Some Thoughts About the Future of Eating Disorder Treatment

The last two posts point out where the advancement in eating disorder treatment occurs at the moment: social media and, inadvertently, the pharmaceutical industry.

The clinical establishment—medicine and psychology—have had little true impact on new roads for recovery. Treatment centers rely on old approaches to care, and the larger companies now running most of the residential options focus on turnover and profit.

Any progress is driven by frustrated and incredulous people with eating disorders or their families and clinicians willing to use any tools available to improve care.

There are many reasons why institutional interest in eating disorders care is so limited, but, critically, financial and medical pressures just don’t merit improved outcomes. At hand, the question is what the current forces for better treatment find most compelling.

Psychological treatment of eating disorders has benefit but limited, very slow and not effective for enough people with these disorders. Seeing eating disorders solely through the psychological lens is necessary but insufficient.

Medicine remains wary of these illnesses. Some doctors who specialize in nutrition sciences (and there are very few) can help add knowledge about our metabolism to treatment options. Dietitians truly specialized in eating disorders, of which there are also few, can do something similar through a clinical lens. Other specialists such as endocrinologists or rheumatologists don’t have the background or knowledge to help develop new ways to consider eating disorder care. They can add their own knowledge but not in a precise way to treat eating disorders.

Laypeople very concerned about the lack of progress focus on the overlap between eating disorders and other illnesses. Clinicians increasingly see more cases of autoimmune disease, dysfunction of the autonomic nervous system, Mast Cell Activation syndrome and Ehlers Danlos syndrome, among others.

The suggestion of so many overlapping medical illnesses suggests a broader spectrum of eating disorders with various causal components, many of which might be medical.

Granted, any long term change in eating behavior merits psychological treatment as well to alter ingrained patterns; however, concomitant medical interventions aimed at a person’s specific medical concerns might truly speed up care and recovery.

The future of treatment demands more attention to the figure out the medical and psychiatric illnesses that are part of an entrenched eating disorder. More external pressure on the treatment community can push clinicians to see why more progress is possible and essential.