Explore the many treatment choices available to help recover from an eating disorder. Investigate as many options as possible, and be open to things both familiar and unfamiliar. The more weapons in your arsenal, the bigger the fight in you will be.
Individual Therapy: There are many types of therapists who treat patients with an eating disorder, including psychologists, psychiatrists, licensed counselors and social workers, and interns completing their degree in the counseling field. Typically psychiatrists or medical doctors are the ones to prescribe any needed medications, and many psychiatrists also provide therapy sessions. There is no "best" type of therapist to see; it all depends on your needs, your issues, your treatment goals, and if a therapist is a good fit for you or not. It is recommended you give a new therapist at least a few sessions to see how you work together. If you then feel it's best to try another one, it's perfectly fine to stop the sessions with the current therapist and start a search for another one. While many people prefer to see a therapist who specializes in treating clients with eating disorders, this is not mandatory. There are many terrific professionals who do not focus on this population who are still qualified to treat anorexia, bulimia, binge eating disorder, and EDNOS. When making the initial appointment, you can ask if the therapist treats people with eating disorders.
Therapy usually begins with an intake, which is creating a sketch of your life so that the therapist has an idea of your past and what you are dealing with now. You can discuss your reasons for attending therapy and what you hope to achieve. Some therapists spend a great deal of time talking about past life experiences and situations, such as childhood, while others focus more on current day events and struggles. Any issues that accompany your eating disorder, such as depression, anxiety, trauma, obsessive compulsive disorder, and others, will be assessed. Therapy can last from several weeks to several years, depending on the amount of work to be done, how often you attend sessions, and the speed at which you make progress.
Everyone is scared when they first contemplate going into therapy, but it can be one of the greatest gifts you give yourself. It is a self-examination that leads to higher self-esteem, the ability to love yourself, and eventually recovering from your eating disorder. Therapy can help you in ways you may not have even considered, and it is considered essential when treating an eating disorder.
Couples & Family Therapy: While individual therapy is very helpful, additional therapy that focuses on a relationship or family can offer tremendous support, too. Spouses and partners of an eating disorder sufferer often feel helpless, frustrated, and unsure of how to support the person they love. Couples therapy can provide a safe way for people to express their points of view to each other, and learn to work together throughout recovery. Family therapy can be helpful when a family dynamic needs addressing, and the individuals involved are willing to see a professional and work together. This can include situations such as a parent with an eating disorder coming to treatment with their spouse/partner and children, or a teenager or adult child coming to therapy with their parents, siblings or other family members. This allows for loved ones to come together to better understand what each one is experiencing as a result of the eating disorder, and learn to develop healthy skills, such as boundaries and clear communication.
Cognitive Behavioral Therapy: Many therapists use CBT to treat their patients with eating disorders. This approach focuses on the relationship between thoughts, feelings, and behaviors, with a focus on problem solving. The goal is to teach the patient to change their belief system, and choose better ways to cope with specific problems. Homework assignments are often given, and the patient learns to practice challenging their negative thoughts and assumptions outside of sessions. :
Dialetical Behavior Therapy: DBT is a modifed version of CBT (see above description) that was originally created to treat a suicidal and/or self-harming population with borderline personality disorder. It is now used more commonly, and has proved helpful with other issues, including eating disorders. This approach focuses on accepting negative thoughts, feelings, and behaviors, identifying them and transforming them. DBT skill sets are developed, such as being mindful and staying present in the moment, and learning relaxation techniques. Homework assignments are often given.
Group Therapy/Support Group: Group therapy can take place in an outpatient or inpatient setting. Groups that take place inpatient are led by a therapeutic professional. Groups that take place outpatient are sometimes led by a therapist or intern, while others are led by someone whose expertise comes from having recovered from an eating disorder, or they are in strong recovery. The group may be affiliated with an eating disorders organization or a community group. Group therapy and support groups give their participants the chance to come together as a team, hear the experiences of others, and interact with them. A bond can form that allows the members not only to learn how to identify risk factors and challenge them in each other, but also to apply that skill set to themselves. The group often works as a team to encourage each other to learn new recovery skills and apply them.
Outpatient: This type of treatment usually takes place at a facility or clinic, and often involves attending treatment several days a week. It is sometimes referred to as "intensive outpatient treatment". It can be helpful for someone who needs more intensive and regular help for their eating disorder than they are getting from just individual therapy, but does not yet qualify for, or is not able or willing to attend, inpatient treatment. It can also be affective as step-down treatment used after leaving an inpatient facility. Sessions may be a few days a week or daily, and can last from a few hours a day up to all day. Often meal times are included so the patient an eat in a supervised setting and process their emotions. Different things are offered with each program, and can include individual therapy, group therapy, art therapy, and other options.
Inpatient/Residential: A person going inpatient/residential will stay away from home in a program for a period of several days to several months. These facilities are often made to feel as homey as possible, rather than feeling clinical and sterile, like a hospital setting. Patients usually share a room with one or two other people, eat their meals together, and sometimes take supervised outside trips as a group. Depending on the program, many things can be offered as part of treatment, including: individual therapy, group therapy, nutritional counseling, medical care, art therapy, equine therapy, dance/movement therapy, yoga, and spiritual counseling. The patients may work together doing small chores around the house, cooking together, gardening, and exploring nature on the grounds of the facility.
When the patient leaves, they may return home immediately or they may enter transitional care, which includes living off campus in a housing situation with others who are transitioning out. It is recommended that anyone leaving inpatient returns home to extended care, such as outpatient treatment or seeing their private therapist. While residential care can be a lifesaver in terms of helping someone with anorexia, bulimia, binge eating disorder, or EDNOS get on the right path, graduation from the program does not mean the person is cured or will not need further consistent help.
Hospitalization: Being hospitalized as part of treatment for an eating disorder usually takes place when a person is so medically compromised, often nutritionally, that they need to be stabilized before further treatment can happen. Sometimes a person may qualify to go into inpatient treatment, but first needs to be medically stable before the program can accept them, thus requiring hospitalization beforehand. In other cases, a sufferer is also dealing with a mental health issue such as depression, anxiety, or post-traumatic stress disorder, and is in an emotional position precarious enough that it's necessary to stabilize their mood before they begin further treatment.
Art Therapy:Art therapyis a commonly used technique that helps a person express themselves non-verbally, and develop their creative skills, which are often helpful in recovery. Forms of art expression include drawing, painting, sculpting, mask-making, collages, and media. Trained art therapists help a client to discover and articulate their conflicts and emotions, reduce anxiety, and become more self-aware. It is often used as a tool in treating mental health and addiction issues.
Equine Therapy:Equine therapy is the use of interacting with horses to help bring about emotional growth and an understanding of communication. Many inpatient facilities offer this option, with it being particularly successful with clients who are treatment resistant. This type of therapy is done by someone who is certified or trained in equine therapy. Benefits include improved confidence, communication, trust, self-acceptance and social skills.
Dance/Movement Therapy: The principle of dance/moment therapy is that the mind, body and spirit are interconnected, and utilizing this type of therapy will result in harmony among the emotional, cognitive, physical and social parts of a person. Dance/movement therapy is used with many populations, including eating disorders and other mental health issues, rehabilitation, nursing homes, day care centers and private practice.
The Maudsley Method: Maudsley is a family-based therapeutic approach in which parents and sometimes other family members play an active role in treating the sufferer. It works best for those with anorexia, within a younger age population, such as teenagers and college age people. Rather than focusing on the cause of an eating disorder, the spotlight is on food as medicine, with the parents taking the lead role in serving and supervising feeding times for their child. After time, the child begins to assume more responsibility for their intake. Possible drawbacks of the Maudsley Method include parents who do not fully understand the concept and are trying simply to force feed their child, or avoid any needed professional therapy for their child due to a fear of being blamed for their child being sick. Many therapists are trained in the Maudsley Method and can give guidance and supervision during this treatment.
12 Step: This approach is part of the widely known 12 step form of treatment for alcohol, addiction, and other problems. Food Addicts Anonymous and Overeaters Anonymous both offer free support groups based on the 12 step principle, which includes accepting the idea that as long as the "addiction" is present in your life, your life is out of control.
Eye Movement Desensitization & Reprocessing: EMDR is designed to help a person heal from the distress associated with painful memories of life events, including traumatic events like domestic abuse, sexual assault, combat, and being the victim of a crime. It is shown effective in treating such problems as low self-esteem and feeling powerless. EMDR involves an eight-phase treatment conducted by a trained professional, and include assessing the targeted memories and current events that may trigger them, the development of coping skills, and the use of eye movement.
Online Support: Interactive online support often includes a forum, which is a set of bulletin boards people post on and interact with each other virtually. Eating disorder forums offer a place to talk openly yet anonymously about having an eating disorder. Members can ask for and give ideas, support, and challenges to each other, knowing that everyone there understands what it's like to suffer. Be aware that not all eating disorder forums are created equal; some promote anorexia and other eating disorders as a lifestyle and encourage and teach their members how to stay sick. They are commonly known as "pro-ana (as in "anorexia)" sites. Make sure any set of bulletin boards you or someone you care about joins is pro-recovery, and does not allow things like triggering information and pictures, medical advice, tips on dieting and how to hide an eating disorder.
Nutritionist/Dietician: A trained, nutritional professional can help a person eat healthy for where they are now, and readjust their intake as their needs change. A nutritionist or dietician can help plan meals, answer questions, provide accountability, and coordinate with other treatment providers, such as a therapist or doctor, in order to help the sufferer achieve their goals.
Medication: There are not any prescription or over-the-counter meds that specifically address anorexia, bulimia, binge eating disorder, or EDNOS. However, a large number of people with an eating disorder also have an accompanying issue, such as depression, anxiety, obsessive compulsive disorder, or post-traumatic stress disorder, that adds to their difficulty in engaging fully in recovery. Sometimes the right medication can help even out a person's mood, and allow for them to more easily enter and stay in recovery. Often a sufferer only needs a temporary amount of time using a med so that they can achieve a 'level playing field' mentally and emotionally.