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Upon diagnosis, it must be determined if long-
Treatment should include an internist, nutritionist and therapist.
"The challenge of treating eating disorders is made more difficult by the metabolic changes associated with them. Just to maintain a stable weight, individuals with anorexia may actually have to consume more calories than someone of similar weight and age without an eating disorder. In contrast, some normal weight people with bulimia may gain excess weight if they consume the number of calories required to maintain normal weight in others of similar size and age." 10
Biochemical connections between depression, obsessive-
Regaining weight must be a very slow process. There is an impairment of digestion in starvation and the body needs time to rebuild the enzymes of the liver and pancreas. Rapidly ingesting food after starvation may result in bloating, nausea, vomiting, and even congestive heart failure due to the strain on the weakened heart from the large metabolic rebound.
Group therapy is more effective with bulimics than anorexics. This is because the bulimic is aware that s/he has a problem.
"In a recent study of bulimia, researches found that both intensive group therapy and antidepressant medications, combined or alone, benefited patients. In another study of bulimia, the combined use of cognitive-
In treatment, the patient rather than the illness is often seen as the "problem."
The patient is blamed and guilt becomes the treatment of choice. This approach actually exacerbates the problem.
The perfectionism of the patient is a major factor in the feelings of being "bad" and deserving of punishment. Counselor's need to consider their own thoughts, feelings and actions with their clients. The client needs more than food to regain health, they need acceptance, hope, concern, respect, care, and love. Christ calls us to love our neighbor as ourselves in Matthew 19:19. This type of love, love that considers the well-
Eating disorders are a result of complex behaviors made up of many reasons. Counseling needs to be individualized.
Conditional love, criticism, black and white thinking, perfectionism, low self-
"As most clients with eating disorders are bright and active, they are usually quite well-
Clients need a relationship with their counselors that is based on trust and that is based in truth.
They also need understanding. A sense of empathy will help ease the feelings of loneliness in their disease. We mustn't assume we know how the client feels but allow thoughts and feelings to be expressed in an atmosphere of acceptance and trust. This acceptance and trust will facilitate an environment in which the client can accept and assimilate truth.
An atmosphere in which the illness can be openly discussed is critical to recovery.
The eating disorder has been a behavior that the client has tried to keep secret. They fear that lack of understanding will lead to rejection and punishment. They fear that who they are will be rejected and this is all they have.
The counselor and client will cooperate in the healing process when their is an emotional bonding that cause the feelings of isolation in the patient to be lessened. Knowing and accepting each other will lead to being able to discuss thoughts and feelings. The task is to tell the truth in love as Christ did.
"The largest obstacle to treating anorexia is that those who suffer from the disorder do not want to be treated." 13
Therefore, people with eating disorders may not receive medical treatment and therapy until they are dangerously thin and malnourished. People with bulimia are often at their normal weight and able to hide their illness. Eating disorders in males may be overlooked as they are rare.
Those with eating disorders feel that they must be punished for their "sins."
The counselor and the patient are both "sinners saved by grace." In Romans 3:23-
Resistance to recovery can best be interpreted as fear of change rather than rebellion.
Clients may need to be helped to see that they have permission to change and then protected during the process of change. Knowing the principles of cause and effect that are specifically related to the illness, and presenting them in a caring manner place the power struggle between the individual and the unchanging reality of the consequences of the disorder. The person with eating disorder cannot gain health, joy and acceptance when starving to death. What we reap we sow (Gal. 6:7-
A refocusing of the family's energy will be necessary to reduce the power struggle at home.
The family can be released from the responsibility of the eating behavior and be asked to be responsible only for the unhealthy self-
If the child had cancer, the family would support and encourage the child and allow the physician to deal with the illness. The physician and family work together to fight cancer, it is the same with the counselor and family working together to fight this illness.
Those with eating disorders are afraid to grow up fearing that they will handle the increased responsibilities as poorly as they have their health.
Counselors need to assist the client in making clear, attainable goals and then teach how to obtain them. As she sets more realistic goals, and sees small successes, she can feel that entering into adulthood in freedom and as a responsible individual may actually be possible.
Signs of recovery include: acceptance of self and others; love of self and others; appropriate self-
"When these thoughts, feelings, and behaviors are present to a reasonable degree and when they have become a very part of the individual's personality, one can be reasonably sure that the eating disorder has been resolved." 14
~ In Christ, Dr. Kim West
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