The assessment, diagnosis and treatment plan for people with eating disorders has changed dramatically in recent years.
Historically, the initial appointment comprised of a standard psychological intake followed by medical, therapeutic and nutritional follow-up. These components are still essential to any treatment plan.
Eating disorder symptoms clinically appear to be connected to other biological systems as well, predominantly metabolic, endocrine and immune (autoimmune disorder and Mast Cell Activation Syndrome). In addition, there has been more data connecting other psychiatric disorders such as Attention Deficit Disorder (ADHD) or Autism Spectrum Disorder (ASD) with eating disorders as well.
It’s unclear whether these connections are causative or even possibly point to a different way to conceive of eating disorders. Despite the lack of relevant information, diagnosing and treating these concomitant illnesses aids eating disorder treatment for many people.
A clinician now needs to take into account this entire set of medical and mental health considerations as well when developing a plan for treatment. Medicine may not yet know how and why these organ systems or psychiatric disorders seem connected to eating disorders, but distinguishing different causes and symptoms related to each person’s illness can enable a clinician to individualize treatment.
The holy grail of medical and psychological research into treating eating disorders is finding an underlying biological cause. Through such a breakthrough, the long lasting torment of these illnesses might be shortened significantly.
The ingrained behavior patterns of an eating disorder become entrenched so behavioral therapy would still be indicated, but combining a medically-informed treatment with therapy might shorten the length of care needed to get well.
A thorough assessment needs to include several elements.
- Psychological evaluation
- Nutritional assessment
- General medical exam
- Labs tailored to assess metabolic function
- Assessment of inflammatory symptoms
- Screening for attentional deficit or autism spectrum when indicated
The combination of a standard psychiatric evaluation plus the extended assessment for other associated conditions will help determine the best course of treatment for any individual and increase the chance for a successful outcome.
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