Treating Eating Disorders

Treating Eating Disorders

The treatment of eating disorders must address both problematic eating behaviors and the misuse of food to manage stress and emotions. Treatment for anorexia nervosa first involves averting a medical crisis by restoring adequate body weight; then the psychological aspects of the disorder can be addressed. The treatment of bulimia nervosa or binge-eating disorder involves first stabilizing the eating patterns, then identifying and changing the patterns of thinking that lead to disordered eating. Treatment usually involves a combination of psychotherapy, medication, and medical management. Friends and family members often want to know what they can do to help; for suggestions, see the box “If Someone You Know Has an Eating Disorder.”

People with milder patterns of disordered eating may benefit from getting a nutrition checkup with a registered dietitian. A professional can help determine appropriate body weight and calorie intake and offer advice on how to budget calories into a balanced, healthy diet.

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Many approaches work, but the simplest formula for weight management is moderate food intake coupled with regular


Assess your weight-management needs. Do you need to gain weight, lose weight, or stay at your current weight?

List five things you can do to add more physical activity (not exercise) to your daily routine.

Identify the foods you regularly eat that may be sabotaging your ability to manage your weight.


Make an honest assessment of your body image. Is it accurate and fair, or is it unduly negative and unhealthy?

If your body image presents a problem, consider getting professional advice on how to view yourself realistically.

Keep track of your energy needs to determine whether your energy-balance equation is correct. Use this information as part of your long-term weight-management efforts.


• Excess body weight increases the risk of numerous diseases, particularly cardiovascular disease, cancer, and diabetes.

• Although genetic factors help determine a person’s weight, the influence of heredity can be overcome to an extent.

• Physiological factors involved in the regulation of body weight and body fat include metabolic rate and hormones.

• Energy-balance components that an individual can control are calories taken in and calories expended in physical activity.

• Nutritional guidelines for weight management and wellness include controlling consumption of total calories, unhealthy fats and carbohydrates, and protein; monitoring portion sizes and calorie density; increasing consumption of whole grains, fruits, and vegetables; and developing an eating schedule based on rules.

• Activity guidelines for weight control emphasize engaging in moderate-intensity physical activity for 60-90 minutes or more per day; regular, prolonged endurance exercise and weight training can burn a significant number of calories while maintaining muscle mass.

• The sense of well-being that results from a well-balanced diet can reinforce commitment to weight control; improve self-esteem; and lead to realistic, as opposed to negative, self-talk. Successful weight management results in not using food as a way to cope with stress.

• In cases of extreme obesity, weight loss requires medical supervision; in less extreme cases, people can set up individual programs, perhaps getting guidance from reliable books or by joining a formal weight-loss program.

• Dissatisfaction with body image and body weight can lead to physical problems and serious eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorder.

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