Eating disorders can cause brief illness or lead to a chronic or life-threatening disorder. Prompt diagnosis and assertive treatment led by specialists in eating disorder treatment is essential. Caught early, and treated aggressively, the disruption to the patient's life and health can be temporary. Although optimism is appropriate and helpful, families should expect to make supporting their loved one's recovery and relapse prevention the number one priority for the next six to twelve months. Just as if your child had cancer or was recovering from a traumatic injury - jobs, school and social activities must temporarily become secondary to recovery from this life-threatening illness.
There is no single standard of care subscribed to by all clinics and clinicians. Individual clinicians are not trained or able to advise the family on all options available so families must take the initiative to evaluate and participate in treatment decisions. Patients, due to brain functioning problems caused by even mild malnutrition (anosognosia), are often not able to evaluate treatment options. It is often the responsibility of the parents to fully research and evaluate the appropriate treatment approach and location for their dependent children.
Evidence-based treatment approaches
Although eating disorders have been treated for centuries, treatment has been guided by the training, experience, and observations of the individual clinician. Over time, countless ideas have circulated about both the causes and best treatments for anorexia and bulimia but few have been tested to see how well they work in practice when compared to one another. FEAST believes that just as is done with drug treatments, it is important for treatment approaches for mental illness to be ''evidence-based.
" In the past few decades, researchers have started to carry out careful research comparing approaches and have been able to identify some treatments as more likely to be effective than others.
There are, currently, no pharmaceutical treatments specifically for eating disorders, though some psychiatric medicines can be helpful for co-morbid conditions. Medical treatments are often necessary for the medical damage done by malnutrition and purging behaviors.
Nutritional stability and normalization of body composition are the initial goals in modern eating disorder treatment as the psychological symptoms are understood to be exacerbated and held in place by brain changes from inadequate or erratic nutrition, and weight loss.
Psychotherapy is generally considered to be an important component of treatment. There are many approaches out there, and many combinations of approaches. F.E.A.S.T. believes families have a right and responsibility to pursue evidence-based care as appropriate. Unfortunately, very few psychotherapy approaches have been rigorously studied for use with eating disorders. We suggest parents do careful reading about both evidence based and other untested ways to approach the illness.
Although most treatments have not been researched, as of now, only the following have been researched in controlled trials and supported for the treatment of eating disorders:
For other diagnoses and ages, and when these approaches are not appropriate to the individual or have not been helpful, there is no research to indicate what approaches might be more effective. There are no treatments that can be expected to work for everyone, so identifying evidence-based treatment as a first option is important. Just as not all approaches have been tested, the above evidence-based approaches are often used with patients from groups where high quality research has not been done. For example, FBT is often used with patients with bulimia and with older patients. CBT is often used with anorexia and younger patients. There is no indication that these approaches are only helpful in the populations that have been studied so far.
Lack of research does not mean that a given approach will be dangerous or unhelpful, but since eating disorder recovery rates decrease the longer a patient is ill it is best to explore evidence-based treatment first when possible.
Each patient and each family is unique, and treatment recommendations are best made by experienced experts in the eating disorder field, after multidisciplinary evaluation, and in close collaboration with medical and psychiatric clinical teams.
Other Treatment Approaches
For a list of other treatment approaches: HERE