What treatment and support is available?
The help and support of friends, family and professionals can help you identify and resolve the underlying causes of your eating problems. Without this, breaking free from a negative relationship with food can be extremely difficult.
“Receiving help early on, from people who are experienced in treating eating problems, is very important. Ultimately, my psychologist, occupational therapist and dietician saved my life.”
Contact a medical professional
You can contact your family doctor if you’re worried you may have an eating problem. They will need to check that any symptoms, such as weight loss or gain, are not due to another underlying physical illness.
Although your family doctor may not have the experience to offer you in-depth support, they should be able to refer you to a medical professional, such as a therapist, and specialist services, such as individual therapy, family therapy, group therapy, and counselling among other specialist support services. They should also be able to refer you to a dietician, who can give you advice about getting the right nutrients and reaching a healthy weight.
Working with a therapist can help you face – and cope with – the underlying issues which may be causing your eating problem.
Therapists use a range of different techniques. Some types of therapy may focus on the past and your life experiences. Others may focus on your relationships with your family and other important people in your life.
Group and family therapy may also be an option, and can be a great way to help your family understand your eating problems. It can allow you and your family to look at ways of supporting and being open with each other.
Common talking therapies for eating problems include:
- Cognitive behaviour therapy (CBT)
- Interpersonal therapy, which helps you look at the connection between relationships in your life and how you feel
- Dialectical behaviour therapy (DBT), which can help you feel more aware of your emotions and accepting of yourself
Cognitive behaviour therapy (CBT)
The leading treatment for eating disorders is CBT. The “behaviour” component of CBT focuses on normalising eating patterns. This includes meal planning, nutritional education, and teaching one to eat small amounts of food more regularly. The “cognitive” element of the treatment is aimed at understanding the way one’s thoughts and feelings affect their behaviour and actions, and to make appropriate changes.
Many people have found that treatment with CBT helps to reduce the severity of symptoms of an eating disorder, especially if they work with a trained therapist, but also with a CBT computer programme which can be accessed through a general practitioner.
“Cognitive behaviour therapy really helped me to change the distorted thoughts flying around my head and move on from my eating disorder.”
You may also be offered medication. There is no medication specifically for eating disorders, but you may be offered antidepressants or other mental health medications to treat underlying causes of the problems.
If you have bulimia nervosa or binge eating disorder, you may be offered antidepressant medications. This is because patients with bulimia nervosa or binge eating disorders often show mood disturbances that may worsen their eating disorder. The most common antidepressant prescribed to people experiencing bulimia nervosa or binge eating disorders is a selective serotonin reuptake inhibitor (SSRI) antidepressant.
If you have anorexia nervosa, you may be offered an antidepressant or a medication called olanzapine. Olanzapine is an antipsychotic medication that helps with the disturbed thinking, specifically about body shape and size, characteristic of patients with anorexia nervosa. Also, one significant side effect of olanzapine is weight gain, which is very desirable in the treatment of anorexia nervosa.
If you are underweight or overweight, drugs may be absorbed more or less quickly into your bloodstream, which could affect the intended effects of the medication. Your doctor will decide whether to offer you medication, and you can decide whether you want to take it.
Admission to a clinic
You may need to go into hospital or to a clinic if your family doctor or a medical professional feel you are very unwell or underweight, if other kinds of treatment haven’t worked, or if your home environment is making it hard for you to stay well.
If you are an outpatient or day patient, you will go home most evenings and weekends. If you are an inpatient, you will stay in the hospital or clinic for most of your treatment. How long you are admitted for will depend on how much help you need to recover.
You will normally receive a range of support as an inpatient. The staff at the hospital or clinic could include:
- Occupational therapists
- Social workers
- Family and relationship therapists
- Specialist nurses
Treatment can include:
- Talking therapies e.g. cognitive behavioural therapy (CBT)
- Working in groups with other people experiencing eating problems
- Medication (see ‘Medication’)
- Refeeding (see ‘What is ‘refeeding’?’)
Your weight and general health will normally be monitored. There may be guidance on buying, preparing and serving food, how to cope with stress and anxiety, how to be more assertive, and how to manage anger and how to communicate well.
What is ‘refeeding’?
Refeeding means being given food with the aim of increasing your weight up to a healthy level. You may be given specific foods because they have certain nutritional values or are particularly good at helping people gain weight.
How this works varies from one clinic to another. Some doctors may do this over a longer period of time, allowing you to gradually increase your weight, whereas others will want to help you back to a healthy weight as soon as possible.
Refeeding can be a distressing process, especially if you do not want to gain weight, and may be something you want to talk about with your doctor in more detail.
Could I be forced to go to a clinic?
If a group of medical professionals agree that you are at risk of harming yourself or anyone else then they could force you to go to hospital under the Cap. 136 Mental Health Ordinance. This is sometimes called being sectioned. This could happen if your eating problem is having a significant impact on your physical health, and medical staff are concerned that you won’t be able to recover without support.