Anorexia Treatments
Anorexia treatments typically involve a combination of medical, nutritional, and psychological interventions. Medical treatment may focus on addressing any physical complications resulting from the disorder, while nutritional therapy aims to restore healthy eating habits. Psychological interventions, such as cognitive-behavioral therapy, help individuals address underlying emotional and cognitive factors contributing to their eating disorder.
7 Key excerpts on "Anorexia Treatments"
eBook - ePubThe Psychology of Eating
From Healthy to Disordered Behavior
- Jane Ogden(Author)
- 2011(Publication Date)
- Wiley-Blackwell(Publisher)
...11 Treating Eating Disorders The previous chapter described the etiology of anorexia and bulimia in terms of six different theoretical perspectives. These were a physiological model, a psychoanalytic model, a cognitive behavioral model, a family systems model, a sociocultural model, and one focusing on significant events. At times models of etiology translate into a treatment perspective. For example, a psychoanalytic theory of the etiology of eating disorders forms the basis of psychoanalytic psychotherapy, a cognitive formulation results in cognitive behavioral treatment, and a family systems analysis results in family therapy. This chapter first describes these three treatment perspectives and evaluates evidence for their effectiveness. Some etiological theories, however, do not translate into a treatment approach, and most treatment approaches involve an integration of the different perspectives. In addition, some individuals with anorexia are in a critical state and need treatment to get them back to a physically stable state. This chapter illustrates how inpatient treatment offers an integrated approach to the treatment of anorexia. Self-help groups for bulimia are also available, which draw on a range of the different theoretical perspectives described below. Other treatment interventions such as drug treatments and, more controversially, surgery are sometimes used, but are not commonplace and are not covered here. This chapter covers the following: Psychoanalytic psychotherapy Cognitive behavioral therapy (CBT) Family therapy Inpatient treatment An integrated approach to treatment Psychoanalytic Psychotherapy The two core themes of a psychoanalytic model of eating disorders were described in chapter 10 as the role of childhood and the symbolic nature of symptoms. Dare and Crowther (1995a) have developed a form of “focal psychoanalytic psychotherapy” specifically for eating disorders, which is time limited, is standardized, and addresses these two core themes...
- Amy E. Wenzel(Author)
- 2017(Publication Date)
- SAGE Publications, Inc(Publisher)
...Long-term residential treatment at a specialty facility may be indicated in rare instances, particularly for those who (a) fail to improve at a lower level of care, (b) are unable to abstain from symptoms without 24-hour supervision, and/or (c) have an unsupportive home environment that impedes progress in treatment. Intensive day and residential treatments involve structured therapeutic meals throughout the day, in addition to several group and individual therapeutic activities designed to address body image concern, improve coping and emotional regulation skills, and develop plans for relapse prevention. The aforementioned guidelines reflect widely accepted transdiagnostic recommendations for most full and subthreshold eating disorder diagnoses. However, several specific psychological treatment approaches are used within this general standard of care for eating disorders, and many demonstrate differential efficacy for AN, BN, and BED. Diagnosis-specific treatment approaches with the strongest empirical support are described in the next section. Empirically Supported Behavioral Treatments Anorexia Nervosa Primary foci of AN treatment typically include weight restoration, identifying and restructuring distorted cognitions around food and body image, and developing adaptive coping strategies to replace the function of restrictive eating and other eating disorder symptoms. Psychotherapy for AN is generally aimed at identifying the factors that maintain restrictive eating behavior and helping patients cope with the distress associated with weight gain as treatment progresses. Patients with AN often incorporate their disorder into their identity and sense of self as the illness progresses. Therefore, exploration of a “new” identity, not associated with maintaining strict control over eating and a low-weight status, is often an important part of therapy. Few randomized controlled trials have evaluated the efficacy of the available AN treatments...
eBook - ePubCognitive Behaviour Therapy
A Guide for the Practising Clinician, Volume 1
- Gregoris Simos, Gregoris Simos(Authors)
- 2014(Publication Date)
- Routledge(Publisher)
...For anorexia nervosa additional components are added such as checking the patient's weight, discussion of weight within the context of goals, review of physical complications and meal planning (Garner et al., 1997). Also, in anorexia nervosa, modifications must be made to the format of therapy to take into consideration the special needs such as the age of the patient and the clinical circumstances, and to determine the format of meetings as individual, family, or a mix of family and individual meetings. General treatment principles There are several general principles that should be considered central to any treatment approach to eating disorders and they will only be briefly mentioned here because they have been elaborated in depth elsewhere (Fairburn, 1985; Garner, 1986; Garner & Bemis, 1982, 1985; Garner & Isaacs, 1985; Garner, Garfinkel, & Bemis, 1982; Garner, Garfinkel, & Irvine, 1986). These include the importance of the therapeutic relationship, cultivating motivation for treatment, differences in treatment for the two main eating disorders, and the two track approach to treatment. The therapeutic relationship Although Beck and his colleagues (Beck, 1976; Beck, Rush, Shaw, & Emery, 1979) have emphasised that CBT treatment, as with other approaches, presupposes a trusting, warm, and empathic relationship with the therapist, this essential ingredient is sometimes overlooked in discussions of the technical aspects of cognitive therapy. Rather than representing a “non-specific” element in the treatment of eating disorders, a strong therapeutic relationship should be regarded as integral to change. This is particularly important in anorexia nervosa where the patient may enter treatment with considerable resistance to change (Garner et al., 1997). Motivation for treatment Enlisting motivation for treatment can be difficult with eating disorder patients since certain symptoms like restrictive dieting are ego-syntonic...
eBook - ePubIntegrating Psychotherapy and Psychopharmacology
A Handbook for Clinicians
- Irismar Reis de Oliveira, Thomas Schwartz, Stephen M. Stahl, Irismar Reis de Oliveira, Thomas Schwartz, Stephen M. Stahl(Authors)
- 2013(Publication Date)
- Routledge(Publisher)
...7 Integrating Psychopharmacology and Psychotherapy in Eating Disorders Phillipa J. Hay, Josué Bacaltchuk, and Stephen Touyz Introduction This chapter focuses on the integrated use of psychopharmacology and psychotherapy as applied to the treatment of patients with anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and eating disorder not otherwise specified (EDNOS). General Description of the Disorder Prevalence and Diagnostic Features In a nationally representative study of EDs in the United States in 2001–2003, the lifetime prevalence of AN was 0.9% in women and 0.3% in men; BN was 1.5% in women and 0.5% in men; and BED was 3.5% in women and 2.0% in men (Hudson, Hiripi, Pope, & Kessler, 2007). In the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5; APA, 2000) AN is characterized by a relentless pursuit of thinness, resulting in weight loss or failure to gain weight during growth, a refusal to maintain a normal body weight, and a fear of gaining weight or becoming fat or persistent behaviors to avoid weight gain. In the fifth revision (APA, 2013) an earlier (APA, 2000) the criterion amenorrhoea was removed, and fat phobia was also be removed as an essential criteria. BN diagnostic criteria (APA, 2013) comprise the presence of regular episodes of binge eating (uncontrolled overeating of large amounts of food) followed by extreme weight control compensatory behaviors and an intense preoccupation with weight and shape issues as an expression of self-worth. BED is characterized by recurrent episodes of binge eating with associated distress and an absence of regular use of the compensatory behaviors found in BN...
eBook - ePub- Linda Smolak, Michael P. Levine(Authors)
- 2015(Publication Date)
- Wiley-Blackwell(Publisher)
...Treating severe and enduring anorexia nervosa: A randomized controlled trial. Psychological Medicine, 43. 1–11. Treasure, J., Murphy, T., Szmukler, G., Todd, G., Gavan, K., & Joyce, J. (2001). The experience of caregiving for severe mental illness: A comparison between anorexia nervosa and psychosis. Social Psychiatry and Psychiatric Epidemiology, 36, 343–347. Treasure, J., & Russell, G. (2011). The case for early intervention in anorexia nervosa: Theoretical exploration of maintaining factors. British Journal of Psychiatry, 199, 5–7. Vitousek, K., Watson, S., & Wilson, G. T. (1998). Enhancing motivation for change in treatment-resistant eating disorders. Clinical Psychology Review, 18, 391–420. Von Holle, A., Pinheiro, A. P., Thornton, L. M., Klump, K. L., Berrettini, W. H., Brandt, H.,…Bulik, C. M. (2008). Temporal patterns of recovery across eating disorder subtypes. Australian and New Zealand Journal of Psychiatry, 42, 108–117. Watson, T., Bowers, W., & Andersen, A. (2000). Involuntary treatment of eating disorders. American Journal of Psychiatry, 157, 1806–1810. Watson, T., Bowers, W., & Andersen, A. (2001). Involuntary treatment of eating disorders. Eating Disorders Review, 12, 1–7. Williams, K. D., Dobney, T., & Geller, J. (2010). Setting the eating disorder aside: An alternative model of care. European Eating Disorders Review, 18, 90–96. Wonderlich, S., Mitchell, J. E., Crosby, R. D., Myers, T. C., Kadlec, K., Lahaise, K.,…Schander, L. (2012). Minimizing and treating chronicity in the eating disorders: A clinical overview. International Journal of Eating Disorders, 45, 467–475. Woodside, D. B., Carter, J. C., & Blackmore, E. (2004). Predictors of premature termination of inpatient treatment for anorexia nervosa. American Journal of Psychiatry, 161, 2271–2281. Yager, J. (1992). Patients with chronic recalcitrant eating disorders. In J. Yager, H. E. Gwirtsman, & C. K. Edelstein (Eds.), Special problems in managing eating disorders (pp. 51–86)...
eBook - ePub- Carlos M. Grilo(Author)
- 2014(Publication Date)
- Psychology Press(Publisher)
...Dare and colleagues (2001) reported that family therapy and a psychoanalytic psychotherapy were superior to a control condition. McIntosh and colleagues (2005) reported that a nonspecific supportive clinical management method was superior to interpersonal psychotherapy, while cognitive behavioral therapy (CBT) was intermediate to the other two treatments. Interestingly, Russell and colleagues (1987) in the earlier study noted above that reported the superiority of the Maudsley Method for younger cases of AN noted a tentative finding that individual supportive therapy was more beneficial for older patients. Pharmacotherapy Various medications (antipsychotics, antidepressants, anxiolytics, appetite-enhancing agents, prokinetic agents) have been tested for anorexia nervosa without much success. Although the literature is peppered with open-label case reports regarding potential promise of medications for promoting weight gain, the few controlled studies have consistently failed to support their usefulness (Attia, Haiman, Walsh, & Flater, 1998; Biederman et al, 1985; Halmi, Eckert, LaDu, & Cohen, 1986; Vandereycken, 1984). Medications have not been found to promote weight gain in this patient group. Medications have also not been found to improve eating disorder psychopathology in AN patients nor to improve associated general psychopathology. Thus, at present, there is no established role for pharmacotherapy for the treatment of AN. Although it is commonplace in clinical practice to use concurrent pharmacotherapy (as part of multimodal treatments), it remains uncertain whether any additive effect occurs. Attia and colleagues (1998) at Columbia University conducted a randomized, placebo-controlled, double-blind study to test whether seven weeks of fluoxetine significantly enhanced a structured intensive inpatient program for AN...
eBook - ePubFuture Work in Clinical Child and Adolescent Psychology
A research agenda
- Mitchell J. Prinstein, Mitchell J. Prinstein(Authors)
- 2018(Publication Date)
- Routledge(Publisher)
...We firmly believe that more rigorous and methodical research in these areas will bring us closer to realizing the goal of broad implementation of effective prevention and treatment interventions that will help reduce the population prevalence of eating disorders. REFERENCES Agras, W. S., Crow, S. J., Halmi, K. A., Mitchell, J. E., Wilson, G. T., & Kraemer, H. C. (2000). Outcome predictors for the cognitive behavior treatment of bulimia nervosa: Data from a multisite study. American Journal of Psychiatry, 157, 1302–1308. Alsiö, J., Olszewski, P., Norback, A., Gunarsson, Z., Levine, A., Rickering, C., et al. (2010). Dopamine D1 receptor gene expression decreases in the nucleus accumbens upon long-term exposure to palatable food and differs depending on diet-induced obesity phenotype in rats. Neuroscience, 171, 779–787. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. American Psychological Association Task Force on Psychological Intervention Guidelines. (1995). Template for developing guidelines: Interventions for mental disorders and psychological aspects of physical disorders. Washington, DC: American Psychological Association. Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68, 724–731. Avena, N. M., Bocarsly, M. E., & Hoebel, B. G. (2012). Animal models of sugar and fat bingeing: Relationship to food addiction and increased body weight. Methods in Molecular Biology, 829, 351–365. Bacon, L., Keim, N. L., Van Loan, M. D., Derricote, M., Gale, B., Kazaks, A., et al. (2002). Evaluating a ‘non-diet’ wellness intervention for improvement of metabolic fitness, psychological well-being and eating and activity behaviors. International Journal of Obesity and Related Metabolic Disorders, 26, 854–865. Bardone-Cone, A. M., Harney, M...
