How can eating disorder treatment outcomes be accurately measured especially since treatments for eating orders are complex? Renouncing eating disorder behaviors elicit anxiety, fear, panic, and frustration, as many patients experience difficulty concentrating, initiate abuse of alcohol or drugs, or even become suicidal.
When this turmoil of emotions becomes too much to handle, patients often leave treatment prematurely, resulting in treatment dropout rates as high as 46 percent, as reported in the American Journal of Psychiatry.
Despite a wide array of research on the matter, there exist substantial limitations regarding data on outcomes in eating disorders. Almost all studies have been inhibited by the issues of treatment dropout or non-participation in follow-ups.
Discrepancies can be found in the definitions of outcomes and choice of outcome measures, amid a scarcity of studies focusing upon the subjective perception of recovery for different patients.
Determining measuring outcomes
Björk et al. aimed to investigate methodological issues in measuring outcomes following treatment for eating disorders. Specific areas of investigation included non-participation in long-term follow-ups, the role of self-image in treatment dropout, outcome among patients who drop out, patients’ subjective perspectives of recovery, and the impact of different methods of measuring outcome.
Results revealed that non-participation and dropout were independent entities. Those avoiding further participation in follow-ups reported considerably lower levels of obsession-compulsion and anxiety. Self-image and levels of self-blame distinguished dropouts from completers and remainders, significantly predicting treatment dropout.
However, patterns of treatment response revealed that those who completed treatment made significantly greater changes in terms of reduced eating disorder symptoms, fewer psychological problems, and a more positive body image compared to dropouts.
Dropouts were more dissatisfied with treatment. However, those who completed treatment made more significant changes in terms of reduced eating disorder symptoms, fewer psychological problems, and a more positive self-image than the dropouts.
It was also observed that patients tended to view recovery in terms of being able to relate in a relaxed and accepting manner to food, their bodies, themselves as individuals, and their social environment.
Some perceived recovery in terms of coping better with emotions, while others experienced themselves as healthier than people generally regarding food and weight.
The three R’s for Remission
Achieving respite from eating disorders can be categorized into the following three steps:
- Weight restoration (re-feeding)- requiring increased calorie intake to gain and maintain weight
- Repair of physical damage (resting)
- Developing new non-restrictive neural patterns in response to usual anxiety triggers (brain re-training).
It’s more than just physical
It is crucial for successful treatment to realize that eating disorders are neurobiological disorders. Simply weight restoration cannot help you achieve a sustainable recovery. This is a long-standing condition that can only be managed, not cured.
People with eating disorders may have underlying psychological and emotional problems that contribute to the disorder. Having low self-esteem, struggling with perfectionism, behaving impulsively, and experiencing troubled relationships all significantly contribute to the disorder.
For a vigorous remission, alongside weight restoration and physical treatment, it is just as essential to address the anxiety and unease you feel when eating unrestrictedly. Dysfunctional responses to this anxiety such as dieting and exercising need to be unlearned, and with the help of a guide, it is essential to learn adaptive techniques to cope with anxiety.
Cognitive behavioral therapy, dialectical behavioral therapy, and exposure/response prevention therapy, among other treatment approaches, are all viable options to explore with a counselor or therapist.
Engaging familial support has been found to be a consistently important element of recovery.
Eventually, the application of well-adapted responses comes naturally, as the underlying anxieties ease as well.
Brain re-training is an extension of this where finally past destructive behaviors are replaced with a healthy lifestyle.
There is a desperate need for more significant agreement on how eating disorder outcomes should be measured. This is crucial in order to make comparisons between various outcome studies significant and to clarify the overall picture of eating disorders outcome. Consequently, this may help to devise more targeted approaches to treat eating disorders and focus on long-term recovery.
About the Author:
Sana Ahmed is a journalist and social media savvy content writer with extensive research, print, and on-air interview skills. She has previously worked as a staff writer for a renowned rehabilitation institute, a content writer for a marketing agency, an editor for a business magazine and been an on-air news broadcaster.
Sana graduated with a Bachelors in Economics and Management from the London School of Economics and began a career of research and writing right after. Her recent work has largely been focused upon mental health and addiction recovery.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Reviewed & Approved on June 5, 2019, by Jacquelyn Ekern MS, LPC
Published June 5, 2019, on EatingDisorderHope.com