"... lost in the darkness of my own circumstance, criticizing echoes leaving me awake in the night... the barrier and blockades that keep me safe and in control while I pretend that I am okay... " – Lani, anorexia sufferer, in her journal
Because Anorexia Nervosa is such a complex disorder that affects not only a person's psychological well being but also their physical health, and because it can present so very differently in individuals, anorexia treatment is no simple task.
Anorexia Treatment Must be Comprehensive
Anorexia treatment must encompass all aspects of a person. Not only do the physical medical issues need to be addressed, but in order to achieve true recovery, psychological therapy must also be employed to correct the harmful behaviors of self-denial that Anorexics engage in.
Medically speaking, anorexia treatment should be aimed at increasing body weight to at least 95% of what would be normal for a person of the same height and weight. In addition, specific treatments for the complications of anorexia, such as electrolyte and hormonal imbalances, bone loss, heart arrhythmias, concomitant mental health problems like anxiety or depression, and nutritional deficiencies must be corrected.
Not only will anorexia treatment involve increasing caloric intake, but it may also include an increase in vitamins and minerals. Medication may also be necessary. Drugs that increase bone mass, combat depression and anxiety, regulate heart rhythm, or supplement hormones may be given.
Dieticians and Nutritionists may also be involved in an anorexia treatment plan. They can help design healthful diets for Anorexics in recovery, as well as educate subjects about food. They teach anorexics about healthy portion sizes, proper calorie requirements, and how to design healthful meals.
Psychological Aspects of Anorexia Treatment
While the physical aspects of Anorexics are addressed in anorexia treatment, the underlying psychological issues must also be confronted. Anorexia treatment should include some form of psychotherapy or cognitive-behavioral therapy (CBT) to process psychic trauma and teach Anorexics how to have a healthy relationship with themselves and with food. Damage to self-esteem must be repaired and any denial of the disease or distorted body image must be overcome.
The anorexia treatment of choice is a specific type of CBT tailored to the needs of Anorexic patients. In this form of treatment, Anorexics learn how to think about themselves and food in a healthy manner as well as to understand how the dysfunctional thought patterns negatively affects their behavior. CBT is a time-specific and goal-oriented anorexia treatment meaning that patients are treated for a discrete amount of time with a specific aim in mind.
Other types of therapy may also be employed. Besides traditional psychotherapy, family therapy may be necessary. This type of anorexia treatment involves the entire family unit and helps the Anorexics understand the dysfunctional roles they may play in their family system.
Finally, anorexia treatment may take place in a variety of settings. For people with advanced and active Anorexia, or for those who have a dangerously low body weight or other medical issues, anorexia treatment may need to take place in a hospital or in a residential facility. Other patients who are healthier may be able to be treated in an outpatient setting.