If you weigh less than 75% of your ideal body weight, you will probably be hospitalized. The majority of symptoms of anorexia are reversible with weight gain. Hospitalized patients with eating disorders should increase their body weight by 80% to 85% before being discharged. Patients with lesser degrees of weight loss (e.g., a small amount of weight loss or less than 6 months of eating abnormally) are usually managed as outpatients.
If you have low levels of potassium (a condition called hypokalemia), you will need to be hospitalized and given potassium and other nutrients intravenously. Hypokalemia can be dangerous and possibly fatal because potassium plays an essential role in the body, regulating heartbeat, nerve impulses, and kidney function. Potassium is depleted when the body loses high volumes of fluid. This can be caused by vomiting, diarrhea (from laxative use), malnutrition, and water pills (diuretics). If left untreated, it can cause kidney failure and cardiac arrest. Potassium and other nutrients will need to be given intravenously to ensure that proper levels are restored.
If you recognize that you have an eating disorder, seek early treatment. It is vital to treat eating disorders early in order to minimize potential complications. The longer this abnormal eating behavior continues, the more deeply entrenched it becomes. Recognizing the problem is often a challenge, as people with eating disorders are often unaware there is a problem, or hide it from those around them.
If your abnormal eating behavior has a destructive impact on your self-image, see a mental health professional. Anorexia may be a single, limited episode with large weight loss within a short period of time followed by a recovery. However, anorexia and bulimia may begin with very strict dieting or weight loss. In addition, binge eating may start with occasional bingeing. Many of those with anorexia will eventually develop bulimia.
Eat small meals frequently throughout the day. A primary goal for treating anorexia is weight gain. A nutritionist is helpful, and can advise you on proper diet and eating regimens. Normal food intake for women and teens is 2,000 to 3,000 calories per day. Most patients regain 1 to 3 pounds per week. Most complications associated with anorexia are reversible as you gain weight.
Your doctor is the best source of information on the drug treatment choices available to you.
If you have an eating disorder, you need to participate in some form of psychotherapy to deal with your underlying emotional issues. A psychologist can help identify issues that need attention, and can help you try to replace negative thoughts and behaviors with positive ones. In effect, psychotherapy tries to change the negative behavior underlying the eating disorder. Binge episodes can be reduced with cognitive-behavioral psychotherapy, which helps patients to change abnormal thoughts and behavior by educating them about bulimia, teaching methods to reduce dietary restraint, prescribing a regular pattern of eating, and identifying and correcting dysfunctional beliefs. Interpersonal issues related to the eating disorder may be resolved through family or marital therapy. Therapists can help families understand eating disorders and teach them new techniques for coping with problems. Group therapy can also be of some use for patients and families dealing with an eating disorder.
If eating disorders are left untreated, serious complications can develop. Eating disorders do not usually go away without proper treatment; even with treatment, recurrent psychiatric and eating disturbances are common. Without appropriate treatment, one in ten cases of anorexia ends in death from starvation, suicide, or medical complications that include stomach and heart problems, kidney and dental problems (for bulimics), and dehydration. Approximately 1,000 women die of anorexia each year.
Most complications experienced by anorexics and bulimics are reversible as patients achieve and maintain a healthy, normal weight.
If you have an eating disorder and have had intensive treatment, you are 50% more likely to achieve and sustain a normal weight. The majority of patients with anorexia regain 1-3 pounds per week while being treated. As women gain weight, they are likely to start menstruating again. Both those with bulimia and with those with anorexia nervosa tend to persist with slightly abnormal eating and dieting behaviors, even after the recovery period; however, continued treatment usually resolves this for bulimics.
The long-term prognosis for normal physical and mental health is poor for anorexics who do not receive treatment.
Bulimics may have poorer long-term prognosis than anorexics. People may have trouble detecting bulimia in someone they are close to, as those with bulimia binge and purge in secret, and maintain a somewhat normal body weight. Bulimics can often successfully hide their problem from others for years (including their doctor), delaying treatment and allowing the illness to ravage the body. Some individuals with bulimia struggle with addictions, including drug and alcohol abuse, and compulsive stealing. Clinical depression and other psychiatric illnesses are also quite common in bulimics. These problems, combined with impulsive tendencies, put them at higher risk for suicidal behavior.
Continue psychotherapy for at least one year. Psychotherapy attempts to change negative thoughts and behaviors, and explores the psychological issues underlying the eating disorder. It can help you to recognize the root of your negative self-image, and attempt to replace negative thoughts with positive, healthy ones. Anorexic patients in particular need counseling for at least a year in order to work on changing the emotions that are causing the eating problems. Counseling may involve resolving a traumatic event that initially triggered the disorder.
Combining familial and marital therapy may prevent relapses by resolving the interpersonal issues related to the illness. In addition, therapists can help family members deal effectively with the illness.
Contact your physician if your eating disorder does not resolve after multidisciplinary treatment. A physician, a nutritionist, and a mental health professional are usually involved in treating eating disorders. A physician may be the initial contact, seeing the patient who presents with a complication resulting from the eating disorder, and may rule out any other medical illness. A nutritionist is involved in changing eating habits by recommending appropriate foods and eating regimens for the patient to follow. Lastly, the mental health professional plays an integral part in changing the negative behavior that underlies the condition.
Promptly report any drug side effects or complications to your physician. Drugs should be used in conjunction with psychotherapy. Not all patients will receive drug therapy; those who do should be aware of the side effects.
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