Treatment of anorexia

Before treatment of anorexia can begin, a medical examination needs to be under gone; this is because weight and nutritional state of the body needs assessing so that any medical complications can first be rectified before treatment can be successful. Anorexia patients are difficult to help, mainly because they do not want the help and have little trust in professionals due to the intense fear of weight gain they possess.

The following types of treatment are available,

•Hospitalization.

•Psychotherapy.

•Medication.

•Self help.

Hospitalization

This needs to be a decision not taken lightly by any medical professional and can be a difficult decision to make. If the individual is at the point of starvation and at risk of death then the decision is made to admit them to hospital.

This is so that fluid and nutrients can be replaced, keeping them alive is more important that addressing the psychological issues they have at this stage. The difficulty with this decision is that most anorexics feel they are overweight let alone underweight and can be very uncooperative and distressed during their stay in hospital.

If the patient is in fact at risk of death then hospitalization is not only a priority but an imperative aspect of the intervention process.

Inpatient programmes for treatment of anorexia nervosa usually are based on behaviour and rewards for certain behaviour, these also ensure that the patient does not purge following meals. A patient would be rewarded for meeting targets and eating well. Once weight gain has taken place, privileges may be awarded such as use of the telephone, or access certain areas of the hospital.

A target weight for the patient to achieve would normally be set, and upon reaching this target they will be discharged from hospital and enter an out-patient programme. This may consist of therapy groups, single therapy and doctor’s visits.

In most in-patient programmes (once the patient is out of immediate danger of death or starvation) consist of six meals per day, the daily caloric intake is gradual and increases as the patient improves.

Such programmes work on the psychological issues surrounding the eating disorder, such as self image and reasons behind their behaviour. If too much emphasis is put on weight, then success is often limited.

A limitation with hospitalization is; patients may appear to be making progress and be extremely cooperative. However they may be because they realise the sooner they reach their target weight, the sooner they can be released and return to their eating disorder.

Effective follow up treatment needs to be put in place to decrease the possibility of a relapse.

Psychotherapy

Firstly whether on an inpatient or out-patient programme, if the individual appears emaciated and seriously malnourished a priority is to restore their nutritional/health requirements first.

The patient must then have a trustworthy relationship with the psychotherapist. The client/clinician relationship is a huge aspect of the treatment and can certainly have a big impact on whether recovery is successful.

The main issue that needs addressing as mentioned previously is the self image issues that the patient is obsessed with. Issues that are fuelling the eating disorder need to be discovered and solved as much as possible. This can often take away the need for the eating disorder although by this point it has usually become a way of life and one that individuals are not too willing to relinquish.

For the patient to understand why they have been behaving in this manner and why their relationship to food and themselves has been negative is also an important aspect of treatment. It allows them to find closure and find another way to deal with such issues.

Psychotherapy usually lasts for a period of six months, changing ones behaviour, attitude and response to certain things is a lengthy process and sometimes additional therapy is required.

Some therapy involving friends and family is very effective; this is because an understanding of the eating disorder by the family can improve the support system for the patient. And also if any family dysfunctions are the cause, these can sometimes be rectified in order to improve the recovery rate.

Medication

In some cases medication can be an effective part of treatment, however it is important to remember that no medication can cure anorexia itself (as it is very complex and needs a range of treatment), it can only aid the treatment/intervention process. Antidepressants may be prescribed such as Amitriptyline, this kind of medication speeds up the process by allowing the patient to feel more positive in general thus they will respond better to therapy and more likely to tale on board what the psychotherapist is saying.

Medication would need to be monitored, especially if the patient is vomiting, this would decrease the effectiveness of the medication. In some cases chlorpromazine is administered for those suffering severe anxiety and obsessive behaviour.

Self help.

Self help is not rated enough as a treatment method; this is mainly because there are not many professionals involved and is not a practiced method of recovery. However this method can be very successful. Attending regular support groups consisting of people going through the same thing can be very beneficial in aiding the recovery process. It allows for ideas to be shared, direct feedback on self image, positive reinforcement and motivation, if one person is succeeding then others are likely to be spurred on to succeed themselves. Also an environment filled with trust and understanding can easily be established.

Keeping a diary of eating habits, meal plans, targets and routines can give the individual a feeling of empowerment. Learning about healthy eating can also reinforce knowledge about what their diet needs.

Self help books are available, these often contain; success stories, positive thinking strategies, FAQs and what to expect from their body/ emotions, how they may feel and how to deal with such feelings. They also provide information about how to increase caloric intake, what to eat and why they should eat certain things.

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