An eating disorder is a condition which causes irregularities in the daily diet of the patient. This could include severe limitations of caloric intake or an excessive increase in consumption followed by ritualized purging. These disorders can effect men as well as women and typically develop during the teens or early adulthood. However, any of these disorders could develop at any point. There are several types of eating disorders; however, the most prevalent are anorexia and bulimia.
People with anorexia nervosa are obsessed with the food they eat and their weight. They believe themselves to be overweight even when they are dangerously underweight. They will attempt to achieve and maintain a weight far below what is healthy for their height and age. To lose weight, or prevent gaining weight, they may exercise excessively or starve themselves. Some patients will use both methods to maintain control over their weight.
Patients with bulimia nervosa eat large amounts of food and then attempt to rid their body of the excessive calories through purging. Patients may purge by inducing vomiting or diarrhea or may engage in excessive exercise rituals. As with anorexic patients, bulimics have an altered body image.
These disorders must be treated both medically and psychologically. The disorder can cause dehydration, destabilization of electrolytes, muscle loss, low blood pressure, irregular heartbeat and a variety of other problems. Treatment of the disease begins with proper nutrition and hydration, possibly via a feeding tube and intravenous fluids.
Medications may be used to reduce the symptoms of these eating disorders. Antidepressants such as fluoxetine may be used to treat bulimia. Unfortunately, no medications have been specifically proven to help patients suffering with anorexia, although a variety of antidepressants may provide some benefit.
The psychological components of the treatment will be more long lasting. Individual, family, and group therapy are often indicated in patients with anorexia. Individual therapy helps the patient identify the destructive behaviors contributing to the disorder and find healthier ways of dealing with those impulses and behaviors. Family therapy can teach family members how to help the patient care for herself and how to identify symptoms that may indicate a relapse. Group therapy allows the patient to meet with and identify with others who are currently living with the disorders as well as those who are in recovery.
Therapists are arguably the most important component in treating patients with eating disorders. While it is certainly true that the medical damage can be immense, it can be treated in a finite period of time. Patients with eating disorders will often need years, if not lifelong, counseling.
As a therapist, how long do you typically see a patient with an eating disorder? Which form of therapy have you found to be most beneficial for your patients?