Anorexia and Bulimia
Anorexia and Bulimia covers assessment, medical risk management, and evidence-based psychotherapy for restrictive and binge–purge disorders across adolescence and adulthood. This page turns guidelines into coordinated care: medical stabilization and refeeding safety, electrolyte correction, and monitoring of cardiac risk; family-based treatment for youth; and CBT-E or other structured therapies for adults. If you’re comparing events like an eating disorders conference, you’ll find staged pathways that integrate nutrition, psychotherapy, and pharmacotherapy for comorbid anxiety/depression without reinforcing weight bias or stigma. Because multidisciplinary collaboration is essential, we link to Nutritional Psychiatry in Eating Disorders for dietetic planning, micronutrient considerations, and behaviour-change strategies aligned with recovery goals.
Complex presentations require careful sequencing. Teams address medical instability first—orthostasis, electrolyte derangements, arrhythmia risk—then phase psychotherapy and family work, with negotiated weight targets and exposure to feared foods. Co-occurring conditions (OCD-spectrum traits, trauma, substance use) are treated without compromising nutritional rehabilitation; sleep and GI symptoms receive supportive, non-addictive care. Equity and access matter: culturally sensitive language, accommodation of religious fasting periods, and pathways for rural or low-resource settings improve engagement. Digital supports (meal support groups, remote monitoring) extend reach, while clear relapse-prevention plans and early warning signs help sustain progress after discharge.
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Medical risk and stabilization
- Assess vitals, ECG, and electrolytes; determine inpatient vs outpatient safety.
- Start refeeding with careful monitoring; prevent refeeding syndrome.
Psychotherapy pathways
- Use FBT for youth and CBT-E or other structured therapies for adults.
- Set functional goals and exposure plans with shared decision-making.
Nutrition and metabolic care
- Coordinate dietetic plans, micronutrients, and GI symptom management.
- Avoid appetite-suppressing or sedating medications that hinder recovery.
Comorbidity management
- Treat anxiety, depression, and OCD traits without undermining weight restoration.
- Use non-addictive sleep strategies; screen for substance misuse carefully.
Service Models and Recovery Supports
Family engagement
Provide psychoeducation, meal coaching, and crisis plans; address carer burnout.
Integrated medical–psych care
Run joint clinics with psychiatry, medicine, and dietetics for aligned decisions.
School/work reintegration
Plan graded return with accommodations for meals, rest, and appointments.
Digital and community supports
Offer moderated groups and tele-sessions with privacy safeguards and escalation rules.
Equity and cultural responsiveness
Adapt materials for language, culture, and body-image norms; counter weight stigma.
Relapse prevention
Teach early warning signs, coping plans, and rapid re-entry pathways after lapses.
Measurement and outcomes
Track weight trends, vitals, function, and QoL; integrate patient-reported outcomes.
Ethics and consent
Balance autonomy with safety in high-risk scenarios; use transparent documentation.
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