Personal Treatment and Addressing Co-Occurring Disorders

Woman working on Long-Lasting Recovery from Anorexia

No matter how much information is generated on eating disorders and co-occurring disorders, there will never be a one-size-fits-all treatment for the disorders.

Researchers and clinicians can share those approaches and tools that work most of the time, but, just as every person is different, so are their disorders and the treatments that will help in overcoming them.

It seems obvious that what works for one person doesn’t necessarily work for another, whether it be relationships, careers, or mental health. From the day we are born, our biology, surroundings, interactions, and experiences are dictating how we interpret and understand the world around us.

As such, no two people see the world and their place within it the same way. Two women from the same town, at the same age, with similar physical appearances, families, and upbringings could both struggle with anorexia nervosa yet still not have the same experience with the disorder.

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Perhaps one began engaging in disordered eating behaviors because of external pressure surrounding appearance, and the other did so as an unhealthy coping mechanism for a trauma she experienced.

They both need to receive treatment but what will that treatment address?

Addressing Treatment

Beyond that, one may be an outgoing personality while the other is introverted, making group therapy a comfort to one and an uncomfortable nightmare for the other.

Every unique aspect that makes an individual different from another person presents another aspect that needs to be considered and worked around in treatment. Studies show that purely addressing the disordered eating behaviors is less effective, as it doesn’t address the underlying problem.

If the underlying problem differs for each individual, as it does most often, shouldn’t treatment address the root of the problem as it stands for each person?

Even with this logic, everyone wants empirical evidence that tailoring certain aspects of treatment to meet individual needs and differences results in better treatment outcomes. Therefore, researchers have developed studies examining just that.

One study introduced a treatment program that included individual counseling sessions to the traditional group format of day hospital treatment and found that individuals in the new program showed increased weight gain and decreased engagement in disordered symptoms [1].

Another study examined patients with bulimia nervosa, with half of the participants receiving traditional CBT and the other receiving more individualized, broader, CBT treatment. Results of “the study provided preliminary support for the superiority of higher level of individualization in terms of the response to treatment, and relapses [2].

It is important to note, however, that the studies mentioned, and many others, support more a combination of manual-based and individualized treatments. Manual-based treatments are those that are “often empirically-validated, more focused, and more disseminable [2].”

Co-occurring Disorders

Essentially, what these studies are finding is that treatments are most successful when they have the structure of traditional or manual-based treatments with added areas of individualization, such as the first study adding individualized sessions to the group-based daily treatment already provided.

These results are of particular importance when considering dual diagnosis, as now there are two unique disorders being experienced by an individual with their own beliefs and understandings of the world and themselves in it.

Woman laying in grass thinking of treatmentWhether a clinician takes a manual-based, individualized, or combination approach to the treatment of eating disorders and co-occurring disorders, what is absolutely essential is that they keep an open mind about another treatment approach, should their initial approach not work for their patient.

Holding fast to a treatment approach that is not working for a particular individual does them a disservice and can push them further away from recovery.

Image of Margot Rittenhouse.About the Author: Margot Rittenhouse is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


[1] McFarlane, T. et al. (2015). The effectiveness of an individualized form of day hospital treatment. Eating Disorders, 23:3, 191-205.
[2] Ghaderi, A. (2006). Does individualization matter? A randomized trial of standardized (focused) versus individualized (broad) cognitive behavior therapy for bulimia nervosa. Behaviour Research and Therapy, 44, 273-288.

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 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.

Published on November 8, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on November 8, 2017.
Published on