Treatment for an eating disorder

Seeking Treatment

Talking to the Doctor

Going to the doctor can make you feel nervous or scared.  There may be difficult issues you want to discuss or questions you want to ask.  Sometimes it can helpful to write down a list of questions before you go. If you find the answers difficult to follow, then ask the person to explain until you do understand. It is important that you know what is happening and why. Take notes if you think it will help you to remember.

Here are some questions you might want to ask:

• What will happen next?
• What will my treatment involve?
• Are any other people likely to be involved?
• What are the drugs/ medicine for?
• Is there anyone I can go to locally that I can talk to about my feelings?
• Do I have to go into hospital?

You need to feel confident that your doctor understands you and that you can trust them.  If you feel that you cannot talk to your usual doctor, you can usually see another doctor in the same practice or you can talk to some one else in the surgery like a nurse or health visitior.

You can contact NHS Direct for details about other doctors and how to move to another practice.

“It was quite good having someone with me when I had to talk about my eating disorder. If there was something I didn’t understand or if I wanted to ask anything, she would help me. Sometimes she didn’t understand either, and she would find out, which made me feel less stupid!”

“I was so scared about telling my doctor. I really believed that he would tell me that I was too fat to have anorexia. He said that I should tell my parents, but I didn’t want to because I didn’t want to let them down. Now I don’t know what I would have done without them.” 

What will my treatment involve?

Eating disorders are complex conditions, and it can take a number of different professionals working together to treat them. Your GP should be able to make a diagnosis and tell you what sort of eating disorder they think you have. They may ask for a specialist to see you and make an assessment of your treatment needs.

Eating disorders affect you physically as well as emotionally and your treatment needs to address this. If you are a very low weight, then starting to eat again will be a priority, and your treatment may focus on this. You should be offered some psychological therapy- talking to a counsellor or therapist to help you with any emotional difficulties the eating disorder has caused. A Dietician or Nutritional counsellor can help with meal plans and food choices.

If you are a young person, you may be offered family therapy. This isn't because all your family is ill too- it is because having your family involved in helping you get well is proved to be the most effective.

If you need to see a specialist, most treatment takes place as an out-patient. Only the most seriously ill people and those who are also physically very frail should need to become an in-patient and stay in a hospital ward or special eating disorders unit.

The types and availability of treatment varies around the country and different types of help may be offered. Treatment should include dealing with the emotional as well as the physical issues but this must be done quite slowly so that you can cope with the changes. Help with eating and simply regaining weight is usually not enough by itself.

If someone is so ill their life is at risk, they can be treated even if they don't want to be. This is very rare, and there are legal safeguards in place that doctors have to follow very carefully. The beat website www.b-eat.com can access you to other useful websites with more information and advice.

The National Institute for Health and Clinical Excellence (NICE) have published treatment guidelines for England and Wales; and Quality Improvement Scotland (QIS) has produced guidelines for Scotland.

The National Institute for Clinical Excellence (NICE) guidelines for the treatment of eating disorders are the basis for most treatment in England and Wales, you can access further information on the NICE website at www.nice.org.uk   As well as the treatment guidelines NICE also publish information for patients and their carers. At the moment there are no equivalent guidelines for treatment in Northern Ireland, or Scotland.

The type of professional support you will be offered will depend upon your own particular disorder, the availability of services in your area or the arrangements that your Primary Care Trust (PCT) have made to purchase ‘Out of Area Treatment Services’ (OATS) from other health authorities.

Compulsory Admission

When you lose a great deal of weight the effects of starvation on your brain can affect your ability to think. This can make any rational decisions about your own treatment or circumstances very difficult. In extreme circumstances, when all other alternatives have failed and your life or health are ‘at risk’, you may be fed or treated against your will under a ‘section’ of the Mental Health Act. In a survey of people who had been fed or treated against their wishes, half said that, looking back, they thought it had been ‘a positive thing’.

Other treatment options include

beat runs self-help and support groups, proven to be highly beneficial by those who have attended the sessions. On this website there is a database of professional therapists working in eating disorders in the HelpFinder directory.

National Institute for Clinical Excellence (NICE)

On 28th January 2004, the National Institute for Clinical Excellence (NICE) published their Eating Disorders Treatment Guideline. beat was involved in drawing up the guideline and welcomes the publication of this valuable and useful document. Visit the section on this site with full information about the NICE Treatment guidelines

Problems accessing treatment?

In the first instance contact your local Patient Advice and Liaison Services (PALS).

PALS provide:

• confidential advice and support to families and their carers
• information on the NHS and health-related matters
• confidential assistance in resolving problems and concerns quickly
• explanations of complaints procedures and how to get in touch with someone who can help
• information on how you can get more involved in your own healthcare.

To contact your local PALS: Phone your local clinic, GP surgery, health centre or hospital and ask for details of PALS, phone NHS Direct Online on 0845 46 47 or visit www.pals.nhs.uk