Outpatient eating disorder treatment involves a combination of medical, nutritional, and therapeutic support. It is my intention to describe the roles each member of your treatment team will play as they collaborate with each other (and with you!) to provide a comprehensive treatment approach that best meets your needs. It should be noted a higher level of care may be recommended in the event an individual meets certain medical criteria, a topic beyond the scope of this article.
Medical Doctor and/or Psychiatrist:
Routine visits with a doctor who is familiar with eating disorders are a necessary component of recovery. Your doctor will monitor your vitals, assess your lab work, and in some cases evaluate things like bone density to determine the unseen effects your eating disorder may have on your body. Their job, in essence, is to help keep you medically “stable”. The information they gather is vital in determining the appropriate level of care (AKA amount of support) you may need. They may also refer you to a Psychiatrist for support in addressing co-occuring issues such as anxiety, OCD, and depression.
It is important to find a doctor familiar with eating disorders so they know the specific things to be looking for. For example, someone in eating disorder recovery requires vitals to be taken both lying down and standing up to assess for orthostatic hypotension. A doctor experienced in this area may also be more sensitive in ensuring your weight be taken “blindly,” thereby reducing exposure to potentially triggering scenarios.
Your dietician will be your battle-companion as you navigate the nutritional rehabilitation portion of recovery. A dietician will partner with you to develop a meal plan for restoring your body to its optimal mental, physical, and emotional functioning. A dietician will help you identify and problem solve the sneaky ways your eating disorder will push back against recovery efforts in its fight to keep itself around. They’ll help you challenge the rules/myths your eating disorder holds about food and your body, increase food flexibility, synchronize your hunger and fullness cues, and coach you through effectively listening to your body- something your eating disorder likes to interfere with.
Don’t be surprised when your eating disorder has a difficult time trusting your dietician. Complying with their recommendations may require you to loosen your grip on “control” and confront an eating disorders’ greatest fear: uncertainty. You can help this by sharing your fears and concerns with your dietician openly and routinely reminding yourself that he or she is working for you, despite what your eating disorder voice may try to tell you.
Like your doctor, your dietician is working to “stabilize” your ED symptoms and in turn prepare you to do the deeper therapeutic work of addressing the issues that contributed to your eating disorder. Also like your doctor, it is important your dietician is familiar with eating disorders so they can spot the sneaky ways it will present, and thereby avoid “colluding” with disordered behaviors that masquerade as “healthy” or “normal.”
You may be wondering why I listed therapy last in a lineup of the three prongs of eating disorder treatment. This is not because therapy is the least important piece, but because without the other two components stabilizing you physically, cognitively, and emotionally, therapy can only be so effective.
Your individual therapist will be there to provide you with information about your disorder (as will your doctor and dietician), equip you with skills and tools needed for recovery, and empower you through the emotional hurdles you face along the way. When things become more stabilized, your therapist will be there to support you in identifying and healing through the factors that led to your eating disorder.
Family work is also often integrated into treatment. It may involve exploring ways your family can work together to create a supportive recovery environment, as well as to address unhelpful patterns and dynamics that may exist. Your family will have the opportunity to ask questions, gain insight into eating disorders and some of what you might be experiencing, and is an opportunity for them to share their feelings and experiences as well. It should be noted that the individual in recovery is not “the problem,” nor is an eating disorder your family’s “fault.”However, modern psychology understands conditions like eating disorders to be (at least in part) a consequence of dysfunctional patterns and dynamics that exist within a family system. This is why the family piece is so important: so these issues can be brought to the surface and addressed, rendering long term recovery more likely.
Last but not least, many find group therapy to be an important component of recovery. Here, you can find a supportive network of men and women in various stages of recovery and who may also have a unique understanding of what you may be going through. Group therapy is an opportunity to partner with others to acquire and practice helpful skills, be held accountable, and navigate through the challenges and victories that come with the recovery process.
For more information, feel free to contact Makenna Clements at 925.820.1467 x604.