Treatments for eating disorders include counseling, education and medication. Find out what works.

By Mayo Clinic Staff

Eating disorder treatment depends on your particular disorder and your symptoms. It typically includes a combination of psychological counseling (psychotherapy), nutrition education, medical monitoring and sometimes medications.

Eating disorder treatment also involves addressing other health problems caused by an eating disorder, which can be serious or even life-threatening if they go untreated for long enough. If an eating disorder doesn't improve with standard treatment or causes health problems, you may need hospitalization or another type of inpatient program.

Having an organized approach to eating disorder treatment can help you manage symptoms, regain a healthy weight, and maintain your physical and mental health.

You may start by seeing your family doctor or mental health counselor, such as a psychologist. You may also need to see other health professionals who specialize in eating disorder treatment. Other members of your treatment team may include:

  • A registered dietitian to provide nutritional counseling.
  • A psychiatrist for medication prescription and management, when medications are necessary. Some psychiatrists also provide psychological counseling.
  • Medical or dental specialists to treat health or dental problems that result from your eating disorder.
  • Your partner, parents or other family members. For young people still living at home, parents should be actively involved in treatment and may supervise meals.

It's best if everyone involved in your treatment communicates about your progress so that adjustments can be made to your treatment as needed.

Managing an eating disorder can be a long-term challenge. You may need to continue to see your doctor, psychologist or other members of your treatment team on a regular basis, even if your eating disorder and related health problems are under control.

You and your treatment team will determine what your needs are and come up with goals and guidelines. This will include a plan for treating your eating disorder and setting up treatment goals. It will also make it clear what to do if you're not able to stick with your plan or if you're having health problems related to your eating disorder.

Your treatment team can also:

  • Treat physical complications. Your treatment team monitors and addresses any medical issues that are a result of your eating disorder.
  • Identify resources. Your treatment team can help you discover what resources are available in your area to help you meet your goals.
  • Work to identify affordable treatment options. Hospitalization and outpatient programs for treating eating disorders can be expensive, and insurance may not cover all the costs of your care. Talk with your treatment team about financial issues ― don't avoid treatment because of the potential cost.

Psychological counseling is generally the most important eating disorder treatment. It involves seeing a psychologist, a psychiatrist who specializes in psychotherapy or another mental health counselor on a regular basis.

Counseling may last from a few months to years. It can help you to:

  • Normalize your eating patterns and achieve a healthy weight
  • Exchange unhealthy habits for healthy ones
  • Learn how to monitor your eating and your moods
  • Develop problem-solving skills
  • Explore healthy ways to cope with stressful situations
  • Improve your relationships
  • Improve your mood

Treatment may involve a combination of different types of counseling, such as:

  • Cognitive behavioral therapy. This short-term, structured treatment focuses on addressing behaviors, thoughts and feelings related to your eating disorder. After helping you normalize your eating behaviors, it helps you learn to recognize and change distorted thoughts that lead to eating disorder behaviors.
  • Family-based therapy. With family-based therapy, family members learn to help you restore eating patterns and achieve a healthy weight until you can do it on your own. This type of therapy can be especially useful for parents learning how to help a teen with an eating disorder.
  • Group cognitive behavioral therapy. This type of treatment involves meeting with a psychologist or other mental health provider along with others who are diagnosed with an eating disorder. It can help you address thoughts, feelings and behaviors related to your eating disorder, learn skills to manage symptoms, and regain healthy eating patterns.

Your psychologist or counselor may ask you to do homework, such as keep a food journal to review in counseling sessions, and identify triggers that cause you to binge, purge or do other unhealthy eating behaviors.

Registered dietitians and other professionals involved in your treatment can help you better understand your eating disorder and help you develop a plan to maintain healthy eating habits. Goals of nutrition education generally include:

  • Working toward a healthy weight
  • Understanding how nutrition affects your body, including recognizing how your eating disorder causes nutrition issues and physical problems
  • Practicing meal planning
  • Establishing regular eating patterns — generally, three meals a day with regular snacks
  • Correcting health problems that are a result of malnutrition
  • Taking steps to avoid dieting or bingeing

Medications can't cure an eating disorder, but they may help you follow your treatment plan. They're most effective when combined with psychological counseling. Antidepressants are the most common medications used to treat eating disorders that involve binge-eating or purging behaviors, but depending on the situation, other medications are sometimes prescribed.

Taking an antidepressant may be especially helpful if you have bulimia or binge-eating disorder. Antidepressants can also help reduce symptoms of depression, anxiety or obsessive-compulsive disorder, which frequently occur along with eating disorders.

You may also need to take medications for physical health problems caused by your eating disorder.

Hospitalization may be necessary if you have serious physical or mental health problems or if you have anorexia and are unable to eat or gain weight. Severe or life-threatening physical health problems that occur with anorexia can be a medical emergency.

In many cases, the most important goal of hospitalization is to get back to a healthy weight. Achieving your healthy weight can take months, so you'll probably need to continue outpatient treatment to accomplish your goals once you get out of the hospital.

Day treatment programs are structured and generally require attendance for eight or more hours a day, several days a week. Day treatment can include medical care, group, individual and family counseling, structured eating sessions, and nutrition counseling.

With residential treatment, you temporarily live at an eating disorder treatment facility. A residential treatment program may be necessary if you need long-term care for your eating disorder or you've been in the hospital a number of times but your mental or physical health hasn't improved.

Eating disorders can cause serious health problems related to inadequate nutrition, overeating, bingeing and other factors. The type of health problems caused by eating disorders depends on the type and severity of the eating disorder. In many cases, problems caused by an eating disorder require ongoing treatment and monitoring.

Health problems linked to eating disorders may include:

  • Electrolyte imbalances, which can interfere with the functioning of your muscles, heart and nerves
  • Heart problems
  • Digestive problems
  • Nutrient deficiencies
  • Dental cavities and erosion of the surface of your teeth from frequent vomiting (bulimia)
  • Low bone density (osteoporosis) as a result of irregular or absent menstruation or long-term malnutrition (anorexia)
  • Stunted growth caused by poor nutrition (anorexia)
  • Mental health conditions such as depression, anxiety and obsessive-compulsive disorder
  • Lack of menstruation and problems with infertility and pregnancy

You are the most important member of your treatment team. For successful treatment, you need to be actively involved in your treatment and so do your family members and other loved ones. Your treatment team can provide education and tell you where to find more information and support.

There's a lot of misinformation about eating disorders on the Web, so it's important that you follow the advice of your treatment team and get suggestions on reputable websites to learn more about your eating disorder. Examples of helpful websites include the National Eating Disorders Association (NEDA), the Academy for Eating Disorders (AED), and Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T.).

Jul. 29, 2014