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

By Mayo Clinic Staff

Eating disorder treatment depends on your particular disorder and your symptoms. It may include psychological counseling (psychotherapy), nutrition education or medications such as antidepressants.

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, hospitalization or an inpatient program may be necessary.

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, such as:

  • Your primary care doctor or other medical doctors involved with your care.
  • A psychiatrist, a medical doctor specializing in medication management, when medications are necessary. Some psychiatrists also provide psychological counseling.
  • A dietitian to provide nutritional counseling when a meal plan is necessary.

It's best if everyone involved in your treatment communicates about your progress so adjustments can be made to your treatment as needed. Involving your partner, parents or other family members is also important.

For young people still living at home, parents will be actively involved in treatment and may supervise meals.

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.

At the beginning of your treatment, you and treatment professionals will come up with goals and guidelines. This will 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 will consider what your needs are and what resources are available in your area. The cost of treatment programs may be a factor. Hospitalization and outpatient programs for treating eating disorders can be expensive, and insurance may not cover all of the costs of your care. However, don't avoid treatment because of the potential cost. Work with your doctor to identify affordable treatment options.

Psychological counseling (psychotherapy) is generally the most important eating disorder treatment. It involves seeing a psychologist, psychiatrist or other mental health counselor on a regular basis.

Counseling may last from a few months to years. A number of different methods of counseling are used to treat eating disorders. They include:

  • Cognitive behavioral therapy. This type of counseling is a short-term, structured treatment that helps you address the thoughts, feelings and behaviors related to your eating disorder. It can help you learn to recognize and change distorted thoughts that lead to eating disorder behaviors.
  • Interpersonal psychotherapy. Another short-term treatment, interpersonal psychotherapy focuses on resolving relationship issues that contribute to your eating disorder. This type of treatment may be especially helpful if you have depression along with an eating disorder.
  • Family-based therapy. With family-based therapy, family members attend counseling sessions. 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 eating disorder symptoms, and regain healthy eating patterns.

Treatment may involve a combination of types of counseling. 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 behavior.

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:

  • Education about how nutrition affects your body
  • Meal planning
  • Establishing regular eating patterns — generally, three meals a day with regular snacks
  • Taking steps to avoid dieting

Nutrition education may involve cognitive behavioral therapy techniques to help you recognize faulty beliefs and thought patterns and understand how your eating disorder causes nutrition issues and physical problems.

Medications 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, but depending on the situation, other medications are sometimes prescribed.

Taking an antidepressant may be especially helpful if you have bulimia nervosa or binge- eating disorder in that it can help reduce symptoms of binge eating and vomiting. Antidepressants can be helpful to 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 ideal 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 programs that generally require attendance for three to eight hours a day. Day treatment can include medical care, group, individual and family counseling, structured eating sessions, and nutrition counseling. You may still be able to work or attend school if you're in a day treatment program.

With residential treatment, you 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 particular type of eating disorder and its severity. In many cases, problems caused by an eating disorder require ongoing treatment and monitoring. Health problems linked to eating disorders can 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 long-term malnutrition (anorexia)
  • Stunted growth caused by poor nutrition (anorexia)
  • Mental health conditions such as depression, anxiety and obsessive-compulsive disorder

You are the most important member of your treatment team. In order for your treatment to be a success, you need to be actively involved in your treatment and informed about your eating disorder, and so do your family members. Your psychiatrist or other members of your treatment team can provide education and tell you where to find information and support. It's a good idea to search for resources on your own as well.

Resources that can help you understand and cope with your eating disorder include:

  • Books and self-help workbooks
  • Community resources such as support groups
  • Internet resources such as nonprofit organizations and online support groups
Aug. 17, 2011