Dr Miriam Stoppard's Health Focus: Anorexia and Bulimia Nervosa Part Two - Getting Help

Article excerpt

No way to treat yourself

PEOPLE with eating disorders are often afraid of asking for help and hesitant in accepting it. They see it as failure.

The sooner you admit you have an eating disorder and accept help, the better the chance of a cure.

The longer you delay in seeking help, the more severe your illness will become - needing more intensive treatment.

Remember, anorexia has one of the highest death rates of all psychiatric illnesses, though deaths can be prevented by proper treatment.

No one form of treatment works for everyone; what's an effective form of treatment for one person may not be effective for you. And, despite best efforts, some people only partly recover.

YOUR GENERAL PRACTITIONER

TO help yourself, you have to be open and honest with your family doctor.

DON'T be ashamed of being anorexic or bulimic or reluctant to admit you have a problem, try not to disguise the condition and be honest about the most important symptoms.

DON'T be frightened of the consequences of admitting you have an eating disorder.

You're entitled to complete confidentiality; this means that your parents and carers needn't know. When you're worried about confidentiality, an agreement should be reached between you and your doctor about what's written in your notes.

A few doctors, including yours, may have the experience and skill to take an active role in your treatment.

In all other cases, it's your right to be referred for assessment by a specialist who has training in eating disorders; you should be seen as soon as possible so that delays and waiting lists can be avoided because you may get worse if you wait too long and then need in-patient rather than out-patient treatment.

SELF HELP

SELF-HELP groups can be a useful addition to treatment but they aren't an alternative.

They're very helpful in getting patients and families to understand they aren't alone with the illness.

And self-help manuals can be useful at first or alongside other treatments. A self-help programme for women with bulimia is available through the Eating Disorders Association (under the medical supervision of a GP).

GENERAL TREATMENT

EFFECTIVE treatment depends on your really wanting to get better and on the skills of your therapist.

All these treatments work: counselling, psychotherapy, cognitive behaviour therapy, group therapy, family therapy, day hospital programmes, in-patient treatment, dietetic advice, and in some instances drugs can be of help in the short term, particularly to bulimics who are depressed. Treatment must address the psychological aspects of anorexia and bulimia nervosa as well as the abnormal eating. Re-feeding is a last resort but may be necessary to save life. Alone, however, it's only successful in short- term weight restoration, but usually isn't effective in the long term.

COUNSELLING

COUNSELLING can be very good if the counsellor has an understanding of anorexia and bulimia and can be on hand over the long haul.

For anorexia, counselling's more effective during the early stages (when less than 25 per cent of body weight has been lost). …