Medical Treatment
There are many physical complications that can result from an eating disorder. Left unattended, they can lead to serious health problems or death. It is important that physical health is monitored, preferably by a medical practitioner with experience in the area of eating disorders. A medical examination may involve several tests, followed by treatment of any medical problems such as anaemia, heartburn, disturbances in heart rhythm, low bone density etc.

Nutritional Counselling/Advice
Dietitians or nutritionists may be useful in the treatment of eating disorders as education and establishment of a well-balanced diet are essential to recovery. Nutritional counselling and advice may be useful to help the person identify their fears about food and the physical consequences of not eating well. Education about the nutritional values of food can be beneficial particularly when the person has lost track of what ‘normal eating’ is. Dietitians or nutritionists may work in conjunction with other professionals.

Psychological Therapy
The basis of psychological treatment is in forming a trusting relationship with the therapist and addressing pertinent issues to the person such as the thoughts, feelings and behaviours that lead to the development and maintenance of the eating disorder. This may include issues with anxiety, depression, poor self esteem and self confidence, difficulties with interpersonal relationships and empowering the person to realise their own resources to overcome their difficulties.

Some particular models of psychological therapy that may be used in the treatment of eating disorders include:


Psychotherapy
Psychotherapy aims to identify the psychological stresses that may have contributed to the onset of the eating disorder. Through talking and other techniques (personal development exercises, etc) the aim of this process is to reduce the feelings of inadequacy, low self-esteem, negative body image and guilt etc and help people to develop their life skills.


Cognitive Behavioural Therapy
CBT has become a popular form of treatment for people experiencing eating disorders. Based on the premise that thoughts and feelings are inter-dependent, CBT encourages people to re-examine and challenge existing thought and behaviour patterns. Challenging distorted or unhelpful ways of thinking can allow healthier behaviours to emerge.

In relation to eating disorders, CBT aims to change the way the person thinks about food and themselves. It aims to identify the characteristic thoughts that reinforce disordered eating behaviour and encourage more positive ways of thinking. Some thought patterns that CBT may challenge include black and white thinking, magnification (of importance of events etc) and errors in attribution (misunderstanding of the relationship between cause and effect).


Interpersonal Psychotherapy
IPT has been used successfully in the treatment of eating disorders, particularly bulimia and binge eating problems. IPT focuses on interpersonal difficulties in the person’s life which are considered to be the basis of the eating disorder. Generally, therapy involves three phases including the identification of interpersonal difficulties, the development of a contract to work on several specific issues and the assessment of changes. The therapy is usually medium term (16-20 weeks).

In the initial stage, the therapist will generally explore the history of eating problems, interpersonal relationships prior to and after the development of an eating disorder, significant life events and self-esteem and depression issues. Major problem areas are identified and typically fall into four categories; grief, role disputes with other people, role transitions and interpersonal skills. A therapeutic contract is developed between the client and the therapist based on the major problem areas in the person’s life.


Group Therapy
The main purpose of group therapy is to provide a supportive network of people who have similar issues to explore issues around their eating disorder. Groups may address many issues from alternative coping strategies, underlying issues, ways to change behaviours, triggers to personal needs and long-term goals. Groups are generally closed in attendance for a specific period of time (eg. 8 weeks).


Family Therapy
Family therapy usually involves the people that are living with or are very close to the person with the eating disorder. This may involve parents, siblings and/or spouses. The family, as a unit, is encouraged to develop ways to cope with issues that may be causing concern including the eating disorder. The success of this treatment is dependent on the family being willing to participate and make changes to their behaviours. Family therapy can also offer education to other family members about the eating disorder and how better to support the person they care about. Overall the family is encouraged to develop healthy ways to deal with the eating disorder.

Family therapy also acknowledges that every family has issues that are difficult to deal with. As a part of a person’s recovery from an eating disorder, it can be useful to address issues in the family context such as conflict or tension between members, communication problems, difficulty expressing feelings, substance abuse or physical or sexual abuse.


Drug Therapy
Drug therapy may be used to treat hormonal or chemical imbalances. In the treatment of eating disorders, anti-depressants belonging to the Serotonin Specific Reuptake Inhibitor group (SSRI) such as zoloft, prozac, aropax and paxil are commonly prescribed.

Research suggests that anti-depressants such as prozac are useful in suppressing the binge/purge cycle, particularly for people with bulimia. For people experiencing anorexia nervosa, they may be useful in stabilising weight recovery. However, like all medications, not all anti-depressants work for everyone as people respond differently. Some people experience side effects in varying degrees of severity such as anxiety, nausea, loss of or increase in appetite, nervousness, insomnia, headaches, rashes, abnormal dreams and blood pressure changes.

The effectiveness of drug therapy increases when combined with other forms of therapy such as Cognitive Behavioural Therapy.


Support Groups
Support groups differ from therapy groups in that they are intended to offer mutual support, increased understanding and information. Where a therapy group is generally closed in attendance and runs for a specified period (eg. eight weeks), support groups are generally open in attendance (people can attend as often as they wish) and meet on a regular basis (eg. fortnightly). Generally, support groups are not run by professionals, but by people who have had experience with the issue, either personally or indirectly.

The EDFV runs two separate support groups, one for people with an eating disorder and one for families and friends. These groups alternate on Monday evenings in Glen Iris. Several times a year the Foundation runs combined groups where people with an eating disorder and relatives and friends meet together.


Hypnosis
Traditional hypnotherapy typically involves a sleep-like state or altered state of consciousness usually induced by a therapist. It is based on the premise that during this altered state of consciousness, a person is more responsive to suggestions and has greater access to influential functions usually outside their conscious control. However, more recent theories of hypnosis may include role playing, story telling and interpersonal influence between the therapist and the client.


Education
Information about eating disorders, their effects, treatments and recovery stories etc, can be a useful resource for people experiencing an eating disorder and their family and friends. The EDFV has a reading list and a library. Books are also obtainable from most book stores.


Alternative Therapies
Alternative therapies can be useful for some people as an adjunct to pysychological, nutritional and medical treaments. For instance meditation can help with reducing anxiety levels or massage can help us to reconnect with our bodies. Each approach is different, however alternative therapies are generally concerned with treating the person as a whole, including their mental and physical health and may include:

Naturopathy Herbal treatment aimed at stimulating the body to heal itself.

Acupuncture An ancient Chinese therapy using needles and herbs to stimulate the body’s energy flow.

Aromatherapy Use of essential oils for relaxation and stress relief.

Meditation Mental relaxation intended to create an inner calmness.

Homoeopathy Aims to stimulate the body’s natural defences (anti-bodies) to illness, by introducing the problem substance into the body.