Treating an Eating Disorder with Medication
There are several common treatments for bulimia and anorexia. Some find cognitive behavioral therapy (CBT) helpful, while others require nutritional counseling. Many patients are also being prescribed medication to help them cope with the obsessive thoughts, anxiety, and depression that comes along with disordered eating.
Antidepressants are commonly known to treat symptoms of depression. Doctors also find that such medications are helpful for a number of other mental health disorders such as panic attacks, obsessive-compulsive disorder, phobias, and post-traumatic stress disorder. Since anxiety, obsessive thoughts, and depression are often seen among bulimic and anorexic patients, it follows that these medications might work to counteract some counterproductive thought patterns. When you can minimize the harmful thought patterns, the resulting behavior (such as binging or exercising to excess) will decrease.
Olanzapine is used as an anti-psychotic in higher doses. It was traditionally given to schizophrenics to treat symptoms of psychosis. However, since anorexics are often paralyzed with irrational thoughts about weight and body image, this medication may help calm delusional ideas about perceived fatness. Olanzapine has helped some patients retain a healthy weight. Olanzapine is meant for short-term use, and once the patient’s weight has been restored, a longer-term medication (such as fluoxetine) is beneficial.
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Few other medications are recommended for anorexic patients. Some antidepressants cause weight or appetite changes and are simply not safe for an underweight patient. For example, bupropion hydrochloride is dangerous for eating disordered patients as it increases the chance of seizures by tenfold. Others cause diarrhea or upset stomach, which discourages the patient from restoring a healthy weight.
Fluoxetine and SSRIs
Fluoxetine has also proved to be effective for bulimic patients. When taken in higher doses, fluoxetine seems to quell the desire to binge and purge. Other SSRIs (selective serotonin reuptake inhibitors), such as sertraline or paroxetine hydrochloride are commonly used as well. CBT is usually recommended in conjunction with medication.
Medications alone will not help the bulimic patient lose weight – they merely suppress the constant thoughts of food. If a bulimic patient needs to lose weight, she may be prescribed sibutramine, which reduces appetite.
The SSRIs are by far the most commonly prescribed medication for treating bulimia. Fluoxetine is actually approved by the USDA for such use. The main reason these medications are effective is because they improve mood, reduce anxiety, and diminish obsessive thoughts.
These medications do not come without side effects though. The SSRIs can cause dry mouth, headache, changes in appetite, sexual dysfunction, sweating, and stomach pain. Some, such as sertraline and fluoxetine, have caused fatal reactions when mixed with certain other medications. SSRIs should not be used in patients who take monoamine oxidase inhibitors.
An Eclectic Approach to Healing
Medications should be used as a part of a multi-faceted approach to treating an eating disorder. Depending on the severity of the disorder, some patients may require inpatient treatment. Anorexics in particular need to be monitored closely in such facilities as they will need to restore depleted nutrition carefully. Without proper monitoring, an anorexic patient can suffer serious complications to major organs, including the heart and brain.
The long-term success rate of medications for eating disordered patients is generally good so long as the sufferer remains on the medication. For many, their weight or food consumption is the only thing in life that they feel they can control. Stopping the eating disordered behavior can provoke an incredible amount of stress. Many will not be able to complete treatment programs due to the monumental task of changing their behavior that has served as a coping mechanism for so long. Some will turn to another method of coping with stress, such as alcohol, drugs or self-harm.
Support for the anorexic or bulimic must come from more than just a physician who prescribes medication. Treatments that focus on only one facet of the disorder have a low success rate. Instead, if you can find a support group or treatment that includes the family (the Maudsley Approach), a patient will feel less isolated. Group therapy, in conjunction with individual therapy, nutritional counseling, and medication, is going to be more effective than any single treatment administered on its own.