When considering treatment approaches for an eating disorder, it is important to understand that different people respond to different types of treatment, even if they are experiencing the same eating disorder.
The evidence-based treatments listed below have been found to be effective for eating disorders. Typically, these treatments are not stand-alone treatments and a person with an eating disorder will usually receive a combination of treatments as part of their recovery program. Some treatments are better suited to specific eating disorders than others and a multidisciplinary approach to treatment is often the best way to treat an eating disorder.
Psychotherapy will for instance usually be conducted by a psychologist. However, other professionals such as psychiatrists, psychotherapists and counsellors can use certain aspects of psychotherapy to treat someone with eating disorder.
Cognitive Behavioural Therapy (CBT)
Cognitive Behaviour Therapy (CBT) is a type of psychotherapy aimed at helping a person to change unhelpful or unhealthy habits of thinking, feeling and behaving and to learn practical self-help strategies.
Its treatment approach is beneficial for a range of mental and emotional health issues, including eating disorders, anxiety and depression. It is a combination of two therapies: ‘cognitive therapy’ and ‘behaviour therapy’, based on the premise that thoughts and feelings are inter-dependent.
When it comes to treating eating disorders, CBT aims to change the way a person thinks about food and themselves. CBT seeks to challenge negative thought patterns, and in the case of eating disorders this may include black and white thinking, magnification of importance of events and errors in attribution, for instance the misunderstanding of the relationship between cause and effect.
Dialectical Behavioural Therapy (DBT)
Dialectical Behavioural Therapy (DBT) is a modified form of Cognitive Behaviour Therapy (CBT). Based on an emotion regulation model, its aim is to help people manage, process and regulate negative emotions in a positive, healthy and productive manner.
Its premise, in the case of eating disorders, is that these are born as a coping mechanism to deal with emotional distress when no other form of coping strategy is available.
Family Based Psychotherapies
Family approaches are most common when adolescents, young adults and children are suffering from an eating disorder.
Family approaches will involve the whole family or support network of the person with the eating disorder during treatment. The aim of a family approach is to treat the person with the eating disorder, while also supporting and educating the entire family about how to provide appropriate care. Focus can also be placed on strengthening family relationships and improving the family dynamic.
The two most common therapies involving the whole family are the Family Based Therapy and the Maudsley Approach.
Self-help approaches are carried out by the person with an eating disorder and often involves forms of Cognitive Behavioural Therapy (CBT).
Self-help treatments can be useful, however, they are most effective when combined with other treatment approaches that are provided by professionals and clinicians. Patients who only adopt self-help approaches and ignore or reject other forms of medical treatment may not recover from their eating disorder and may also be at high risk of recurrence or relapse.
Nutritional management approaches are provided by a dietitian or nutritionist during treatment. They can also sometimes be provided by a GP. This approach has been designed to ensure that the person with the eating disorder is receiving the right level of vitamins and minerals throughout the treatment process and to help develop normal and beneficial eating habits and behaviours.
Medication-based approaches are often vital when a person with an eating disorder also has another type of disorder or illness, such as depression, anxiety, insomnia or psychosis. This is known as a co-morbid disorder.
Medications can be prescribed by psychiatrists or by medical doctors and GPs and should only be used in conjunction with another treatment approach.
In addition to the various treatments available for eating disorders, people have also found complementary therapies helpful in their process of treatment and recovery.
Complementary treatments should not be employed without other medical and psychological treatments provided by a clinician and/or a carer and they should not be considered a replacement for other evidence-based treatment approaches. Instead, they should form part of a comprehensive and holistic treatment plan to increase the quality of life of the person with the eating disorder.
Acceptance and Commitment Therapy
Acceptance and commitment therapy is a cognitive behavioural treatment with a focus on mindfulness and flexibility of thoughts and feelings. It aims to increase awareness of a person’s experiences and responses to their own environment.
Through acceptance and commitment therapy, a person with an eating disorder can learn to break destructive cycles of negative thoughts.
Yoga can help a person with an eating disorder engage in self-care and mindfulness. Research has shown that yoga can reduce stress levels, which can lead to improved health and clearer thinking.
While yoga on its own would not be sufficient treatment for an eating disorder, it can complement psychotherapeutic treatments and medication.
Evidence-based research has shown meditation to be beneficial in the treatment of anxiety, addiction and pain management and as an adjunct to psychotherapy.
Meditation can help to reverse patterns of deregulated behaviours and emotions and decrease destructive coping strategies, while increasing self-acceptance and promoting awareness of the body’s physical cues of hunger. Overall, it is believed that meditation will enable general therapeutic change in a person with an eating disorder.
Mindfulness Based Therapy
Mindfulness teaches people to respond to their thoughts without judgment and promotes a state of being in which the person is present in their thoughts, feelings and body. Mindfulness also teaches acceptance and self-compassion, which can be key in combating negative thoughts and feelings.
Mindfulness can be helpful in the treatment of eating disorders, particularly in addressing the feelings of shame and guilt that often accompany an eating disorder. Mindfulness, as an addition to treatment for eating disorders, can also be effective in the development of skills relating to emotional regulation, distress tolerance and personal relationships.
Remedial massage is a therapeutic form of massage. It involves the systematic manipulation of the soft tissues of the body and is performed by a trained massage therapist.
Research shows massage therapy can help reduce depression, anxiety and stress levels, thereby decreasing body dissatisfaction and the drive for perfectionism in people with eating disorders.
Acupuncture is a form of Traditional Chinese Medicine. It involves inserting fine, sterile needles into specific sites (acupuncture points) along the body.
Acupuncture focuses on both the prevention and treatment of illnesses and maintaining general good health.
Acupuncture can be an effective complement in the treatment of eating disorders as it provides drug-free pain relief and takes a holistic approach to healing addressing physical, psychological and emotional signs.
Choosing a practitioner for additional treatment approaches
If you are interested in one of the above additional treatment approaches, it is a good idea to check that your desired practitioner is registered with a professional body. You should also check whether they have had any experience in working with people with eating disorders.