1)Psychotherapy - psychotherapy in simple terms involves listening to patients, identifying abnormalities in thoughts or beliefs, identifying potential causes for these abnormalities and correcting them via socratic questioning, conversation and behavioral exercises.

The available psychotherapeutic measures effective in the management of eating disorders include

1) Cognitive behavioral therapy - Assuming that all distressing behavior stems from dysfunctional thoughts, patients are taught to monitor feelings, emotions, and disruptions in behavior. Disruptive automatic thoughts are identified and beliefs that lead to these thoughts restructured. Behavioral experiments are designed to prove or disprove the validity of these thoughts. CBT has been proven to be effective in managing anorexia and bulimia Mindfulness based CBT can also be effective in the treatment of eating disorders.

2) Psychodynamic therapy - Involves the identification of events or experiences in the past and its effect on current behavior. Dynamic therapy may work well with those who are "psychologically" minded. We do not offer this here.

3)Hypnotherapy Involves the use of suggestion under relaxation and is effective in a subset of the population.

As CBT gains acceptance, hypnotherapy and psychodynamic psychotherapy are slowing loosing favor among both healthcare providers and patients alike. The evidence in favor of CBT is also much greater. The major advantage of psychotherapy is that it can be administered remotely and the therapeutic effects can be long lasting. The major disadvantage of psychotherapy is that patients need to be open to input  and put in a lot of effort for it to be successful.

The medication options - medications to treat eating disorders.

Evidence supports the use of SSRIs ( selective serotonin reuptake inhibitors ) like fluoxetine in the treatment of eating disorders, especially bulimia. SSRI's act by elevating serotonin levels. Other classes of antidepressants have also been found to be helpful. Carbamazepine (an anti seizure medication) and lithium ( a mood stabilizer) have proven efficacy in treating binge eating disorder. A combination of medications and psychotherapy would be most effective when compared to each modality being used alone.

Hospitalization ?

In cases of anorexia, re-initiation of normal calorie intake may lead to short term complications. This re-initiation must occur in a planned, phased manner to prevent the occurrence of  "re feeding syndrome", a dangerous condition associated with aberrant phosphate levels. Cases of bulimia associated with metabolic disturbances may need hospitalization. Purging episodes may sometimes lead to surgical emergencies that warrant admission.

Psychiatry is a medical speciality, like surgery, general medicine and paediatrics. It involves the study, diagnosis and management of mental illnesses and distressing conditons, pertaining to both the mind and body. Misconceptions about psychiatric illness and treatment have some how prevented help seeking behaviour in those who need it the most. This Wall has to go, wherin visiting a psychiatrist should no longer be taboo, and people should be able to openly and freely discuss mental health issues. More here.

Dr Vikas Prabhav is a psychiatrist in chennai, he runs The Vivid Mind  mental wellness clinic in Anna Nagar. We aim at providing holistic, multimodal care for those suffering from mental illnesses and adjustment issues. We offer effective management strategies for depression, anxiety, unexplained physical symptoms, addictions, child/adolescent problems and other behavioural issues.The information provided in this website does not substitute for a medical consult.