Treatment for Eating Disorders

The present article will review the Treatment for Eating Disorders. We will review three of the most common eating disorders in adults: Binge-eating disorder, bulimia nervosa, and anorexia nervosa.

1. Binge-eating disorder

Binge-eating disorder is characterized by frequent binges (i.e. eating a lot of food in a short time).

A common treatment for binge-eating is psychotherapy, such as cognitive-behavioral therapy and interpersonal psychotherapy, both of which have been shown to be effective for the treatment of this disorder.

The goal of cognitive behavioral therapy is to reduce the dietary restraint behavior, which is a contributing factor to the pattern of alternating binge-eating and dieting. In therapy, patients learn how to self-monitor, return to healthy eating habits, change distorted views and beliefs regarding weight and body shape (e.g., “feeling fat”), and manage situations that might trigger binge eating.

Interpersonal psychotherapy addresses interpersonal difficulties potentially related to disordered eating, such as social isolation, conflicts with a romantic partner, and unresolved grief due to a recent loss.

As a pharmacological treatment for Eating Disorder, a variety of medications (e.g., antidepressants, anti-obesity drugs) have been used to manage binge-eating and related mental health and physical health issues. For instance, a commonly used drug is Vyvanse. Vyvanse, which has been approved by the FDA for the treatment of binge-eating, is a stimulant previously used to treat attention deficit hyperactivity disorder.

2. Bulimia nervosa

Bulimia nervosa is also characterized by binging. However, in bulimia, binging occurs in combination with extreme dieting and compensatory behaviors (e.g., excessive exercise, self-induced vomiting).

Some treatments for bulimia nervosa are cognitive behavioral therapy, interpersonal psychotherapy, family-based treatments (mostly for younger individuals), and medications.

Cognitive behavioral therapy targets food restraint, compensatory behaviors (e.g., abuse of diuretics and laxatives), and preoccupation with weight and shape. Therapy helps these patients establish a healthier eating pattern, and to identify and modify thoughts and behaviors that maintain bulimia.

Interpersonal therapy addresses dysfunctional interpersonal issues. Even seemingly minor issues may contribute to unhealthy eating habits. For instance, a patient with bulimia who is treated like a child by his or her parents might experience intense negative self-evaluations, which are then coped with using a combination of binge eating and self-starvation.

Last, commonly used medications for bulimia nervosa include antidepressants, particularly SSRIs (e.g., Prozac).

3. Anorexia nervosa

People with anorexia nervosa have an extreme fear of gaining weight and thus maintain unhealthily low body weight. Some do so mainly through dieting, fasting, and exercise (the restrictive subtype), while others rely on purging (the binge-eating/purging subtype).

The treatment for anorexia nervosa is somewhat different from the other conditions reviewed because anorexia nervosa is associated with a high risk of mortality. Therefore, depending on a variety of factors (e.g., age, weight, other health issues), the initial treatment for this condition might include hospitalization.

Once a patient’s weight is no longer dangerously low, then psychotherapy could be used to help the individual learn more effective ways to cope and strategies to prevent relapse.

Cognitive-behavioral therapy, for example, can address body image disturbances and encourage regular eating and healthy weight maintenance.

Research also supports the use of family-based treatments for anorexia nervosa, especially in younger patients. The treatment might involve initially giving the parents the responsibility of creating a healthy eating pattern. However, when the symptoms improve sufficiently, the patient is given more freedom and responsibility in creating and following a healthy eating pattern. Because this approach does not consider the initial causes of the disorder, it does not assign blame and focuses instead on improving the symptoms.

Last, in terms of medications, limited evidence suggests some antipsychotics and antidepressants may help with weight restoration and reduction of depressive symptoms.