Fast treatment vital in anorexia therapy
Eating disorders in young people are on the up. A British Medical Journal report says the frequency of eating disorders rose from 32 per 1,000 to 37 in the 10 years from 2000 in people in the age group 10-49. Eating disorders are now fairly common among adolescent girls.
A recent Dutch study found they’re six times more common than in men. Despite this prevalence, anorexia, bulimia and binge-eating disorder are often dangerously misunderstood. Even people with classic symptoms often don’t get any kind of treatment – that’s around 56% in the Netherlands and 28% in the US.
Better results can only be achieved if treatment starts early and that means as soon as possible after diagnosis. Guidelines recommend that all under-18s start treatment within four weeks and if the person doesn’t get effective treatment within the first three years, medical outcomes in anorexia are very poor.
Equally important is that the doctor builds a caring, supportive relationship with the family, not just with the patient. Researchers believe helping the family to see eating problems as separate from the young person is a beneficial strategy. Then the parents and child can team up against the disorder and fight it together.
Prompt referral of patients with suspected eating disorders to a specialist is important as early treatment substantially improves the outlook. This can’t be overemphasised as eating disorders have a relatively high mortality rate as well as impacting physical and mental ill health.
Rapid weight loss, a body mass index <75% of expected body weight, and binge eating and purging several times a day need urgent referral to specialist mental health services for children and young people. Risk assessment of this kind of emergency helps plan immediate and long-term treatment. A high-risk subject might even require inpatient hospital management.
Psychiatric support is crucial as people with anorexia are at a higher risk of suicide than others.
But the two mainstays of management are, firstly, intervening early because it’s linked to greater success. Secondly, it’s vital to strengthen family relationships with anorexia-focused therapy away from the pressures of food while focusing on enjoyable activities together. This all helps parents and patients.
Conceptualising eating problems as separate from the young person so that parent and child can join forces against the disorder, eating regular, balanced meals together as a family where possible, is important too.
And avoiding regular weighing and other forms of body checking will help ameliorate concerns about weight and shape.