Early Intervention in eating disorders is a neglected area in research but a highly important topic. In the research that exists already, results have convincingly shown the effectiveness and necessity of early intervention in the treatment for eating disorders.
The importance of early intervention in eating disorders cannot be downplayed. Eating disorders unfortunately have one of the highest mortality rates among mental illnesses. Treating an eating disorder early can quite literally be the difference between life and death for many. Identifying disordered eating early on allows for speedier recovery, reduces chances of relapsing back into the illness, and significantly lessens the physical toll on the body.
Given that eating disorders have a typical onset age in adolescence, the impact of malnourishment on the brain can be distinctly harmful. Normal brain development can be stunted for many which ultimately leads to more complications in recovery. The earlier that chronic malnutrition can be halted, the more long-term health complications can be avoided.
The age of onset for eating disorders stresses the importance of families in the treatment process as well. One of the most common treatment methods specific to anorexia nervosa is Family-Based Treatment, or FBT. Also known as The Maudsley Approach, the Maudsley Parents Organization describes this treatment plan as follows:
Involving the family can often be an integral part of the treatment process for those suffering from an eating disorder. Caregivers, along with the client and clinical professionals can work together in a great collaborative effort to overcome an eating disorder. However, it is important to remember that each client may fit a different treatment plan. The FBT approach may not be the right approach for your family. FBT requires parent(s) to allot a significant amount of time towards restoring their child’s health. If this is not a viable solution for your family’s lifestyle, other treatment options may be a better choice.
Parents or caregivers can also benefit from involvement in parent support groups to talk about shared experiences and receive support from other parents. Past research has shown that many parents feel more hopeful and empowered after hearing stories from others and feeling that they are not alone in their struggles.
Involving a dietitian in the team is also key for providing a full spectrum treatment. Dietitians provide appropriate meal plans and can be an essential guide in the refeeding process.
The nutrition therapist who specializes in eating disorders can also help the client to have a better understanding of their relationship with food and make positive lifestyle changes. Dietitians also work with clients on improving body image. Nutrition therapy helps the client have a better understanding of why nutrition is so important for their recovery.
Nutrition therapy promotes an all food fits approach for optimal well-being, while also taking into consideration any therapeutic effects of particular foods for specific health conditions.
Treatment options are not limited to the FBT approach. Clients suffering from eating disorders may also benefit from Cognitive Behavioral Therapy (CBT).
CBT is defined by many therapists as follows:
This structured treatment method is useful for clients with eating disorders because of the focus on how thoughts and behaviors can play a role in maintaining an eating disorder. For example, cognitive factors (thoughts) related to eating disorders may have to do with body image, weight and shape, self-worth, or perfectionism. Behavioral factors (actions) may be behaviors like weight-control, dietary restraint, purging behaviors, or body checking. Eating disorders are less about food and are more related to specific personality styles (perfectionism, rigidity, low self-esteem). CBT with a therapist can help the client recognize which specific factors are maintaining their eating disorder and set personal goals that will be addressed throughout the CBT process.
CBT usually requires the client to work with the therapist on a weekly basis. Recent research in early intervention for eating disorders has been done on a method of CBT known as CBT-E(nhanced) which focuses on treating issues and complications specific to eating disorders, regardless of which diagnosis one may have received.
Dialectical Behavior Therapy (DBT) is another option of treatment available to clients. DBT merges Eastern approaches and Western therapies, such as CBT. While learning to change thoughts and behaviors in CBT, Eastern philosophies such as Mindfulness help the client learn to manage difficult emotions and regulate their feelings. DBT can be a great addition to recovering from your eating disorder as the modules coach the client through various difficulties related to disordered eating like perfectionism, low self-esteem, and cultivating fulfilling relationships while also learning important skills in emotion regulation that may interfere with recovery.
As always, intervention treatment options and intensity of treatment will vary based on need and preference for each individual, but recovery is possible with the help of a strong familial support system and trained professionals.
If you’d like to read more about any of the therapies discussed above check out these resources:
https://eatingdisorder.org/treatment-and-support/therapeutic-modalities/family-therapy - FBT for eating disorders
https://eatingdisorder.org/treatment-and-support/therapeutic-modalities/cognitive-behavioral-therapy/ - CBT specific to eating disorders
- The FREED Project (first episode and rapid early intervention in eating disorders): service model, feasibility and acceptability. Amy Brown, Jessica McClelland, Elena Boysen, Victoria Mountford, Danielle Glennon, and Ulrike Schmidt
- Early intervention in eating disorders: a parent group approach. Dasha E. Nicholls, and Irene Yi
- Effectiveness of enhanced cognitive behavioral therapy (CBT-E) for eating disorders: study protocol for a randomized controlled trial. Martie de Jong, Kees Korrelboom, Iris van der Meer, Mathijs Deen, Hans W. Hoek, and Philip Spinhoven
- A pilot evaluation of a novel First Episode and Rapid Early Intervention service for Eating Disorders (FREED). Jessica McClelland, John Hodsoll, Amy Brown, Katie Lang, Elena Boysen, Michaela Flynn, Victoria A. Mountford, Danielle Glennon, Ulrike Schmidt
- Will a Comprehensive, Person-Centered, Team-Based Early Intervention Approach to First Episode Illness Improve Outcomes in Eating Disorders? Ulrike Schmidt, MD, PhD, FRCPsych, Amy Brown, DClinPsy, Jessica McClelland, PhD, Danielle Glennon, BSc Hons, MA, Victoria A. Mountford, DClinPsy