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Treatment of eating disorders

The eating disorders include anorexia nervosa, bulemia nervosa and binge eating disorder. People suffering from eating disorders often also suffer from comorbid depression and anxiety. Misconceptions about psychiatry and mental illnesses prevent people from seeking help. If one does choose to take help, here are the options.

Click here for a short indroduction to eating disorders .


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


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



1) Cognitive behavioral therapy - Assuming that all distressing behaviour stems from dysfunctional thoughts, patients are taught to monitor feelings, emotions, and disruptions in behavior. Disruptive automatic thoughts are identified and beleifs 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 bulemia 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.


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 psychotherpay is that patients need to be open to input  and put in a lot of effort for it to be succesful.


2)The medication options - drugs to treat eating disorders.


Evidence supports the use of SSRIs ( selective serotonin reuptake inhibitors ) like fluoxetine in the treatment of eating disorders, especially bulemia. 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, reinitiation of normal calorie intake may lead to short term complications. This reinitiation must occur in a planned, phased manner to prevent the occurance of  "refeeding syndrome", a dangerous condition associated with abberant phosphate levels. Cases of bulemia associated with metabolic disturbances may need hospitalization. Purging episodes may sometimes lead to surgical emergencies that warrant admission.


Stigma in regard to mental illnesses prevent those who are in need of help from seeking help. The easiest way to get rid of stigma is to talk openly about mental illness. Stop the prejudice, help those in need. Spread the word ! Contribute to a healthier world !


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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.