What is the Best Treatment?
The "best treatment" must be custom tailored for each individual.
The "best" treatment is the program that takes analysis of the the woman's entire being and medical history.
The process of treating women at a top treatment center like ours begins with an evaluation by a consulting physician or counselor. Recommendations include any or all of the following. In general, the more components included in the treatment plan, the faster the person will make progress.
- Hospitalization to prevent death, suicide, and medical crisis.
- Weight restoration to improve health, mood, and cognitive functioning. Note: An anorexic's fear of weight gain, especially forced weight gain in hospital, is a huge obstacle to treatment and recovery. Nevertheless, it is clear that the closer to normal weight is at the end of treatment, the better the chances of complete recovery. In study after study, low body weight is strongly correlated with treatment failure and relapse.
- Medication to relieve depression and anxiety
- Dental work to repair damage and minimize future problems
- Individual counseling to develop healthy ways of taking control of one's life. Cognitive behavioral therapy (CBT) has proved effective in treating bulimia and binge eating disorder. The counseling of choice for anorexia is determined by individual and family circumstances.
- Group counseling to learn how to manage relationships effectively
- Family counseling to change old patterns and create healthier new ones
- Nutrition counseling to debunk food myths and design healthy meals
- Support groups to break down isolation and alienation.
However, support groups by themselves are not sufficient treatment for an eating disorder. To be effective, they must be integrated into a comprehensive treatment plan.
How long does it take to recover?
A few people who refuse professional treatment do eventually recover, but it may take several years or even decades. Most make little or no progress without help. Up to 20 percent do not survive.
People who do get into treatment, and stick with it, in general do much better. About half recover completely. Another 25 percent make significant progress. Unfortunately, the last 25 percent remain chronic sufferers, even with treatment, and a few die from consequences of their disordered behaviors.
With treatment, a few people recover in a year or less. For the vast majority, though, treatment and the recovery process take three to seven years, and in some cases even longer. Recovery takes however long it takes. For most people, changing entrenched food behaviors and resolving the issues that underlie them is a formidable challenge, perhaps the greatest challenge they will ever face.
Usually treatment is more intensive at the beginning: several therapy sessions a week and perhaps even hospitalization. As progress is made, sessions are scheduled less frequently until, at the end, there may be only two or three a year.
Relapses, especially in the beginning, are to be expected. The person learns to cope with life without depending on food and weight manipulation but then encounters a problem. The new coping skills are overwhelmed, and the person, feeling frantic, resorts to old familiar patterns: i.e., binge eating, starving, or purging. A common scenario involves a person receiving treatment, leaving treatment, being successful for a while, relapsing, and then returning to treatment. The cycle may be repeated several times before recovery is stable. There should be no shame in these lapses. They are learning experiences that point out where more work needs to be done.
An outcome study at Rogers Memorial Hospital in Wisconsin indicates that in the case of anorexia nervosa, the longer the person remains in a hospital program, and the closer his/her weight is to normal at discharge, the greater the chances of long-term, stable recovery. If you want a copy of the study, call 1.800.767.4411, extension 310.