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Eating
disorders have many facets and treatment needs to work on different
levels: medical, psychological, behavioural and social.
The medical
complications of eating disorders are serious and can even be life
threatening, so early professional intervention is important. While
there is more to eating disorders than food, the body's basic
requirements must first be addressed and stabilised before the
psychological aspects can be explored. A very low body weight or
long-term bingeing and vomiting can have detrimental effects on the
reproductive system, the digestive system, the heart, kidneys and
teeth
Medical staff will
aim to stabilise the sufferer's weight at a safe level, but this can
really only be achieved with their co-operation. For this reason a
structured specific programme is negotiated with the sufferer so
they are consulted and involved in its design. A dietician will
design a suitable diet and exercise may be curtailed in the early
stages. Nutritional and vitamin supplements may be prescribed and
appetite-stimulating medications may occasionally be recommended.
The psychological
basis that underlies the eating disorder must be properly addressed
also to aid recovery. Psychological approaches promote a greater
understanding of the condition and encourage the individual to
retain responsibility for their health.
Recovery from an
eating disorder requires acceptance and courage. One-to-one
counselling in the initial stages can help to gain a clearer insight
into the mental processes that have led to the eating disorder. The
importance of a trusting, honest and open relationship with a
therapist is paramount. While gently exploring the issues, the
therapist will help the person to develop healthy and more direct
coping strategies.
Rebuilding self-worth
and a realistic self-image are key elements in recovery; the person
must learn to value themselves. Group and peer support reduces that
sense of isolation and offers hope. BodyWhys, a support group for
people suffering from eating disorders and their families, offer a
number of such groups, where people recovering from an eating
disorder can share their experiences and support one another.
Altered behaviour
associated with disturbed eating patterns must also be examined and
healthier coping mechanisms learned.
We all hold
beliefs in life, most are healthy and based on life experiences, but
some are formed through making associations that are not valid. For
example, Some people with eating disorders have come to associate
being slim with success, popularity or control. Behaviour therapies
consider people’s problems as learned responses to life’s
difficulties and attempts to replace unhealthy established responses
with healthier ones.
For some, an eating disorder is an attempt to exert control in
difficult environments. Many young people wrestle with the need for
autonomy and challenge parental wishes. Family dynamics can become
tense, with mealtimes becoming a battle zone.
Social approaches
explore the person's ability to express their needs in a more direct
way, without resorting to control behaviours. Social approaches
examine such topics as communication, anxiety management,
interpersonal dynamics, personal responsibility and assertiveness
skills. People with eating disorders often have low self-esteem, and
feel unable to relate comfortably to others. Social therapies
rebuild self-confidence and encourage assertiveness, and help the
person to recognise their responsibilities to themselves and to
others.
The involvement of
the whole family in the treatment programme is necessary if recovery
is to be complete. |