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Eating Disorder Professional Treatment - Nutritional Rehabilitation

Bridget Engel, Psy.D., Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D.

If you or anyone you know has the symptoms of an eating disorder described above, seek help from a professional trained in the assessment and treatment of such illnesses. It is especially dangerous to try to treat anorexia or bulimia without professional medical consultation! An eating disorder is a complex illness that requires the astute care of a treatment team, including a medical doctor and a licensed mental health therapist.

One of the first steps to getting well is being evaluated by mental health and medical professionals. This evaluation will generally include an interview with you (e.g., the "patient" who is displaying the eating disorder symptoms) and your family. The interviewer will ask for a detailed medical and mental health history, and will ask you verbal questions, as well as give you standardized paper and pencil (or computerized) tests to fill out. You may be assessed with one or more of a variety of screening tools that have been developed to assess behavior, symptoms, attitudes and risk factors of eating disorders. Some of these include questionnaires such as the Perceived Body Image Scale (PBIS), Beck Depression Inventory (BDI), Trauma Symptom Inventory (TSI), Bulimia Test (BULIT-R), Eating Disorder Inventory (EDI), or the Eating Attitudes Test (EAT).

It is important to be as honest as possible when answering questions, even though they may be difficult or painful to answer. Even though you may feel ashamed and embarrassed, particularly if your eating behavior has caused significant health changes, or has occurred for a long period of time, concealing information will impair the ability of your therapist and doctor to get you the best help possible for your condition.

If the medical professional diagnoses you with an eating disorder, he or she will then proceed with making recommendations for treatment, starting with a full medical examination. A dental exam should also be completed, particularly if you have been engaging in purging behavior.

During the medical exam, the physician will complete a routine physical, as well as ask you about your eating habits, diet, and physical symptoms of the disease. You will also be asked to complete laboratory and other tests to check for any medical complications that your disordered eating may have caused and to evaluate organ functioning. Test results will also serve as a baseline for future comparisons to determine whether treatment is helping. During treatment, a medical doctor will continue to monitor physical health, including consistent checks on vital signs, hydration level and electrolytes.

Nutritional Rehabilitation

Treatment should be multifaceted and individualized to your needs. The first priority of treatment, however, is to regain physical health and decrease the medical dangers of the disease. Nutritional rehabilitation is often one of the primary goals in the beginning and the ongoing stages of treatment. Because many individuals with eating disorders are savvy about nutrition, they often believe that they don't need to work with a nutritionist. However, your nutritional knowledge may be distorted by the disordered thinking characteristic of eating disorders. The role of a licensed registered dietitian is to help you return to a normal weight in a healthy manner, stop using laxatives (if necessary), set realistic and healthy eating and exercise goals, plan meals, recognize hunger cues, and make healthy food choices. A dietitian can also help you recognize your distorted thinking about food and weight, as well as teach you about the nutritional dangers of your behaviors.