Eating Disorders - Treatment and recovery from eating disorders





Treatment and recovery go hand in hand. It is very hard to stop an eating disorder without any treatment. Recovery is a long process in which an eating disorder sufferer may have to enter treatment more than once. Some people may even try different kinds of treatment programs during their recovery until they find one that works for them.

There may be obstacles to starting treatment. The fear of becoming fat and losing control, which drives most eating disorders, is very strong and hard to eliminate. Also, an eating disorder sufferer may be in denial about her condition and may be unwilling to consider treatment. These feelings may be based on a fear of letting go of the illness that she feels is part of her identity. The eating disorder sufferer must learn to refocus her thoughts from food and weight to her emotions so that she can deal with what is really bothering her. Since many feelings that need to be addressed have been buried by the disorder, professional counseling is important for a successful recovery.

In order for treatment to work, a person must be ready to be treated. Some sufferers may even say they are ready but really are not. They may pretend to change their attitude about food, but they are still starving themselves or bingeing and purging their food secretively. If a person does not fully commit to a treatment program, she will most likely continue suffering from the deadly illness even after completion of the program.

Treatment Basics

Treatment programs vary in the approach that they take. An eating disorder sufferer needs to find a program that best suits her and her condition. A program may work for one person but be ineffective for another. It is important that the person feels comfortable with and believes in the treatment.

Treatment usually begins with an assessment by a physician or mental health counselor. Depending on the severity of the eating disorder, the sufferer will either enter an inpatient or outpatient program. Inpatient programs, or hospitalization, are for the most severe cases. To be hospitalized, the sufferer is usually at a critical point in her illness where her life is in danger or she may have strong suicidal thoughts. Outpatient programs are conducted at a facility or doctor's office that the patient visits while still living at home.

WORDS OF RECOVERY

Mostly what happened was that my life took over—that is to say, that the impulse for life became stronger in me than the impulse for death. In me, the two impulses coexist in an uneasy balance, but they are balanced enough now that I am alive.

Looking back, I see that what I did then was pretty basic. I took a leap of faith. And I believe that has made all the difference. I hung on to the only thing that seemed real to me, and that was a basic ethical principle; if I was alive, then I had a responsibility to stay alive and do something with the life I had been given. And though I was not at all convinced, when I made that leap of faith, that I had any sensible reason for doing so—though I did not fully believe that there was anything that could possibly make as much sense as an eating disorder—I made it because I began to wonder. I simply began to wonder, in the same way I had wondered what would happen if I began to lose weight, what would happen if I stopped. It was worth it.

It is worth it. It's a fight. It's exhausting, but it is a fight I believe in. I cannot believe, anymore, in the fight between body and soul. If I do, it will kill me. But more importantly, if I do, I have taken the easy way out. I know for a fact that sickness is easier.

But health is more interesting.

Excerpted from Marya Hornbacher, Wasted: A Memoir of Anorexia and Bulimia. New York: HarperFlamingo, 1998, p. 280.

Whether the program is inpatient or outpatient, it will usually include various forms of counseling and medical care to treat the physical effects of the illness. The most common forms of counseling include nutrition, individual, family, and group. Nutrition counseling teaches the patient about healthy eating habits and designs appropriate meals. Its goal is to slowly bring the sufferer's weight back up to a safe level that can be easily maintained without dieting or provoking obsessive behavior about food. The first few months of treatment for anorectics can be very dangerous if the eating disorder has gone on for a long time. This is due to the shock the body experiences from eating food after years of starvation.

Individual counseling is one-on-one counseling in which a therapist helps the sufferer deal with her emotions and take control of her body and life again. Family counseling is when the family of the eating disorder sufferer is involved. This type of counseling helps the family and the sufferer to establish better relationships and change any unhealthy dynamics of the family. In group counseling, a counselor leads meetings of a group of eating disorder sufferers to help them learn how to achieve and maintain strong relationships. It also helps sufferers learn that they are not alone.

In support groups, eating disorder sufferers meet to offer support, understanding, and hope to one another as they battle their disorders. Support groups, like group counseling, help sufferers to not feel so alone in their illnesses and learn from others' experiences.

Some eating disorder sufferers will be prescribed medication to ease depression and anxiety as part of their treatment.

[For more information on types of treatments and therapy, see Chapter 15: Mental Health Therapies.]

The Recovery Process

Recovery is not easy. Most eating disorder sufferers feel that they are not worthy of love or life. It takes time (months, even years) and a lot of support from friends, family, and medical professionals to change the sufferers' self-perceptions. They need to feel worthy again of love from others. However, recovery is not as simple as saying "I love you" to eating disorder sufferers. They need to build their self-esteem so that they can believe that they deserve the love of others. Some people are able to make an initial recovery, but many find recovery to be an ongoing, lifelong process.

An eating disorder sufferer has certain goals, both physical and psychological, that she needs to try to reach in recovery. The physical aims should include the ability to eat a variety of healthful foods (without bingeing and purging) and maintain a healthy weight. Females should start their menstrual periods either for the first time or again without the help of medication.

The psychological aims of recovery should include a noticeable decrease in the fear of food and becoming fat as well as the ability to establish strong relationships with family and friends again. Another goal should be to realize the role society and the media play in furthering disordered thinking about people's weights and body shapes. This realization will help sufferers learn to accept and like their bodies without having to live up to unrealistic standards of beauty and thinness. An eating disorder sufferer should also work to establish new, positive coping skills and engage in activities that do not involve food or weight control.

WHAT TO DO IF YOU THINK SOMEONE HAS AN EATING DISORDER

  • First, voice concerns to the person privately.
  • Listen carefully to what that person is saying.
  • Avoid using judgmental statements.
  • Let the person know that you are concerned about her health.
  • Be familiar with some resources, such as reading materials, web sites, or community centers, that can be introduced to that person.
  • If the person exhibits behaviors that are life-threatening, such as bingeing and purging several times a day, fainting, or expressing suicidal thoughts, tell a trusted adult immediately.

The goals for recovery should start small. Learning to meet modest goals first will provide a sense of accomplishment that will help push a person toward meeting larger goals. It is easy to become overwhelmed and fall back into familiar patterns of living. Eating disorder sufferers have taught themselves how to starve or binge and purge and are familiar with using the disorder to help them cope with life. They need time to relearn healthy eating habits and how to feel good about themselves again at a healthy weight.

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