Where to Get Help for Eating Disorders
Eating disorders are considered psycho-physical, meaning the body and the mind are simultaneously affected in a number of harmful ways. As a result, those who are suffering from symptoms that are indicative of an unhealthy relationship with food should seek professional help immediately. There are myriad treatment options available, including private rehabilitation centres, NHS-operated rehab centres, charities and residential care.
Family members who are looking for options for loved ones or individuals seeking assistance for themselves can rest assured that there is help available and people do recover. There has been a rapidly growing problem with eating disorders in the UK, (1) which has largely been put down to diagnosis and treatment not occurring early enough. Speak to a GP or research the private options online to make sure care is accessed as soon as possible.
The importance of treating eating disorders and when to seek treatment
Eating disorders are notoriously difficult to self-treat for many reasons, a key factor being that unlike substance abuse or substance dependence, abstinence is not an option. They also carry the highest mortality risk out of all commonly recognised mental illnesses, including bipolar disorder, depression and schizophrenia.
Anorexia is the deadliest disorder among them, with a mortality rate of 20% within 20 years and 0.5% of those with the disorder dying every year. To put that statistic in perspective, one in five people suffering from anorexia over two decades dies. (2)
Making a full recovery is entirely possible with effective treatment, and early intervention greatly increases the chances of this happening. An eating disorder is not an addiction; rather, it is a compulsive disorder that can embed itself in a person’s way of life. To prevent this from happening, treatment should be sought the moment someone suspects they or someone close to them is displaying an unhealthy relationship to food.
Understanding eating disorders
Eating disorders are severe mental illnesses that involve overeating, undereating and purging consumed food through unhealthy means such as laxatives, vomiting, fasting and/or excessive exercise. They present themselves in various ways and are very personal to the individual suffering from the disease. (3)
Anorexia is characterised by an obsession with maintaining an extremely low weight by eating as little as possible. Sufferers perceive that they are fat and need to keep losing weight, no matter how much they have lost. In bulimia, a person binge eats, feels guilty and then purges using laxatives, self-induced vomiting or excessive exercise. Those suffering from binge eating disorder eat large quantities rapidly until uncomfortably full without purging but feel intense depression or guilt afterwards. (4)
The most commonly diagnosed disorder in the UK (5) is other specified feeding or eating disorder. This is no less serious than the aforementioned illnesses; rather, it means the symptoms of the sufferer don’t exactly match the criteria for anorexia, bulimia or binge eating disorder.
Treatment and rehab options
- Charities
- NHS Options
- Private Rehab
- Residential Care
Private rehab vs free treatment options for eating disorders
There are several factors to take into account when considering whether NHS funding or a private clinic is appropriate for each individual. For those who cannot afford to put themselves through a treatment program, an NHS waiting list is the only option. It is important to note that there are no specific NHS rehab facilities. A client who applies for public funding is treated at a private clinic that accepts NHS clients or in an NHS hospital facility.
It can take several months for a space to become available with NHS funding, and the person does not choose which facility they go to. Those who opt for private care can do their own research and choose the facility that best suits their needs.
Call our admissions line 24 hours a day to get help.
Executive/luxury rehab programs for eating disorders
Some individuals may be intimidated by the idea of a rehabilitation unit with shared facilities and imagine most of them to be sterile environments without home comforts. There are luxury treatment centres and rehab clinics with luxury suites for those who are happy to pay more. Luxury clinics have extras such as en-suite bathrooms, on-site gyms and plush décor to enhance the comfort of its clients. (5)
What Happens in Eating Disorders Rehab?
On the first day of treatment, clients receive a comprehensive initial assessment to give the medical staff a starting point to base treatment on. This usually includes asking questions about the history of the eating disorder and any previous treatment, blood tests, urine samples and measuring height and weight. Meals are eaten in groups and supervised by the staff, who work closely with each individual to create a meal plan and help them to stick to it.
Residential clients follow highly structured routines, with each day planned out in detail. The day-to-day activities usually involve a mixture of individual therapy sessions, group therapy sessions, group activities and chores. (6)
The eating disorders rehab admission process
Those who apply for NHS funding are assigned a case worker and put on a waiting list. They are initially offered outpatient treatment where possible. (7) For both private and public treatment, a detailed questionnaire will be filled out and the individual or carer is asked to provide details of their medical history and any other relevant information.
At this point, a private client can choose from a list of the options that are suitable for them, and once payment is processed, they are admitted. An NHS client usually waits for around 12 weeks to be admitted to the first available treatment program.
Eating Disorders Assessment
The first thing that happens when a client is admitted to rehab is a full medical assessment. This gives them the opportunity to become acquainted with their nutritionist and the medical staff at the facility. A doctor asks relevant questions about their medical history and builds up an initial profile, as well as administering the first round of medication. They will also assess the height, weight, blood pressure and bone density and test the blood and urine for any underlying health problems. (8)
Acceptance of the problem
It is widely believed that the overeating or undereating behaviour people suffering from eating disorders display is a response to emotional stimulus. It can give them a sense of control or act as an emotional crutch and provide comfort in times of stress. Many of the therapies that have been devised to combat eating disorders have acceptance as a core value. In order to be treated successfully, the sufferer must understand and acknowledge that they have a problem.
Once they have come to terms with the fact that they are suffering from an illness, it is imperative they learn to accept their emotions. Rather than covering up how they feel by associating negative emotions with body image, allowing themselves to feel and try to understand their emotional stress is a step towards recovery. (9)
Medically assisted/controlled detoxification
Unlike drug rehabilitation or treatment for alcoholism, there is no detoxification process when it comes to eating disorders. Instead, the medical staff assists the sufferer in normalising their eating patterns. There have been varying levels of success in using medications, with anorexia being difficult to treat but becoming more effective for bulimia and binge eating disorder
Often anxiety and depression are co-occurring in people with eating disorders, and medication is used effectively to treat those symptoms. This helps the compulsive behaviour associated with binge eating. There are some medications that are known to elicit minor weight gain, which can be effective for anorexia. (10)
Rehabilitation
The rehabilitation process begins with the person suffering from the eating disorder seeking help and admitting there is a problem. The goal of treatment is to address any underlying psychological problems and create a unique diet plan for each individual. The client will attend various workshops and therapy sessions that aim to give them the tools to continue with their plan after treatment has ceased.
Eating disorders present themselves in many different ways, and the clients are often high achievers with complex personalities. This means it is imperative that each person is given a bespoke care plan during rehab.
Recovery
Recovering from an eating disorder can be a long process that requires not only the support of medical practitioners but also immense love and care from family and friends. It is widely believed that the most difficult aspect of recovery is the doubt and anxiety involved in a long-term healing process.
It is not uncommon for sufferers to revert to old habits during the recovery process; these relapses are normal, and the focus should always remain on progress. Setbacks need to be dealt with gently, and all involved parties must stay positive and understand the nature of recovery from an eating disorder. (11)
What Is an Inpatient Rehab Program?
Those who are selected for inpatient treatment or hospitalisation will usually be displaying severe symptoms of their illness and deemed medically and psychologically unstable. The illness may be causing significant harm to their vital signs, and their mental health may be rapidly declining. People suffering from bulimia usually stay for 7-10 days, while one with anorexia often stays for several weeks.The individual is monitored 24/7, bathrooms may need to be locked and clients may be accompanied by a member of staff to prevent purging.
All meals are planned and supervised, or the individual may be hooked up to a drip in extreme circumstances. (12)
Types of therapy offered to clients
The type of therapy a person receives is based on the severity of their eating disorder, as well as any co-occurring illnesses that may be present. Usually, clients are initially offered outpatient care that is unrestrictive to the individual and gives the medical team a chance to assess whether further care is required.
There are various forms of therapy that help people with eating disorders. The main ones are cognitive behavioural therapy, medical nutrition therapy, dialectical behavioural therapy, acceptance and commitment therapy, art therapy, dance movement therapy, equine therapy, exposure and response prevention therapy, family therapy, interpersonal psychotherapy and the Maudsley method. (13)
These therapies involve psychiatrists using various methods to change the attitude and viewpoint of the person suffering from the eating disorder. Therapy helps them form new behavioural patterns and understand why they have been acting in a way that causes them harm. Once the client understands why they do what they do, they can work towards establishing a healthier relationship with food.
What Is Outpatient Rehab?
Outpatient rehab is where the individual regularly visits a medical facility for therapy, medication and treatment. An interdisciplinary team approach is usually taken, and the client has access to individual therapy, group therapy, nutrition therapy, medical monitoring and psychiatry services if they are required. (14)
This is the least intrusive form of care as it leaves a lot of personal responsibility and trust in the client to follow the advice and help themselves to implement meal plans and routine changes.
Day programs
Day programs allow those suffering from an eating disorder to live independently but still spend a significant amount of their time receiving treatment. This care level is recommended for people who are technically medically and psychiatrically stable but whose day-to-day functioning is impaired by the condition. The team that assessed them would have deemed that they require monitoring on a daily basis due to excessive binge eating, purging, fasting, limiting food intake or other pathogenic techniques to lose weight.
The client usually attends the facility five days a week and has two supervised meals per day, with a full daily schedule of therapy sessions and workshops. Group sessions tend to be effective and include the development of interpersonal processes, psychoeducational and expressive psychotherapy and coping skills. Clients may also have access to individual nutrition counselling and family therapy. (15)
This level of treatment is suitable for people who would struggle to leave the comfort of their homes but are at risk and in serious need of intensive treatment.
Intensive outpatient programs
Intensive outpatient treatment is where the individual is deemed medically stable and doesn’t require daily medical monitoring. It is seen as a step down from inpatient care and a step up from outpatient care. Clients usually have their symptoms under control enough to function socially, vocationally or educationally and are seen to be making sufficient progress to not require constant medical attention.
Clients meet with care practitioners an average of three times a week for sessions lasting up to three hours. The majority of therapy is group based, but they do have several supervised meals a week and meet with a psychiatrist or nutritionist on at least a weekly basis. (16)
This level of care gives the individual the freedom to be independent, earn money, go to school and carry out their life as normal, with treatment fitted in so as not to obstruct the client’s day-to-day life.
Call our admissions line 24 hours a day to get help.
Ongoing care
The aftercare or ongoing care that is provided following the successful treatment of an eating disorder is almost the most important part. Those suffering from an eating disorder usually find it easier to stick to their meal plan in a controlled environment or where they know they are being checked up on. Without supervision, it can be easy to slip back into old habits or react to negative stimuli in the ways that brought on the disorder in the first place.
Most facilities offer aftercare services, and outpatient treatment is usually recommended for those who have just finished residential or inpatient rehab. Family therapy is another important aspect of ongoing care that can help to prevent relapse. If the family is not aware of how and why the client has recovered, they are at risk of repeating behaviour that may have led to the disorder in the first place. (17)
How Is Medication Used to Treat Eating Disorders?
According to experts, (18) nutritional rehabilitation and therapy should be used as the initial treatments for anorexia nervosa. If clients are not responding, there are medications such as certain antipsychotics that can be administered to encourage small increases in weight. Unfortunately, these medications do not alleviate the delusions associated with anorexia but can be highly effective when used in conjunction with behavioural therapy.
SSRIs are often used to treat bulimia and binge eating disorder alongside behavioural therapy. Although scientists do not yet know exactly why they are effective, these medications have been shown to reduce the psychological symptoms, purging, binge eating and the extreme drive for thinness. (19)
Medications Used in Co-Occurring Addiction Treatment and Rehab
- Naltrexone (Vivitrol)
- Buprenorphine (Buprenex)
- Methadone
- Disulfiram (Antabuse)
- Acamprosate (Campral)
- Paroxetine (Paxil)
- Modafinil (Provigil)
- Desipramine (Norpramin)
- Mirtazapine (Remeron)
- Bupropion (Buproban)
- Gabapentin (Fanatrex)
- Vigabatrin (Sabril)
- Baclofen (Kemstro)
- Topiramate (Topamax)
Psychotherapy for Eating Disorders Treatment
Significant advancements have been made in recent years in relation to treating individuals who are afflicted with an eating disorder. (20) Cognitive behavioural therapy (CBT) and interpersonal treatment therapy (IPT) have remained the most widely used treatments for bulimia nervosa and binge eating disorder.
No single model of treatment has proved to be the most effective for anorexia. Therapists believe taking a stepped-care approach and introducing different types of therapy at different stages of the illness to be the most effective approach. Evidence shows that speciality psychotherapy treatments given over a long-term period are the best way to tackle eating disorders. (21)
Coping-focused psychotherapy
Coping-focused therapies such as dialectical behavioural therapy (DBT) can help individuals learn how to process and manage their emotions in non-extreme ways. DBT was developed for clients who suffer from a condition called emotionally unstable personality disorder (EUPD) or borderline personality disorder (BPD).
Those who suffer from eating disorders use food as a means of coping with their emotions, (22) and learning to understand what drives them into their behaviour can give them greater control over managing it. Coping-focused therapies are usually made up of components such as practising mindfulness and learning regulation of emotions and can give men and women the tools to learn how to regulate unstable emotions. (23)
Experts advise that treatment approaches should teach strategies for coping with emotions as well as focusing on removing the psychological obstacles that prevent those suffering from eating disorders from regulating their own emotions. (24)
Social skills/interpersonal/growth psychotherapy
This form of therapy, commonly known as interpersonal growth therapy (IPT), focuses on the issues an individual may have with interpersonal growth. Causes of interpersonal issues include role disputes, unresolved grief, interpersonal deficits and role transitions. Honing in on these areas and helping clients resolve their issues has been shown to lead to greater self-esteem and better body image. (25)
IPT is a long-term treatment that addresses the root causes of what has led to disordered behaviour. Follow-up research has shown that 64% of individuals in a study who were suffering from anorexia showed improvement — better than the results from cognitive behavioural therapy (CBT) or specialist supportive clinical management.
IPT has shown encouraging results in clients suffering from binge eating disorder, with follow-up studies showing 77% of clients who undertook IPT suffered no objective binge episodes up to five years after treatment. While evidence has shown that IPT is just as effective as behavioural therapy, it has also demonstrated that the results are slower than with a treatment like CBT. (26)
Call our admissions line 24 hours a day to get help.
Exploratory psychotherapy
Exploratory therapy (ET), also known as psychodynamic therapy, usually involves a series of appointments in which the person suffering from the eating disorder can explore their thoughts and feelings with an experienced therapist. The practitioner often carries out an assessment and then works very closely with the client to understand where their difficulties stem from and devise strategies to make changes to make them feel better.
The focus of ET is on the interaction between the therapist and the client and building enough trust to enable the client to open up. It aims to help individuals unravel their past experiences and get a clear grasp of their deep-rooted feelings and find ways to resolve them. The philosophy behind the treatment deems that the unconscious mind internalises painful memories and feelings that the conscious mind finds too difficult to process. (27)
Types of psychotherapy used in the treatment of eating disorders
- Act acceptance and commitment therapy
- Art therapy
- Cognitive behavioural therapy
- Counselling
- Dialectical behaviour therapy
- Experiential therapy
- Family therapy
- Fitness therapy
- Group therapy
- Holistic therapy
- Individual therapy
- Meditation
- Music therapy
- Psychodynamic therapy
The Recovery Process
It is widely accepted that there are five key stages of recovery (these can be broken down further) that people seeking help from an eating disorder broadly fall into. The first is the pre-contemplation stage in which the sufferer is in denial of the problem. At this stage, loved ones are encouraged to gently educate the individual and encourage them to seek help.
At the point they are ready to accept help, they have reached the contemplation stage, which transitions into the preparation stage once they are ready to take active steps towards change. The fourth stage is the action stage, in which the client is ready to tackle the disorder and begin implementing strategies to facilitate change. Once the action stage has been sustained for around six months, the individual has reached the maintenance stage. (28)
Elements of recovery
- Developing hope
- Secure base
- Sense of self
- Supportive relationships
- Empowerment
- Social inclusion
- Coping skills
- Giving meaning
How Long Are Rehab Programs for Eating Disorders?
The duration of inpatient rehab programs varies depending on the type and severity of the eating disorder. Sufferers of bulimia and binge eating disorders usually enter treatment for 7-10 days, while anorexia sufferers can range from around two weeks up to 12 weeks in severe circumstances.
Outpatient treatment tends to be ongoing and can be offered as a primary and aftercare solution. It is particularly
important for individuals who have recently completed a treatment program and are in remission from an eating disorder to access outpatient services on a regular basis to help prevent relapse.
How Much Does Rehab for Eating Disorders Cost in the UK?
Treatment for eating disorders can be sought from the NHS, but spaces are very limited and the waiting lists can be long. The cost of private care varies depending on where in the UK clients are based. An example of prices for those in London and the South East are as follows:
- Clinical report £45
- CPA meeting with two clinical staff £189
- Initial assessment for eating disorders £189
- Eating disorder nurse specialist £80 per hour
- Therapeutic support worker £25 per hour
- CBT £100 per hour
- DBT £100 per hour
- Clinical psychologist £120 per hour
- Dietician specialist £80 per hour
- Family Therapy £80 per hour
- Hypnotherapist £80 per hour
- IPT £80 per hour
- 6-week group therapy courses £295 (30)
Eating Disorders Addiction Recovery and Aftercare
As a mental illness with biological influences, it is difficult for experts to ascertain if clients are ‘cured’ of eating disorders. It is generally thought that those who fully recover have entered long-term remission in which they no longer actively engage in the disordered behaviours.
Many clients who have recovered emphasise the need to remain vigilant and constantly make an effort to not slip back into old habits. As such, maintaining a level of professional care is strongly advised to maintain their personal dialogue and address any setbacks that occur in a healthy manner. (31)
Recovery and community
Once the client has demonstrated the propensity to manage their own eating patterns and has reached a healthy weight, they are considered to be in recovery. Often, more support from friends and family makes the chance of relapsing far less likely. It is also very important that they find a way to reintegrate into the community through education, work and social activities.
Support groups
There are various support groups and organisations that exist with the sole aim of helping people who are affected by eating disorders. Many people find it extremely helpful to meet with fellow members of the recovery community, especially just after finishing a residential or inpatient program. It gives people an arena to share their thoughts and feelings in a space where others understand what they have been through.
NHS-funded community groups often consist of a mixture of people suffering from substance dependence, alcoholism, eating disorders and other various mental illnesses. While this can help people to empathise with others, it could be argued that choosing a community support group in which everyone shares similar experiences is more helpful.
12-step
These programs are offered in public spaces such as churches and community centres and provide individuals with a support network and the opportunity to be rewarded incrementally for periods of recovery with plastic coins. It follows a 12-step principle that places the notion of yielding to a higher power as the key to recovery.
Ready to Start Rehab?
People often see rehab as a last resort for tackling serious illnesses such as eating disorders, but recovery is far more likely if the problem is caught at an early stage. If an individual or loved one is displaying an unhealthy body image and relationship towards food, professional help should be sought as a matter of urgency.
Take control of your life — get started on the road to recovery
Those who are suffering from an eating disorder often closely link feelings of control with food and eating habits. This sense of control is misdirected, and the sufferer of the eating disorder needs to realise that they will only truly take control of their life once they start the recovery process.
It is of utmost importance that the beliefs and motivations behind unhealthy weight loss or weight gain are explored to prevent serious health complications.
Call our admissions line 24 hours a day to get help.
Source
- (1) https://www.theguardian.com/society/2019/feb/15/hospital-admissions-for-eating-disorders-surge-to-highest-in-eight-years
- (2) https://www.huffpost.com/entry/eating-disorders-treatmen_b_1086308?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAADzsyjrxenYUqG3o7OemPIkPJNwOUNMVeXRSl6qPUowDEpRbymaXfe3Ie-hVR_ZhoTJo7m9xcDATbJhBweHWrkiW1VLwul6tx1-LMVElvj0_lnw59lTAOA4yc3rW8CZa_crwCPD1qQ9SLjR8q-zFeNnYS075aosHCEHErrzsfN89
- (3) https://www.beateatingdisorders.org.uk/types
- (4) https://www.ukat.co.uk/primroselodge/
- (5) https://www.nhs.uk/conditions/eating-disorders/
- (6) https://www.eatingdisorderhope.com/
- (7) https://www.nhs.uk/conditions/anorexia/treatment/
- (8) https://www.eatingdisorderhope.com/
- (10) https://www.verywellmind.com/medications-used-to-treat-eating-disorders-4153046
- (11) https://www.nationaleatingdisorders.org/stages-recovery
- (12) https://www.nationaleatingdisorders.org/sites/default/files/NEDA%20Webinar%20Levels%20of%20Treatment.pdf
- (13) https://www.eatingdisorderhope.com/
- (14) https://www.nationaleatingdisorders.org/sites/default/files/NEDA%20Webinar%20Levels%20of%20Treatment.pdf
- (15) https://www.nationaleatingdisorders.org/sites/default/files/NEDA%20Webinar%20Levels%20of%20Treatment.pdf
- (16) https://www.nationaleatingdisorders.org/sites/default/files/NEDA%20Webinar%20Levels%20of%20Treatment.pdf
- (17) https://www.nhs.uk/conditions/anorexia/treatment/
- (18) https://www.verywellmind.com/medications-used-to-treat-eating-disorders-4153046
- (19) https://www.verywellmind.com/medications-used-to-treat-eating-disorders-4153046
- (20) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096990/
- (21) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096990/
- (22) https://www.beateatingdisorders.org.uk/types
- (23) https://www.eatingdisorderhope.com/treatment-for-eating-disorders/types-of-treatments
- (24) https://www.ncbi.nlm.nih.gov/pubmed/7931199
- (25) https://www.eatingdisorderhope.com/treatment-for-eating-disorders/types-of-treatments
- (26) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096990/
- (27) https://www.counselling-directory.org.uk/psychodynamic-therapy.html
- (28) https://www.nationaleatingdisorders.org/sites/default/files/NEDA%20Webinar%20Levels%20of%20Treatment.pdf
- (29) https://www.nationaleatingdisorders.org/sites/default/files/NEDA%20Webinar%20Levels%20of%20Treatment.pdf
- (30) https://www.breathetherapies.co.uk/eating-disorders-treatment-charges/
- (31) https://www.eatingdisorderhope.com/treatment-for-eating-disorders/types-of-treatments
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