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EATING DISORDERS TREATMENT

LEIGH HOLMAN, PHD IAAOC PROCESS ADDICTIONS COMMITTEE

TREATMENTS FOR ANOREXIA NERVOSA


Another focus of treatment is correcting disturbed cognitions, especially client misperceptions and attitudes about eating and weight
Using cognitive approaches, therapists correct disturbed cognitions and educate about body distortions

TREATMENTS FOR ANOREXIA NERVOSA


Another focus of treatment is changing family interactions Family therapy is important for anorexia

The main issue is often separation

TREATMENTS FOR ANOREXIA NERVOSA


The use of combined treatment approaches has greatly improved the outlook for people with anorexia nervosa But even with combined treatment, recovery is difficult The course and outcome of the disorder vary from person to person
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TREATMENTS FOR ANOREXIA NERVOSA


Positives of treatment: Weight gain is often quickly restored 83% of patients still showed improvements after several years

Menstruation often returns with return to normal weight


The death rate from anorexia is declining
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TREATMENTS FOR ANOREXIA NERVOSA


Negatives of treatment: Close to 20% of patients remain troubled for years

Even when it occurs, recovery is not always permanent Anorexic behaviors recur in at least one-third of recovered patients, usually triggered by stress Many patients still express concerns about body shape and weight
Lingering emotional problems are common
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TREATMENTS FOR BULIMIA NERVOSA


Treatment is frequently offered in specialized eating disorder clinics The initial aims of treatment for bulimia nervosa are to: Eliminate binge-purge patterns Establish good eating habits Eliminate the underlying cause of bulimic patterns Programs emphasize education as much as therapy
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TREATMENTS FOR BULIMIA NERVOSA


Several treatment strategies: Cognitive Therapy The insight approach receiving the most attention is cognitive therapy, which helps clients recognize and change their maladaptive attitudes toward food, eating, weight, and shape As many as 65% stop their binge-purge cycle Interpersonal Therapy If cognitive therapy isnt effective, interpersonal therapy (IPT), a treatment that seeks to improve interpersonal functioning, may be tried A number of clinicians also suggest self-help groups or self-care manuals
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TREATMENTS FOR BULIMIA NERVOSA


Several treatment strategies: Behavioral therapy Behavioral techniques are often included in treatment as a supplement to cognitive therapy Diaries are often a useful component of treatment Exposure and response prevention (ERP) is used to break the binge-purge cycle

TREATMENTS FOR BULIMIA NERVOSA


Several treatment strategies: Antidepressant medications During the past decade, antidepressant drugs have been used in bulimia treatment Most common is fluoxetine (Prozac), an SSRI Drugs help as many as 40% of patients Medications are best when used in combination with other forms of therapy

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TREATMENTS FOR BULIMIA NERVOSA


Several treatment strategies: Group therapy Provides an opportunity for patients to express their thoughts, concerns, and experiences with one another Helpful in as many as 75% of cases, especially when combined with individual insight therapy

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TREATMENTS FOR BULIMIA NERVOSA


Left untreated, bulimia can last for years

Treatment provides immediate, significant improvement in about 40% of cases An additional 40% show moderate improvement
Follow-up studies suggest that 10 years after treatment about 90% of patients have fully or partially recovered
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TREATMENTS FOR BULIMIA NERVOSA


Relapse can be a significant problem, even among those who respond successfully to treatment Relapses are usually triggered by stress
Relapses are more likely among persons who: Had a longer history of symptoms Vomited frequently Had histories of substance use Have lingering interpersonal problems
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TREATMENTS FOR BULIMIA NERVOSA

Finally, treatment may also help improve overall psychological and social functioning

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