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Bulimia and Anorexia Treatment
Relevant information about Bulimia and Anorexia Treatment.
Bulimia or Bulimia Nervosa is a mental disorder related to food. The person has episodes of binge eating, followed by a deep sense of guilt and a sense of anguish and loss of control. Usually alternate with periods of fasting or very low food intake, but soon returned to have episodes of binge eating. While Anorexia is an eating disorder, characterized by the abnormal lack of appetite, and may be due to physiological causes, such as gastroenteritis, or to psychological causes, usually within a depressive symptoms –usually in women and adolescents- and can be very serious.
Both are eating disorders. The eating disorder sometimes causes the depression or the depression can lead to the eating disorder. All in all, eating disorders are very complex emotional issues. Though they may seem to be nothing more than a dangerously obsessive weight concern on the surface, for most men and women suffering with an eating disorder there are deeper emotional conflicts to be resolved. In this article all the topics around the treatment of Bulimia and Anorexia appear, like keys of succes, typical problems, terms, complications and more.
- What does the treatment consist on
The better way to treat eating disorders like bulimia or anorexia is diagnosed them early. This is the key of the successful -the sooner, the better-. Eating disorders are physically and emotionally destructive. People with eating disorders need to seek professional help immediately. Early diagnosis and intervention significantly enhance recovery. If not identified or treated in their early stages, eating disorders can become chronic, debilitating, and life threatening.
Unfortunately, even when family members confront the ill person about his or her behavior, or physicians make a diagnosis, individuals with eating disorders may deny that they have a problem. Thus, people with anorexia may not receive medical or psychological attention until they have already become dangerously thin and malnourished. This behavior of hiding the disease can even occur for several years. It is therefore important that the family is mindful of the appearance of typical symptoms. Anorexia and bulimia in boys and men are relatively rare. Consequently, the big problem treating anorexia and bulimia is catch the illness. Getting -and keeping- people with these disorders into treatment can be extremely difficult.
Another key to get a successful treatment over anorexia and bulimia is to make and interdisciplinary approach over the sick person. This is very important to build an appropriate recovery process. The complex interaction of emotional and physiological problems in eating disorders calls for a comprehensive treatment plan, involving a variety of experts and approaches. The interdisciplinary challenge may involve physician, internist, nutritionist, an individual psychotherapist, and a psychopharmacologist -someone who is knowledgeable about psychoactive medications useful in treating these disorders-. The efforts of mental health professionals need to be combined with those of other health professionals to obtain the best treatment. This team of experts should be the ideal situation of treatment over anorexia and bulimia. The psychoterapy is needed. A psychiatrist, psychologist, or other mental health professional meets with the patient individually and provides ongoing emotional support, while the patient begins to understand and cope with the illness. Group therapy, in which people share their experiences with others who have similar problems, has been especially effective for individuals with bulimia. The treatment should be individually tailored. Treatment will vary depending on the severity of the disorder and the client's particular problems, needs, and strengths. Psychological counseling needs to address both the eating disordered symptoms and the underlying psychological, interpersonal and cultural forces that contributed to the eating disorder. Typically, care is provided by a licensed health professional, including but not limited to a psychologist, psychiatrist, nutritionist, and medical doctor. There is a third key about the treatment. It’s the family. Parents and other family members are important in helping a person see that his or her normal body shape is perfectly fine and that being excessively thin can be dangerous. In many cases, family therapy is one of the best way to eating healthily again.
- How is the treatment performed
If an eating disorder is suspected, particularly if it involves weight loss, the first step is a complete physical examination to rule out any other illnesses. Once an eating disorder is diagnosed, the clinician must determine whether the patient is in immediate medical danger and requires hospitalization. Some patients can be treated as outpatients. However, some patients need hospital care. The initial stage of analysis of symptoms involves a diagnosis and treatment plan considering: review of patient's history, review of current symptoms presented, assessment of physical status, assessment of other psychiatric issues or disorders such as depression, anxiety, substance abuse, or personality issues.
The consensus is that good treatment often requires a spectrum of treatment options. These options can range from basic psychoeducational interventions designed to teach nutritional and symptom management techniques to long term residential placements. The possibilities of treatment are:
- Outpatient Care: Many people with eating disorders respond very well to outpatient therapy. There are several types of outpatient psychotherapies with demonstrated effectiveness in treating patients with eating disorders. Cognitive-behavioral therapy, interpersonal psychotherapy, family therapy, and behavioral therapy have all shown promising results in treating eating disorder sufferers. The program is for individuals who are medically stable, without acute psychiatric symptoms and actively working with an outpatient bulimia treatment team. In this type of care is essential to monitor the evolution of the patient's physical and nutritional. Regular consultations with a dietician can be an effective means of support and information for patients who are regaining weight or normalize their eating. It’s needed also a medical monotoring over the pacient. This conditions are imperative to achieve a perfect balance in the Outpacient Care.
- Psychopharmacology: Psychiatric medications have a demonstrated role in the treatment of patients with eating disorders. National Institute of Mental Health-supported scientists have examined the effectiveness of combining psychotherapy and medications. In a recent study of bulimia, researchers found that both intensive group therapy and antidepressant medications, combined or alone, benefited patients. For patients with binge eating disorder, cognitive-behavioral therapy and antidepressant medications may also prove to be useful.
- Intensive Outpatient Therapy (IOP): IOP is a form of partial psychiatric hospitalization. IOP is more intense than weekly outpatient therapy and less intense than inpatient hospitalization. IOP clients come for therapy several days per week for several hours at a time. IOP is often done in groups. IOP treatments are shorter in duration than full Partial Hospitalization Programs known as PHPs. The typical IOP program offers group and individual services of 10-12 hours a week. IOP allows the individual to be able to participate in their daily affairs, such as work, and then participate in treatment at an appropriate facility at the end of the day.
- Day Hospital Care: Day treatment programs provide structured eating situations and active treatment interventions while allowing the individual to live at home and in many continue to work or to attend school. PHP programs (see below) would fit into the day hospital care category.
- Partial Hospital Program: Partial Hospital Programs (PHPs) are more intense than IOP programs. PHPs imposes a routine with long hours and responsibilities. Attempts to emulate a situation of full employment. Usually the pacient is bussy all day, from 11 am to 7 pm.
- Inpatient Care: Inpatient treatment provides a structured environment in which the pacient has access to clinical support 24 hours a day. Many programs are affiliated with day and outpatient programs that allow clients to step up or down to the appropriate level of care depending on their clinical needs. Patients whose eating disorders is severe enough that they require inpatient care receive continuous monitoring of their condition, ongoing meal planning, therapy and support, and the security needed to ensure that they follow the treatment regime. The purpose of inpatient treatment of bulimia is to achieve medical and behavioral stabilization and acceptance by the patient of the need to change disordered behaviors.
- Residential Care: Residential programs provide long term treatment for those with eating disorders. The treatment needs of each individual will vary. It is important for those struggling with an eating disorder to find a mental health care professional they trust to assist in developing and coordinating their treatment plan. One benefit of residential living is that it begins to integrate patients back into the community. They may dine at restaurants, go shopping and cook. Residential settings typically are comfortable and inviting. This can aid in the treatment of bulimia by putting patients in a more positive state of mind.
- How is the post-treatment process
The description of types of treatments explained previously reveals an important fact: there is not one fixed term for the treatment of bulimia and anorexia. Term dependens of the severity of the sick person and the type of treatment provided by the medical team. The battle against the illness can take many years. At this time no treatment program for anorexia nervosa is completely effective. Two long-term studies (10 to 15 years) reported recovery after treatment in between 76% and 90% of patients. Most continued to eat less than normal. Bulimia and excessive eating continued to be very common at the end of the study.
In anorexia, women who develop this eating disorder at an early age have a better chance of complete recovery, but most people with anorexia will continue to prefer a lower body weight and be concerned to some extent by the food and calories. Weight management can be difficult and may require a long-term treatment to help maintain a healthy body weight.
In bulimia, the speed of treatment is one of the most important factors to give a prognosis. Those who receive it in the early stages of the disorder have a higher recovery and more permanent. Only you can recover from this disease if the person in question takes the decision to fight and change (this is a mental illness). So, it’s impossible to fixed an specific term for the recovery. It depends on each person.
Treatment aims to stabilize the patient. In the long term, the objective is to work psychologically on the patient to achieve reverse this malaise in the personality that leads him to suffer such illnesses. This is what does the treatment, in many cases successful.
However, there are cases in which recovery is not successful. Yet to be successful, in many cases certain habits that patients of anorexia and bulimia had, are not reversed. As an example, anorexic patients usually continue to eat small amounts of food. This is what does not the treatment.
The post treatment also depends on the pacient and the gravity of the case. Usually, the programs of post treatment have a duration of two years. In this context, the approximated average is: improved total 40-60%, improved partial 20-30%, never improvement 15-30%, death rate; 4%.
The several complications of anorexia are:
- Risk of death: Many studies of anorexic patients found mortality rates ranging between 4% and 20%. The risk of death is significant when weight is less than 60% of suicide normal. Half of the deads for anorexia are suicides. Men with anorexia are a particular risk, probably because it is usually diagnosed later than girls.
- Heart disease: Heart disease is the most common medical cause of death in people with severe anorexia. People suffering from this disease, after an extended period of time, suffer from an abnormally slow heart rate and very low blood pressure. This causes the heart muscle itself to change. The chance of heart failure rises as heart rate and blood pressure decrease.
- Electrolyte imbalances: Minerals such as potassium, calcium, magnesium and phosphate are usually dissolved in body fluid. Calcium and potassium are particularly critical for the maintenance of the electrical currents that cause the heart beat regularly. Dehydration and starvation of anorexia can reduce fluid levels and mineral content, a condition known as electrolyte imbalances, which can be very serious unless the fluids and minerals are replaced. Because of the lack of calcium in a person's diet, since they are not getting enough food in general, there is a great risk of reduced bone density, which is known as osteoporosis. This results in very dry and brittle bones which makes them very susceptible to breaking. Also muscle weakness and potential muscle loss. This can lead to more serious muscular disorders.
- Reproductive and hormonal abnormalities: Anorexia causes low levels of reproductive hormones, changes in thyroid hormones and increased levels of other hormones such as cortisol stress hormone. Irregular or absent menstruation in the long term is common, which over time can cause sterility and bone loss.
- Neurological problem: People with severe anorexia may suffer nerve damage and experience seizures, disordered thinking and tingling, loss of sensation or other nerve problems in the hands or feet. Brain scans indicate that parts of the brain undergo structural changes and abnormally high or low activity during the anorexic states, some of these changes return to normal after weight gain, but there is evidence that some damage may be permanent.
- Blood problems and Gastrointestinal problems: Anemia is a common result of anorexia and starvation. A particularly serious blood problem is pernicious anemia, which can be caused by severely low levels of vitamin B12. If anorexia becomes extreme, the bone marrow greatly reduces its production of blood, a potentially fatal condition called Pencitopenia.
On the other hand, the inflammation and constipation are both very common problems in people with anorexia.
The several complications of Bulimia are:
- Medical problems: The organs that suffer the most are: heart, kidney, brain, digestive system, bones, skin and endocrine glands. The erosion of the teeth, cavities and gum problems are common in bulimia. Bulimic episodes may also result in water retention and abdominal swelling and inflammation. Occasionally, the process of eating and purging result in excessive fluid loss and low potassium levels, which can cause extreme weakness and almost paralysis, this is reversed when administered potassium. Dangerously low levels of potassium can lead to dangerous heart rhythms and sometimes fatal. The bones become weak due to the development of low bones density after many years of suffering from bulimia. People can and do complain about their bone's aching plus they have lots of pain and the bones can break from even minimal strain or pressure. Kidney damage is very common among long term bulimics. The kidneys are organs that normally correct mineral abnormalities in the body. But when a person's mineral balance is constantly disturbed, like in case of bulimia, the kidneys are under enormous strain to correct it and eventually they get damaged. In women, menstruation becomes irregular or stops and because of this a woman is unable to conceive and have a baby.
- Psychological and self-destructive behavior: Women with bulimia are prone to depression and are also in danger of impulsive dangerous behaviours, such as sexual promiscuity and kleptomania, which have been reported in half of people with bulimia. The alcohol and drug abuse is more common in women with bulimia in the general population or in people with anorexia. In a study of non-anorexic bulimics, 33% abused alcohol and 28% abused drugs, with 18% overdosed repeatedly. Cocaine and amphetamines were the drugs most commonly abused. In the same study, were common to other self-destructive behavior, including self-cutting and theft. So, the long time effects of brain damage from bulimia are: suicidal thoughts, self-cutting and other self-harm symptoms. Impulsive behavior can occur and people can become less responsible for their action.
- Counter medicines: Women with Bulimia frequently abuse nonprescription drugs such as laxatives, appetite suppressants, diuretics and drugs that induce vomiting -usually Ipecac-. These drugs leads the pacient to a big risk. Diet pills, including herbs and prescription medications can be dangerous, particularly if they are abused.
“The individual needs to learn how to live peacefully and healthfully with themselves and food”.
This is the big challenge in these times of expansion of the Bulimia and Anorexia.
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