The first step is to get a good physical exam with a physician who understands the medical issues involved with eating disorders. He/she will need to rule out any physical cause for the disorder and evaluate your physical condition.
Most people can be treated in an outpatient setting, but sometimes hospitalization is necessary. Hospitalization is usually considered when weight loss is severe, when there are serious metabolic disturbances, when there is a risk of suicide due to clinical depression, when binging and purging is severe or when you are experiencing psychosis.
Because eating disorders involve complex emotional, psychological and spiritual issues, you need a comprehensive plan that will help you overcome the disorder. Usually a team of multidisciplinary professionals is assembled to treat you. The team should include a registered dietitian, a physician, a mental health practitioner who can provide individual, group and family psychotherapy and a psychopharmacologist-someone knowledgeable about psychoactive medications used to treat these disorders if needed.
The dietitian will help you establish good eating habits, correct faulty information about food, and help you gain or lose the appropriate weight safely and sensibly. The emphasis is on teaching you to use food as nutrition, not as a coping mechanism. The nutritionist, along with the therapist and physician, agree on a target weight for you to achieve. It is her job to nudge you along to your target weight.
The mental health practitioner is usually a psychologist, clinical social worker, marriage and family therapist or counselor. The therapist helps you deal with the underlying emotional, spiritual and interpersonal issues that are playing out through preoccupation with food. The most effective models of individual therapy use a cognitive-behavioral or interpersonal therapy approach. The focus is usually examination and change of thoughts and behaviors.
Group therapy can be helpful in sharing your struggles with others who have the disorder. Groups help you feel less isolated, ashamed and more supported. Many groups provide good information along with support. Therapy groups can assist you in the practice of assertiveness, help you find your voice and identity, and explore interpersonal issues.
Family therapy is especially needed with young girls and teens. It is highly recommended for all types of eating problems. Family involvement aids treatment. Family work deals with family dynamics that contribute to the disorders.
Sometimes, not always, medications are used to help an underlying depression or anxiety problem. A psychopharmacologist may provide treatment recommendations to improve mood, control urges to binge and deal with excessive anxiety blocking progress.
Overall, the work of recovery and eventual freedom is a team effort using the resources of many fields. People with eating disorders often deny the seriousness of the problem. Some react with anger when help is sought. Denial of the problem is strong. Face your problem. Help is available. Early intervention leads to success.
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