Eating disorders are complex and serious conditions that affect millions of people around the world. While there are evidence-based treatments that are effective for many people with eating disorders, these methods do not work universally. For a significant number of people, conventional treatments may provide limited benefits or may not address the complexity of their condition. These differences highlight the need for personalized and customizable treatments that meet individual needs and circumstances.
Chronic eating disorders are characterized by their long-term persistence and persistence despite ongoing treatment. They manifest themselves in entrenched eating habits such as restricting food, bingeing, or vomiting. These disorders often lead to significant physical and psychological consequences, including chronic health problems, social and occupational limitations, and chronic emotional distress. Resistant eating disorders, characterized by severe or atypical symptoms that make standard treatments difficult, require adaptations of standard methods to treat both the eating disorder and co-occurring mental illnesses.
Three innovative approaches to chronic and resistant eating disorders
Recovery from chronic or intractable eating disorders requires perseverance, patience, and a creative and adaptable treatment approach. Whenever possible, it is ideal to involve treatment professionals with a high level of expertise and access to advanced treatment interventions specifically designed for more complex conditions.
For severe, complex and long-lasting eating disorders, several highly specialized treatment approaches are promising.
1. DBT for eating disorders
Dialectical behavior therapy was originally developed to treat severe emotion disorders, self-harm, and chronic suicidality, but it has expanded far beyond this original scope. DBT is now highly valued as an intervention for a wide range of mental health issues, including eating disorders. DBT-ED is a hopeful solution for individuals whose eating behaviors are used to regulate intense emotions such as fear, sadness, or anger. In other words, someone might engage in restrictive eating, binge eating, or vomiting to block out or escape overwhelming feelings. When standard treatments fail to provide effective emotional coping strategies, these disordered behaviors can become entrenched as essential, albeit problematic, coping tools. DBT-ED addresses this by providing alternative, health-promoting strategies for managing emotions, offering crucial support where traditional methods may not be enough.
Notably, DBT is also an important solution for individuals with eating disorders as well as dangerous behaviors or impulses such as the urge to self-harm or take one’s own life. The structure of DBT helps therapist and patient to monitor these impulses and behaviors together and block them by using more adaptive coping skills.
2. Specialist clinical management
SSCM offers a promising approach to treating chronic and severe anorexia nervosa in adults. The approach focuses on adapting to the patient’s evolving goals and supporting them through varying degrees of readiness and resistance. As an outpatient treatment, SSCM combines clinical management with supportive psychotherapy, filling gaps left by traditional methods that often fall short in patients who have undergone multiple treatments with minimal success.
SSCM focuses on educating patients about their condition, providing them with attentive and compassionate support, and promoting empowerment through a strong therapeutic relationship. Although weight restoration is a key component, the primary focus is on improving the patient’s overall quality of life. The approach includes regular monitoring of physical health through weighing and blood testing, as well as ongoing nutritional education to ensure treatment is tailored to the patient’s needs and delivered in a less intimidating manner.
3. Family-based and dialectical behavioral integration for adolescents
For some adolescents, standard treatments for eating disorders may not be sufficient, particularly when emotion regulation disorders, self-harm, and suicidality are present as complicating factors. In these cases, traditional treatment approaches must be adapted to effectively treat the patient’s entire condition.
One of the leading treatments for eating disorders in adolescents, family-based therapy (FBT), includes a central role for parents or caregivers, who are tasked with guiding their teen’s eating and weight stabilization until the teen can assume responsibility for their own diet. This approach is very effective in many cases, but can be more difficult when there are high levels of impulsive, suicidal, or self-injurious behaviors; dialectical behavior therapy is usually the treatment of choice for these complex problems. However, in DBT, parents are not specifically involved in managing food and nutrition, which may be necessary when the teen is refusing much-needed food. Integrating DBT with FBT increases parent involvement. This combination equips parents with skills in regulation, communication, mindfulness, and distress tolerance, allowing them to more effectively support their child while helping the teen restore nutrition and physical health.
Important reading on self-harm
It is not the treatment that fails in people, but the treatment that fails in people
Sometimes the responsibility for treatment failure is placed solely on the patient, suggesting that it is the patient’s fault for not “overcoming” their eating disorder. In reality, treatment rarely fails; rather, it is the individual who fails.
When therapies are not tailored to a patient’s individual needs or do not incorporate cutting-edge procedures, patients may not achieve the outcomes they desire. In addition, gaps in access to specialized care and continuity of support can result in patients not receiving the comprehensive help they need to effectively manage their complex challenges.
Blaming individuals for treatment failure also misses important systemic issues in healthcare. Many people face barriers such as inadequate access to qualified professionals, financial hurdles and inadequate insurance coverage, which can complicate their path to recovery.
Hope for full recovery
By improving treatment methods and providing more nuanced support, we can more effectively address the needs of a diverse range of people suffering from eating disorders and help them achieve the recovery they deserve. By continuing to develop and expand these sophisticated treatments, we have a growing opportunity to improve outcomes and help people overcome even the most severe and intractable eating disorders.
:max_bytes(150000):strip_icc():focal(749x0:751x2)/Ava-Hunt-dorm-room045-08232024-19dcd17f394f421da28ae32ffe8f7708.jpg "Check out Chiefs heiress Ava Hunt’s spacious and very pink dorm room")
