Friday, 26 February 2010 19:42

Published: Wednesday, February 24, 2010 11:04 PM CST
Recognizing that one has an eating disorder and seeking treatment is the most critical step in getting healthy and overcoming an eating disorder. “The earlier people get good treatment, the better off their health,” said Erin Pederson, ISU student counseling services staff counselor.

Since it is just a critical, difficult step for many suffering with an eating disorder to take, the support and understanding of friends and family can be especially important. If one has a friend who one may be concerned has an eating disorder, be prepared before confronting him or her. Think about who is the best person to approach them, and limit the conversation to one or two people so he or she does not feel overwhelmed. It is also important that one talks and presents the matter in a very caring way and give specific examples of behavior that are alarming. For example, “I noticed you quit coming down to eat with us at night.”

Be as encouraging, supportive and understanding as possible — offer to be with him or her when they make the phone call or walk with them to the counseling center. “Remember you can’t fix it. The best thing for a friend or family member is to model healthy behaviors themselves,” said Michelle Roling, ISU student counseling services staff counselor. Roling also said to model healthy behaviors — ask oneself if one is eating a balance meal, have a good relationship with the body and watch to see if one finds that conversation involving dieting and weight frequently occurs.

There are different types of treatment depending on the seriousness of the condition. These treatments are outpatient treatment, intensive outpatient treatment, inpatient treatment and residential treatment. An assessment is the best way to determine level of medical care, and “until the right tests are done, you don’t know how bad the disorder really is,” Roling said. Outpatient treatment is typically on a one-hour appointment basis with a therapist, nutritionist, doctor and psychiatrist. There is usually group counseling as well, but everything is done while the individual is still at home or at school. Intensive outpatient treatment involves the individual still living at home or at school, but he or she may go for half a day to a facility to have two meals with staff and other clients.

Roling said, “If someone does outpatient, it is vital that they do it with someone who specializes in eating disorders. Choosing a therapist that has training and experience with eating disorders is very important so that they can make an accurate assessment on the level of care you need.” Inpatient treatment is when 24-hour care begins. Roling said that the practice of symptom interruption takes place where someone with an eating disorder is put in an environment where he or she is monitored. This is done to decrease negative behaviors and help regulate and get the body acclimated to regular food intake again; which is a very important step. The individual will also go through therapy and group therapy and will have a team of staff to focus on each angle of the eating disorder that the individual is facing.

University of Iowa Hospital in Iowa City is the only facility in Iowa that offers inpatient treatment and partial hospitalization for individuals with eating disorders. The hospital obtains clinical information to decide the appropriate level of care [outpatient, partial hospitalization or inpatient care]. The team of people working with the patients is the same whether one is in the partial hospitalization or inpatient care. Faculty is highly experienced with an average of 15–30 years under their belt. The hospital uses a cognitive therapy behavioral approach because “it’s the only evidence based therapy for eating disorders,” said Shirley Haley, referral coordinator for the University of Iowa Hospitals eating disorder services. “It’s a very structured program,” Haley said. “At first, individuals don’t order their food, because we think of food as medicine here. You don’t order your own medicine that you get from the doctor, so you don’t order your own food.”

After patients begin to make progress, they get the privilege of beginning to make their own food selections again.

Haley said they accept males and females, with an increase in male attendance lately. “We are also one of the very few eating disorder establishments that offer treatment to men,” she said. Most of the patients are of adolescent, high school and college age. There is a school attached to the facility so that children are still able to continue with education.

 Residential treatment is in settings that aren’t so much hospitals, but rather more like a living quarters. Residential treatment consists of a longer stay and may include things such as equine therapy, activities such as rock climbing and spirituality. Two residential treatment centers, Remuda Ranch in Arizona and Roger’s Memorial Hospital in Wisconsin, are sponsors of Eating Disorder Awareness Week. At Iowa State, anyone is able to contact the student counseling services, even if one is not associated with Iowa State. If one is not a student, the counseling center will give information and recommendations for places to start. If one is a student, the center will begin the process with an assessment and take it from there. “We take a biological, social, psychological approach in treatment here,” Pederson said. “We also have group therapy — which clients have said to benefit a lot from — in addition to individual therapy.”