Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder and Obesity can have a severe negative impact on your health. Anorexia Nervosa can be life-threatening if left untreated (see section on medical complications) and Obesity contributes to several life-threatening illnesses (see medical complications). If you are slightly overweight, do not purge and have identified that you do not have an eating disorder, then read the section on dieting. If you have identified that you, or someone you know, has an eating disorder, then please read the following carefully. Most people first wish to deal with the visible aspects of an eating disorder i.e. the weight problem (either too little weight, or too much weight, the purging, etc). Eating disorders should never be treated by dietary and/or exercise input alone! An eating disorder is a multi-factorial problem that requires a multi-disciplinary approach. That is, a team of professionals must deal with the problem. A good treatment programmes follows NICE guidelines. The following professionals should be consulted.
1. The family physician or general practitioner is sometimes the first person to be approached with this problem. You family doctor will carry out the necessary tests for the specific eating disorder. These may include tests for electrolyte balance, kidney and live function tests and blood counts. Please ask your practitioner for the name of a reputable psychologist who works with eating disorders. This may involve a referral to an outpatient eating disorder service, or to someone in private practice (contact us). Private practice is becoming more evident in the UK because of work overload in the health care system.
2. A psychologist who specialises in this area of work (contact us). If you know of a reputable professional who works in this area then s/he can usually be approached directly and the professional will contact your G.P. This is not a problem that can be solved in a few sessions and long-term therapy is usually required. See causes to understand the kind of psychological factors that are at play with eating disorders and with disordered eating. Do not dabble with this problem. Seek the right help as soon as possible. Usually professionals who work with eating disorders and/or disordered eating work in conjunction with a dietitian.
3. A dietitian. As commented above, eating disorders and/or disordered eating should never be treated from the dietary aspect alone. Dietitians who specialise in eating disorders and/or disordered eating will work in conjunction with a psychologist who specialises in this field.
4. A psychiatrist, if necessary. Usually the family physician or the psychologist can assess whether this problem requires the additional input of a psychiatrist.
6. An exercise specialist. An individual who is severely anorexic will not be allowed to exercise until a healthier weight has been achieved. If you are slightly or grossly overweight, our exercise specialist at Mindalot can advise you on a suitable exercise regimen once the psychological reasons for your weight problem have been assessed. Seek help from the right people!
Treatment for weight loss often focuses around the areas of exercise and diets and seldom includes a psychological component. Those programmes that do offer some psychological input, usually offer practical advice on how to deal with stress or how to gain control over food, such as putting less food on a plate, or not shopping on a full stomach. Unfortunately, this kind of help offers only minimal relief and I think often leaves individuals feeling more helpless and further entrenched in their problem. The cause and the severity of an eating disorder and/or disordered eating can vary from person to person. The severity itself is an important clue to the problem. This may manifest or show itself in the symptoms and in behaviour such as excessive eating, not eating/or fasting, binging and purging, excessive exercise, the use of laxatives, diuretics and enemas.
There are many individuals who maintain a normal weight but who actually have an eating disorder, such as Bulimia Nervosa or Binge-Eating Disorder. Unfortunately, most often change is aimed around the symptom, i.e. the aspect or manifestation that is observable. This could be the weight problem (either too low or too high a weight), or it could be the need for exercise. An attempt to change only the symptom is one of the reasons why the problem reappears. Few people have only been to one treatment programme. It is important to catch the manifestation of the problem as early as possible, as there is a strong likelihood that the individual will simply move onto the next treatment programme if the clues are ignored. There are psychological and historical causes to anorexia nervosa, bulimia nervosa and obesity. It is never just about too little or too much food or the lack of exercise! It is also about your relationship with yourself and how this manifests in your relationship with food.