Life skills can stop relapses in people with eating disorders, expert says

Health services should teach eating disorder patients life skills to help more people recover and avoid relapse, an expert has said.

Anorexia, bulimia and other eating problems affect millions of people, and eating disorder specialist Bethany Crowley warns that eating disorders are often misunderstood. She suggests that a more integrated approach to treating people is needed, to focus on the whole person rather than just the eating disorder.

Calming negative thoughts, learning to cope with emotional triggers and practicing self-compassion are among nine key skills outlined by the therapist in a new book.

“An Integrative Approach to Eating Disorder Treatment” aims to demystify the complexities and nuances of eating disorders. The intention is also to help patients understand their thoughts, feelings and behaviors.

Traffic signs

An estimated 30 million people in the United States are affected each year by eating disorders, including anorexia, bulimia, and binge eating disorder, and every 62 minutes, someone dies from them.

The relapse rate is high among those seeking treatment.

The author says that eating disorders are difficult to treat because everything is metaphor and one of the key skills in recovery is understanding the meaning of food and eating. A bag of chips, she adds, can serve as a symbol of love and replace a hug.

Sensitivity to rejection, obsessive thoughts and compensatory behaviors such as eating only after exercise are among the many warning signs – or red flags – of a possible eating disorder, Crowley warns. Teaching patients to use their authentic “voice” is key to recovery, Crowley suggests, and learning to calm negative thoughts.

She also says that people with eating disorders often have difficulties in daily life and relationships such as social situations, and that another key skill is understanding attachment styles and needs for develop healthier relationships.

Other skills include people changing the story or narrative they have been repeating for years. Crowley says some people consider their eating disorder their best friend.

“What is needed,” she says, “is for them to learn to let go of rigid thinking and the belief that they cannot change a negative situation, even when opportunities to do so present themselves.”

Evidence-based treatment

Crowley’s advice is based on multimodal therapy (MMT), an evidence-based therapy that explores the biological, psychological and social aspects of why a person develops an eating disorder. MMT uses several therapeutic techniques at once, instead of just one, which can lead to neglect of underlying factors.

Crowley, who has 20 years of experience treating eating disorders, says therapists need to develop a better understanding of patients’ struggles from the start of treatment until they are discharged.

Patients are provided with a framework they can use to develop the skills necessary for positive recovery.

She says: “Psychoeducation is an essential part of my method of treating eating disorders. Helping clients understand how their thoughts, behaviors, feelings, and perceptions relate to their eating difficulties and body dissatisfaction has been a cornerstone of the effectiveness of my approach. .

“For example, people who have trouble eating often have trouble asking questions when things don’t make sense, which may be due to their anxiety or need for control. If they don’t ask no questions, how can they hope to get better? It’s our job to help them clarify their issues, so they can eventually ask the right questions, then better follow through and practice the skills needed for recovery? an eating disorder.

The book also advises therapists to use a physical and emotional energy scale to help patients identify the body’s resting signals. A lower number means the person is physically and emotionally tired and should act accordingly.

Additionally, the book provides details on how patients can identify their emotional triggers, their window of tolerance for emotional discomfort. The upper limit is hyperarousal, such as agitation, and the lower limit is hypoarousal, such as feeling hopeless.