Helping People With Anorexia and Other Eating Disorders
Binging – obesity, hypertension, diabetes mellitus. For any form of eating disorder, there may also be accompanying depression, anxiety, substance abuse, and personality disorders.
Other Considerations: Persons with eating disorders are very susceptible to life stressors. Anorexia nervosa is thought to be as a result of the individual’s difficulty in controlling some aspects of the individual’s life or fears (aspects such as maturity, independence, failure, sexuality, and parental demand). Individuals with anorexia are usually angry about concern from others and frequently use denial as a defense mechanism. Bulimia patients use avoidance, isolation of affect and intellectualization mostly.
Help and Treatment: Success in helping actually depends on the patient’s motivation. So, assess the level of motivation of the individual for help and treatment. Ask her to rate her desire for help and treatment on a scale of 1 to 10. Formulate a helper-patient contract and help protocol and gain patient’s commitment. The protocol should specify patient and expectations and responsibilities about meals, weighing, timing of meals, amount of drinking water, vital signs, bathroom privileges, close observation, diet foods, and food substitutions. Graduate the patient’s independence over meal selection and scheduling. Stabilize patient’s nutritional status. Motivate anorexic and bulimic patient to stop trying to lose weight. Motivate her to gain weight. Contract with her to gain at least 1lb per week. Counsel her about healthy eating patterns. Help her to graduate her exercise and focus on fitness. Provide cognitive behavioral therapy (CBT). The CBT should train her in cue avoidance and response change; challenging faulty thoughts, feelings, and assumptions, and finding alternative problem-solving and decision-making responses in high-risk situations. Reinforce her compliance with the contract. Use dance, movement therapy, imagery, relaxation, working with mirrors and depicting the self through art to help her with body image distortion. With patient’s consent, involve chosen family members in planning and intervention. Help family to respect patient’s individuality. Motivate them to serve as support system to the patient. Use group therapy for reality testing, support, peer communication, social alliance, and expression of feelings. Medications are not usually very useful for eating disorders. Antipsychotics, antidepressant and mood stabilizers provide very little benefit.
Check out the following websites:
www.nationaleatingdisorders.org
www.nimh.nih.gov/health/publications/eating–disorders/
Dr. Samson Omotosho
CEO, Futurefocus Wealth Builders. www.futurefocusbiz.com
References:
Copstead, L. C., & Banasik, J. L. (2005). Pathophysiology (3rd ed.). St. Louis, MO: Elsevier Saunders.
Stuart, G. W. & Laraia, M. T. (2005). Principles and practice of psychiatric nursing (8th ed.). St. Louis, MO: Elsevier Mosby.
Varcarolis, E. (2006). Foundations of psychiatric mental health nursing: A clinical approach (5th ed.). Philadelphia: W.B. Saunders.
Williams, P. M., Goodie, J., & Motsinger, C. (2008). Treating eating disorders in primary care. American Family Physician 77(2), 187-195.
Dr. Samson Omotosho is the CEO of Futurefocus Health & Wealth,a non-profit organization dedicated to mental health and business-building. Dr. Omotosho has worked as a professor of nursing in many universities in Nigeria and the US for more than 30 years. He is currently a psychiatric nurse practitioner and director of Optimum Health Systems, Inc., an outpatient mental health clinic and psyciatric rehabilitation program.
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