So far for Eating Disorder Awareness Week, I have talked about the types of eating disorders, misconceptions about EDs, and their signs and symptoms. Today, as promised, I am going to discuss how to go about seeking help for an eating disorder, and begin recovery. It is usually very difficult for eating disorder sufferers to recover without support from professionals, so it is important that you find it as soon as possible. Although gaining access to treatment isn’t always as straightforward as it would be in an ideal world, the sooner that you do seek it out, the more likely you are to make a full recovery.
I’m unsure of what services are available for people outside of the UK, but I know that here, you may face a long wait before accessing NHS treatment, and during this time, self-help is important. Many self-help support services are offered by Beat, including message boards, support groups both online and in your local area, and helpline services, alongside helpful reviews of self-help books. Sites like Overcoming Anorexia Online and Overcoming Bulimia Online can also aid self-help, these sites in particular offer 8 sessions of therapy to help an individual learn, understand, and overcome their condition at their own pace in the comfort of their own home.
When looking for support for a potential eating disorder, the first place to go should always be your GP. Because it can be incredibly difficult, it is advisable to consider speaking to some kind of helpline, a support team at your school or workplace, or a loved one before doing this, to ease any anxiety you may have about asking for support. Once you first talk to your GP, they, and other members of the primary care team such as your practise nurse, will play a key role in identifying your eating disorder. In some cases, people are referred straight to an ED specialist, but your GP may also want you to come back at another time to see how you are- try not to see this as a sign that you don’t require or deserve treatment, and keep the determination that drove you to get help strong throughout the process.
Your GP will look at your weight and how it compares to a healthy weight for your age, and might monitor significant changes in weight. They will likely ask about any issues you have with your self-image and talk to you about eating disorder behaviours, and they might also take some blood for testing. This period will undoubtedly be daunting, but it is important to be as open as possible about how you are feeling and the impact that your problems with food is having on you. If you are feeling nervous, which you likely will, talk to the doctor at the start of the appointment about it- they will be understanding. It may also help if you write down key points you would like to discuss before going into the appointment.
If after this, your GP suspects that you might have an eating disorder, they will refer you for an assessment and potential treatment by a person with more in-depth knowledge of eating disorders, and this should happen as quickly as possible. The NICE guidelines provide clinical information about eating disorders and how they should be treated- you may find it helpful to take a look at them, as they outline the best practise that professionals should follow when treating eating disorders.
The treatment that you will receive for an eating disorder will depend on your diagnosis.
Treatment for Anorexia
If you are diagnosed with anorexia, then most of your treatment will be as an outpatient, and psychological treatment should last for 6 months or longer. However, if you are thought to be at serious risk, you might be referred for inpatient or day patient treatment.
Once diagnosed with anorexia, you might be referred to a number of psychological treatments, which aim to help psychological recovery as well as monitoring aspects of your physical health. Examples of these treatments include cognitive behavioural therapy (CBT), cognitive analytic therapy (CAT), interpersonal therapy (IPT), focal psychodynamic therapy and family therapy. A specialist may also be accessible to give you advice about food and diet, but this should not be the only treatment that you are offered. You may be prescribed medication for anorexia as part of your treatment plan, so be sure to ask your doctor about any side effects that the medication may cause, and ensure that they make a note of them on your medical records.
If your physical health is/becomes very poor as a result of your anorexia, or your team think that you may be at risk of harming yourself, you may be offered inpatient treatment. It could also be recommended if you are in outpatient treatment but your illness has not improved. If you would like to learn more about an inpatient programme for people with anorexia, you may find it useful to read about Katrina’s experience.
Treatment for Bulimia
Your GP may recommend that your first step in recovery involves self-help, with the support of your primary care team alongside it. (I won’t detail self-help methods because I’ve mentioned them already earlier in the post.) For those who do not find that self-help treatment works for them, Cognitive Behavioural Therapy (CBT) will likely be offered. This treatment should include up to 20 sessions, and last for around five months. If this form of psychological treatment is not successful, the NICE guidelines say that Interpersonal Therapy (IPT) should follow CBT, or be offered to those who would prefer to follow this line of treatment anyway.
Alongside a programme of self-help or talking therapies, medication can be offered to bulimia patients. An example of this is Prozac, which contains Fluoxetine; this is a Selective Serotonin Reuptake Inhibitor (SSRI), and it can regulate brain chemicals that control mood, preventing guilt and anxiety about binging. This and other anti-depressants can help to keep emotions stable and reduce the frequency of binge-purge cycles. In the majority of cases, all treatment for bulimia will be as an outpatient, but inpatient treatment may be suggested in situations where someone’s physical health is of concern, or they are at risk of harming themselves.
Treatment for Binge Eating Disorder (BED)
As with bulimia, self-help is often suggested as a first step for recovering from BED (there is some information about self-help earlier on in this post). If your BED is persistent after methods of self-help are implemented, psychological treatment may be offered; cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT) and modified dialectical behaviour therapy (DBT) might be some options that will be discussed with you, and you should be able to have a say in what treatment path you follow
Medication can also be recommend for BED patients, to accompany self-help and talking therapies or be an alternative to them. Lisdexamfetamine (Vyvanse), topiramate (Topamax), serotonergic (SSRI) medications, and sibutramine (Meridia) can reduce the behaviour patterns associated with BED, such as episodes of bingeing. It is uncommon for a BED patient to be admitted as an inpatient, but you may be asked to attend day services to receive advice about meal planning and develop your understanding of diet and nutrition.
Because EDNOS has no specific set of characteristics, treatment for the disorder will vary from patient to patient, but this process usually involves psychological treatments such as CBT. If you feel that you may have EDNOS, but have disordered eating patterns that match the three eating disorders I have talked about in this post, it may be helpful to read through the treatment of those behaviours to get a clearer idea of what options may be available for you.
I hope that this post has been helpful to anyone considering seeking treatment for disordered eating. If you are uncertain about doing so, I would definitely recommend it because things will start to look up. Later in the week, I’m going to write a post talking in detail about recovery, so please be sure to give that a read when it has been posted if you feel that it may help encourage you more. If you do need support in getting help, feel free to leave me a comment and we can talk on most social media platforms if you would like, and if you do choose to seek treatment, I’d love to know how it goes for you!
Thank you for reading! I hope you have found this post helpful and I wish you the best of luck in your recovery. Keep growinggg!