The Role of Psychiatry in Treating Eating Disorders

Many societal myths remain about eating disorders as well as their treatment. As a result, it is not uncommon for people to assume that recovering from an eating disorder requires little more than adopting new habits around food. This couldn’t be farther from the truth. Treating an eating disorder requires a multidisciplinary approach, focusing on not only nutrition but also addressing underlying psychological distress and symptoms of co-occurring mental disorders that may be present. In this article, we will take a look at the basics about eating disorders and how they are treated, as well as the role of medication in treating these complex conditions.

An Overview of Eating Disorders

Eating disorders are serious mental illnesses that significantly impact an individual’s physical and mental health, and quality of life. While there is no singular cause of eating disorders, these conditions are thought to develop due to a combination of biological, psychological and sociocultural factors. They affect individuals of all genders, backgrounds, ages, and walks of life.

Types of eating disorders include anorexia nervosa, bulimia nervosa, Binge Eating Disorder, orthorexia nervosa, Avoidant Restrictive Food Intake Disorder (ARFID), pica, and Other Specified Feeding or Eating Disorder (OSFED). Though these conditions have their own distinct set of symptoms, there are some general warning signs that may signal the presence of an eating disorder including:

Preoccupation with food, calories, weight, or body size/shape
Distorted self-image
Frequent dieting or cutting out entire food groups
Food rituals
Withdrawal from usual activities/isolating from others
Evidence of disordered behaviors- such as purging after eating, hoarding large amounts of food, excessive exercising, etc.
Significant weight loss or gain (though it is crucial to note that individuals of any weight can have an eating disorder)
Physical symptoms such as low energy levels, dizziness, etc.

Recognizing the warning signs can help you to seek support if you notice any of these behaviors in yourself or others.

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How are Eating Disorders Treated?

While it can be a difficult and lengthy process, recovering from an eating disorder is absolutely possible. Despite harmful societal myths about eating disorders, getting better is not a result of ‘snapping out of it’ or ‘just eating’. Treatment must address the underlying factors that have contributed to an individual’s eating disorder.

If an individual is severely underweight or experiencing medical complications due to their eating disorder, addressing malnutrition and focusing on weight restoration is typically the first step. From there, treatment generally combines medical care with nutritional coaching and psychological support. In some cases, psychiatric medications may be beneficial in treating co-occurring conditions that may be contributing to patterns of disordered eating.

The Role of Psychiatry in Treating Eating Disorders

Certain medications such as anti-depressants and anti-anxiety medications can play a positive role in an individual’s recovery from an eating disorder. Many individuals with eating disorders are also living with another mental health condition such as depression, anxiety disorder, obsessive-compulsive disorder, or post-traumatic stress disorder. Treating these conditions can help to reduce distressing symptoms that may be contributing to an eating disorder as a means of coping.

In the treatment of anorexia nervosa, research has shown certain antipsychotic medications (such as Zyprexa) are effective in helping to decrease the intensity of intrusive thoughts around food and fear of weight gain. It can also help to facilitate weight gain if it is needed.

Individuals with Binge Eating Disorder may also benefit from incorporating medication as a part of their recovery. Antidepressants may prove to reduce the frequency and intensity of binge eating episodes, for several reasons. For one, antidepressants increase the amount of serotonin, dopamine, and norepinephrine available in the brain, which can boost mood and help to regulate appetite and impulse control. This may result in less of an urge to binge eat. Studies have also seen these results in individuals with bulimia nervosa as well. Lastly, many individuals with Binge Eating Disorder are also living with depression. For many individuals, alleviating depressive symptoms also reduces binge eating.

Overall, medication can be one important facet of recovery for some. If you are receiving treatment for an eating disorder, talk to your doctor or a mental health professional if you’d like to discuss whether medication may be right for you. However, it is important to acknowledge that medications alone will not cure an eating disorder, or address what has contributed to the development and maintenance of the disorder. It is essential for an individual to also undergo psychotherapy in order to identify and work through the underlying roots of their eating disorder.

If you are experiencing concerns around food, weight, exercise, or body image, reach out for professional support. You are not alone; it is possible to move towards a healthier relationship with food and your body.