What is the best treatment at any given time when recovering from an eating disorder? This is one of the great questions providers, clients, and families alike struggle to answer.
We know there are significant scientifically based therapies that deliver positive outcomes, including weight restoration and behavior cessation. In fact, The Emily Program incorporates these therapies in our programs — Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Family-Based Therapy — and has experienced much success through them.
Having said that, however, we also know that many clients who are able to cease behaviors and achieve weight restoration may continue to experience physiological distress, urges, body dissatisfaction, and anxiety, among other eating disorder symptoms.
Further complicating the issue, eating disorders often occur in secret and many clients may not reveal the intensity of their behaviors, thoughts, and feelings during treatment.
The key for clinicians is assessment. But when we work in a culture where there is hyperconsciousness around body size and shape and where restricting, over-exercise, taking laxatives and body cleansing are considered “normal” behaviors, therapists may not fully understand the intensity of an eating disorder and how it differs from the “norm.”
What’s more, therapists may have their own issues with body size and shape, which may affect their ability to assess their clients with full accuracy.
So when we combine a challenging culture with the difficulty of assessment and the reality of evidence-based therapies, we are left with the question: How do clients really get better?
As a professional in recovery who has worked many years with other experienced professionals in recovery, there are some significant thoughts we all should consider:
At The Emily Program, we have made it a priority to determine how best to assess our clients, when to treat and when to refer them, and what therapies are best to incorporate at any given time.
Dr. Mark Warren is the Chief Medical Officer for The Emily Program and Veritas Collaborative. He is also one of the original founders of the Cleveland Center for Eating Disorders, which became The Emily Program – Cleveland in 2014. A Cleveland native, he is a graduate of the Johns Hopkins University Medical School and completed his residency at Harvard Medical School. He served as Chairman of the Department of Psychiatry at Mt. Sinai Hospital and Medical Director of University Hospital Health System’s Laurelwood Hospital. A past vice-chair for clinical affairs at the Case School of Medicine Department of Psychiatry, he continues on the Clinical Faculty of the Medical School, teaching in both the Departments of Psychiatry and Pediatrics. He is currently a faculty member and former chair of the Board of Governors at the Gestalt Institute of Cleveland. Dr. Warren is a Distinguished Fellow of the American Psychiatric Association, a two-time recipient of the Exemplary Psychiatrist Award of the National Alliance for the Mentally Ill, and a winner of the Woodruff Award. He leads the Males and Eating Disorders special interest group for the Academy of Eating Disorders.
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