I have worked in the field of treating eating disorders for almost 18 years. In those 18 years I have experienced times of great joy as I’ve watched the miracle of a patient’s healing unfold before my eyes.
During that time I also had times of deep sadness as I watched hundreds of women with eating disorders relapse repeatedly. Treatment teams are frequently dismayed, families are in debt for thousands of dollars, and patients themselves feel as if they’ve failed yet one more time.
I became aware early on as an eating disorder therapist that the medical model of treatment, which is cognitive-behavioral therapy and nutritional education with some equine therapy tossed in occasionally, simply doesn’t work. Stuart Agras (1993) stated that only 32% of all people who have had eating disorder treatment are eating disorder free after a year. This is simply not good enough!
It was when I was studying for my PhD at Saybrook in San Francisco that I finally figured out what was missing. Attention to what I call my holy trinity – mind, body, spirit was missing. In the medical model of eating disorder treatment, the body and the spirit were left out!
Treating eating disorders is serious. Eating disorders affect a significant number of Americans, an estimated 5 million every year (Kreipe, Golden, Katzman, Fisher, Rees, Tonkin, et al., 1995). These disorders include anorexia nervosa, bulimia nervosa, binge-eating disorders and several other variants. Although these disorders are more common in adolescent girls or young women, approximately 7 million girls and adult women struggle with eating disorders and approximately 1 million boys and men will struggle with eating disorders this year (Katz, 2003). 10%-25% of all those battling anorexia will die as a direct result of the eating disorder. Anorexia nervosa has the highest mortality rate of any DSM diagnoses.
We often say that there's no such thing as a client with JUST an eating disorder. Nearly all eating disorder clients present with a host of issues that may include anorexia, bulimia and compulsive eating, but also attention deficit disorder, anxiety, depression, trauma, substance abuse, obsessive compulsive disorders, sleep disorders, and a host of other conditions. Almost all eating disordered patients have a dual diagnosis.
Given the complexity of eating disorders, holistic treatment is the one of the few ways to successfully treat eating disorders and their co-occurring conditions.
Holistic eating disorder treatment takes into account the whole person (body, mind, spirit), including all aspects of lifestyle. It makes use of all therapies, both conventional and alternative.
Integrative medicine and holistic eating disorder treatment are partners in treating the whole person, knowing that one part of a person cannot become either ill or well without all of the other parts being affected. Holistic eating disorder treatment depends on a partnership between the patient, therapist, the doctor, and all of the practitioners where the goal is to treat the mind, body, and spirit, all at the same time. While some of the therapies used might be considered unconventional, a guiding principle within holistic and integrative medicine is to use therapies that have some high-quality evidence to support them, such as some therapies used in holistic eating disorder treatment as well.
In a holistic eating disorder treatment center, a multidisciplinary treatment team consists of practitioners from traditional psychiatry, psychotherapy, and medicine who work closely with complementary medicine practitioners. Every member of the staff needs to be an experienced, caring professional who is certified and/or licensed in his or her area of practice and is knowledgeable in the field of eating disorders.
In holistic eating disorder treatment, many types of experiential therapies are used. Clients who have had various traumatic events in their lives are treated through the use of experiential therapies. These therapies include Eye Movement Desensitization and Reprocessing (EMDR), cognitive-behavioral interventions, Gestalt Therapy, Traumatic Incident Reduction (TIR), Emotional Freedom Techniques (EFT) and Neural-Linguistic Programming (NLP). Trauma, Post-Traumatic Stress Disorder and sexual abuse issues are addressed in a professional, respectful, and gentle manner.
Clients in holistic eating disorder treatment are treated as individuals with the utmost dignity and respect.
Holistic eating disorder treatment covers quite a wide range of options for treatment. One eating disorder expert said it like this, “We’re going to knock on a lot of little doors with and for a patient. Some of those doors will open with CBT, others with acupuncture, bodywork, or neurofeedback. But we at least have such a wide variety of little doors that we’ll find whatever it is that will be the way that will take an individual towards healing, health, and wellness.”
This is the first of a series of articles where I will explain the types of alternative therapies that are used in the holistic treatment of eating disorders, why they’re used and, their effectiveness.