focused on food and their weight. They can’t feel comfortable with friends or romantic relationships. They work, but usually don’t have meaningful careers.

The remaining 20 percent don’t improve, even with treatment. Their lives continue to revolve around food and weight. Unfortunately, without proper treatment, up to 20 percent of people with serious eating disorders will die. But with therapy, the number of fatalities drops drastically to 2 to 3 percent.

The treatment for eating disorders is individual and specific to the person suffering. Because many factors contribute to the development of an eating disorder, a team approach makes for the best treatment. The professionals on the healthcare team include doctors, registered dietitians, psychologists or psychiatrists, and social workers. Counseling includes many stages, some in individual sessions and some in groups.

In general, the goals of treatment by the healthcare team include:

  • Return to and maintenance of normal or near-normal weight.

  • Ability to eat a varied diet of normal foods (not just low-calorie, nonfat, and non-sugar items) and the elimination or major reduction of irrational food fears.

  • Restoration of relationships with family members and friends.

  • Application of problem-solving and coping skills.

More than 25 percent of patients with anorexia nervosa require inpatient hospitalization until they reach 85 percent of their ideal body weight. Outpatient programs are another good option for those who have not lost so much weight.

Psychotherapy, family counseling, and medical nutrition therapy to help regain lost weight are part of the team approach needed to take on this disease. Drug therapy hasn’t been effective in treating anorexia nervosa, although drugs may be prescribed to treat depression and other psychological problems common to patients with this disease.

The treatment of bulimia nervosa is usually conducted on an outpatient basis. Psychotherapy is effective, especially in a group setting. Family counseling and medical nutrition therapy are also an important part of the treatment plan.

Many psychiatrists prescribe antidepressants to treat bulimia nervosa, because they may help reduce the frequency of purging episodes. One type of drug for treating depression is proving useful as at treatment for bulimia, as well. The drugs are known as SSRIs or selective serotonin reuptake inhibitors, such as Prozac or Zoloft.

Treatment for binge eating disorder is similar to that used for treatment of bulimia nervosa, often including psychotherapy (especially cognitive behavioral therapy), family therapy, and medical nutrition therapy. Antidepressants may be an effective treatment as well.

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