Treatment Of Eating Disorders Essay, Research Paper
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Abstract
In this paper I have attempted to define both anorexia nervosa and bulimia. Psychologists and psychiatrists have formulated a three-prong approach to the treatment of these eating disorders. First is to focus on the immediate health crisis. Second is to develop a counseling regimen with the patient. Finally, a counseling schedule must be implemented with the family.
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Definition of Anorexia Nervosa and Bulimia
Eating disorders may take different forms but have the same desired effect, the extreme loss of weight. Anorexia nervosa is categorized by eating much less than one needs, becoming extremely thin, and in extreme cases, anorexia nervosa leads to death (Kalat , 293). Bulimia is another eating disorder where the outcome is the same, but the method is different from anorexia. Bulimia is categorized by a fluctuation between eating and dieting. Some (but not all) eat enormous meals then force themselves to vomit (Kalat, 294). In both cases, the disorder label is used once 15% or more of the original body weight is lost, an intense fear of gaining weight or becoming fat, loss of or irregular menstrual cycle, and a distorted body image (Walsh, 1387). Women are ten times more likely to have an eating disorder than men (Nash, 68). Anorexia nervosa and bulimia combined effect about 8 million Americans, chiefly adolescent females (Thub, 8).
A Case Study
Between two tarnished cold metal bars lies me, a frail female body. Thick globs of glucose struggle into my near collapsed veins. My bones protrude slicing through my wrinkled dry skin. Downs like fur entries my starving body trying to insulate me. I was once an elite gymnast now a neurotic anorexic. My mind is focused on one thing only, the terrifying lard being mechanically forced into me making me fat (Crocco, 1). Marisa a 10-year-old gymnast recalls the days before her six-month stay at Cornell Psychiatric Hospital. An accomplished gymnast who had reached national competitions by the age of 10, had fallen to the disease of anorexia nervosa. At this time Marisa heard the words
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of her coach, If you were a little lighter Marisa, maybe you will make something of your self (2). Marisa s parents had no idea of this illness that had destroyed their daughter until her 80 pound, two ounce body had collapsed just minutes before a major gymnastics competition (Crocco, 1). After six years and four hospitalizations, Marisa has finally beaten her struggle with anorexia.
Treatment
According to Dianne Neumark, Prevention of eating disorders falls into primary, secondary, and tertiary categories. (68) Primary prevention reduces or eliminates eating-disorder risk factors. Secondary prevention uses early identification and intervention to reduce the disorders duration. Tertiary prevention seeks to reduce impairments caused by the disorder that is already established (69).
Typically the first health care professional to diagnose anorexia or bulimia is a family doctor or pediatrician. After initial assessment, the person may be referred to a specialist in eating disorders or an eating disorder clinic (Waxler, 3). Initially, victims of eating disorders are given a carefully prescribed diet of simple foods to nourish the starved body. As patients start to gain weight, foods with higher fat content and more calories are introduced gradually (Nash, 69). Patients may need to stay in a hospital or other facility where their nutritional status can be carefully restored (Waxler, 3). During hospitalization, privileges are sometimes granted in return for weight gain. This is known as a behavioral contract, and privileges may include such desirable activities as leaving the hospital for an afternoon outing (Dove, 4).
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Doctor Dove notes that the second step to the treatment of eating disorders is individual therapy. This therapy helps the patient understand the decease process and its effects. Individual therapy focuses on the patient s relationship with family, friends, and the reasons why the patient has fallen into the disordered eating pattern. As patients begins to learn more about their condition, they are often more willing to try to help themselves recover. (4) Experienced clinicians try to focus on more than just weight, the patient s general health and psychological well being are of major consideration as well (WAXLER, 3).
Lisa, a patient suffering with bulimia was given a list to fill out during her first session of counseling and was reluctant to fill it out due to embarrassment. After the first counseling session with Doctor Dianne Spangler, Lisa understood that the list was important for monitoring her progress or decline. The next session, Lisa returned with the completed food record (705). Counseling sessions continued with Lisa and she had later agreed to eat meals at specified times and not to wait until she was hungry (707). By the tenth session (the 8th week of treatment), Lisa was intentionally planning and eating three meals a day with two additional snacks per day regularly. Along with this, her bingeing and purging had decreased dramatically (708).
The third step of the treatment of eating disorders is family counseling, this examines how a patient, parents, and siblings relate with one another (Dove, 4). Dove also states, The goal of family therapy is to help family members relate more effectively to one another, to encourage more mature thinking in the anorectic patient and to help all family members work together for the well-being of the patient and the family unit. (4)
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It is important to have family participation during the treatment of eating disorders, by accomplishing this the therapist begins the process of defining and enhancing parental authority with the regard to the management of the crisis (LeGrane, 731).
Discussion
Eating disorders are not easy to cure, in fact it is a long road that may take years and success depends on the completion of the three steps earlier outlined. In treating eating disorders, it is extremely important to remember that immediate success does not guarantee a permanent cure. Sometimes, even after successful hospital treatment and return to normal weight, patients suffer relapses. Follow-up therapy lasting three to five years is recommended if the patient is to be fully cured. (Dove, 5)
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References
Crocco, M. (1994). Beyond the distorted looking glass. Unpublished work.
Dove, J. (1995). Facts about anorexia nervosa. National Institute of Health.
Kalat, J. (1998). Biological psychology. New York: Brooks/Cole Publishing Company.
LeGrave, D. (1999). Family therapy for adolescent anorexia nervosa. Journal of Clinical Psychology, 6, 730-735.
Nash, M. (1996). Conference on adolescent nutritional disorders: prevention and treatment. Nutrition-Today,31, 68-70.
Neumark, D. (1995). Excessive weight preoccupation. Nutrition-Today, 30,68.
Spangler, D. (1999). Cognitive behavioral therapy for bulimia nervosa. Journal of Clinical Child Psychology, 6, 705-713.
Thub, D. (1994). Disordered eating and weight control among adolescent female athletes and performing squad members. Journal of Adolescent Research, 52,21.
Walsh, B. (1998). Eating disorders: progress and problems. Science, 280,1387.
Waxler, D. (1997). Exceptional lives. Merrill, New Jersey.