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Eating disorders have a reputation for being challenging to treat. It’s not unusual that patients struggle desperately to control their symptoms while the disease maintains a vice grip on their lives. Thoughts around food and anxiety can become overwhelming, as disordered eating behaviors maintain control.

Over the last two decades, we’ve seen a highly concerning trend: the incidence of eating disorders has been steadily increasing.

A recent analysis concluded that the prevalence of eating disorders has risen from 3.5% to 7.8% since the early 2000s (Galmiche 2019). And of the eating disorders, anorexia has the highest mortality rate of any psychiatric diagnosis. Individuals struggling with anorexia are five times more likely to die prematurely and 18 times more likely to commit suicide (Keshaviah 2014).

Numbers for binge-eating disorder also raise concerns. As the most common eating disorder, around 2.8% of women and 1% of men will struggle with binge-eating disorder (BED) at some point over the course of their lifetime (Galmiche 2019). And yet these numbers do not include the individuals that struggle with cravings and overeating who don’t fully qualify for a BED diagnosis.

Considering the trends, you might hope that standard treatment could help provide relief. Unfortunately, standard treatments for anorexia are poorly effective at best.

The latest review of medication treatments for anorexia found that they provided no consistent benefit for reducing symptoms (Cassioli 2020). Psychological interventions fared barely better, also showing poor evidence for efficacy (Solmi 2021).

While standard medications for binge eating disorder may help some individuals gain control over their binge episodes, they don’t resolve the underlying problems. It’s not unusual that even with standard treatment some level of cravings and symptoms persist. And if medication is discontinued, the eating disorder can come roaring back, ready to overtake your self control.

At its core, anorexia is caused by nutritional deficiencies. These deficiencies disrupt brain function causing further food restriction in a positive feedback loop that sustains the disease. Individuals struggling with BED are often plagued with nutrient deficits that disrupt normal hormonal signaling around hunger and satiety.

Leaving these deficiencies untreated is one of the main reasons standard treatment approaches for eating disorders can fail.

There is a better way.

Integrative and functional medicine—a system of medicine that treats you as a unique individual—is a more effective approach. Eating disorders are complex, often related to multiple intermingled biologic components.

By using a functional approach, we can identify and treat these core nutritional deficiencies, while recognizing the additional factors that contribute to symptoms, including gut flora imbalances, hormonal issues, toxicities, stress levels, and other aspects of your personal history.

Evaluating ALL of these factors yields much better outcomes than just prescribing medication or counseling therapy.

Save 50% on 5 online courses through the end of May!

Use code MayMentalHealth50 to get the discount! All online courses come with a full year of access. The courses on depression, anxiety, and ADHD include CME credit for those who qualify.

References

Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. Am J Clin Nutr. 2019;109(5):1402-1413. doi:10.1093/ajcn/nqy342

Keshaviah A, Edkins K, Hastings ER, et al. Re-examining premature mortality in anorexia nervosa: a meta-analysis redux. Compr Psychiatry. 2014;55(8):1773-1784. doi:10.1016/j.comppsych.2014.07.017

Cassioli E, Sensi C, Mannucci E, Ricca V, Rotella F. Pharmacological treatment of acute-phase anorexia nervosa: Evidence from randomized controlled trials. J Psychopharmacol. 2020;34(8):864-873. doi:10.1177/0269881120920453

Solmi M, Wade TD, Byrne S, et al. Comparative efficacy and acceptability of psychological interventions for the treatment of adult outpatients with anorexia nervosa: a systematic review and network meta-analysis. Lancet Psychiatry. 2021;8(3):215-224. doi:10.1016/S2215-0366(20)30566-6