A comprehensive treatment process conducted with the participation of psychiatry, dietitians, and family for conditions such as anorexia nervosa, bulimia nervosa, and binge eating disorder (BED).
Indication
- Anorexia nervosa (severe weight loss, body image disturbance)
- Bulimia nervosa (binge eating with compensatory behaviors: vomiting, laxative use)
- Binge eating disorder (BED) — episodes of overeating with loss of control
- Unexplained rapid weight loss or gain
- Impairment in social, school, or work functioning related to eating behavior
- Coexisting depression, anxiety, or self-harm behavior
Preparation
- Bring previous weight, height, laboratory test, and ECG reports
- Keep a food diary (if possible for one week)
- List of current medications and supplements
- A brief note on family history and family dynamics
How it's performed
- A psychiatrist conducts a comprehensive clinical evaluation
- Body mass index, blood tests, electrolytes, and ECG are checked
- An individualized nutrition plan is prepared by a dietitian
- Cognitive behavioral therapy (CBT) and family therapy when indicated are initiated
- Medications such as SSRIs may be considered when depression or anxiety coexists
- Inpatient treatment is planned in severe cases (significant weight loss, electrolyte disturbance)
Post-procedure
- Weekly or biweekly follow-up visits in the early period
- Monitoring of weight, body measurements, and laboratory tests
- Regular revision of the nutrition plan with the dietitian
- Family meetings and psychoeducation
- Protective follow-up for at least 1 year after recovery
Risks
- Refeeding syndrome that may develop when nutrition is restarted in anorexia
- Worsening of bulimia-related dental, gastric, and electrolyte issues during treatment
- Treatment resistance and risk of relapse
- Side effects such as nausea and headache when medications are used
- Risk of suicidal ideation when depression coexists
FAQ
Are eating disorders only about losing weight?
No. They span a broad spectrum that includes binge eating, compensatory behaviors, and disturbances in body perception. They can also occur at normal body weight.
Is hospitalization mandatory?
No. Most patients can be treated as outpatients; however, admission may be needed in cases of severe weight loss, electrolyte disturbance, or suicidal risk.
Why is family involvement important?
Family-based treatment (FBT) is particularly effective in adolescents. The family plays a key role in maintaining the nutrition routine and emotional support.
I have thoughts of self-harm or suicide; what should I do?
Please call your local emergency number or go to the nearest emergency department. If such thoughts arise during your treatment, inform your physician without delay.
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