Despite references to eating disorders in texts dating from the time of the ancient Pharoes, and even a mention in Shakespeare’s Measure for Measure, the development of effective treatments has been slow.
However, a treatment called cognitive behavioural therapy (CBT) is now yielding results. Indeed, as a result of research demonstrating its effectiveness, CBT is now recommended as the first line treatment for people who have not responded to a self-help approach.
At the heart of CBT lies the deceptively simple idea that eating disorders are driven by an irrational fear of uncontrollable weight gain. This fear leading to counterproductive forms of dieting which, whilst intended to prevent weight gain, often have the opposite effect and thereby cause more distress and further reinforce the original fear. CBT tackles the belief that strict diets are the only way to prevent weight gain by encouraging clients to see what really happens when they give up dieting and take up healthy exercise.
For many with eating disorders the idea of consuming between 1,900 and 2500 kilocalories a day just to see what happens is a terrifying prospect and indeed the treatment is not for the faint-hearted. But what most people find is that their body burns the energy they consume and their weight remains within healthy limits.
Treatment therefore provides a safe and supportive environment in which to take the plunge, give up dieting and see what happens. And, at the end of six months treatment, if people don’t like the results of their experiment in normal eating, then they are free to return to the diets they were using beforehand.
Evidence suggests that about three quarters of people who complete the treatment find it useful. Whilst this is a promising start, the quest to refine the treatment and thereby improve recovery rates goes on.
Doing CBT is a substantial commitment. It takes time, energy, hard work, determination, perseverance and courage. As I tell my clients, “you have to do all the hard work yourself”. But if living with an eating disorder is ruining your life then it might be worth considering if treatment could be right for you. If you’d like to talk to someone about whether CBT could help you overcome an eating disorder your GP will be happy to discuss it with you and to make a referral for treatment if necessary.