A story in today's Los Angeles Times reports that U.S. hospitalizations for eating disorder treatment dropped sharply - by 23 percent - between 2007-08 and 2008-09. Not only are fewer patients being hospitalized, they're receiving treatment earlier in their disease, the story says:
A new breed of patient is getting treatment well before the disease drags them into a downward spiral toward starvation, sustained heart damage, weak bones, kidney damage, long hospitalizations and numerous relapses.
Given that eating disorders are relatively common and potentially lethal, this is fantastic news. One of the biggest challenges associated with treating eating disorders is that these diseases become self-reinforcing over time. For instance, biochemical and brain changes associated with anorexia nervosa become more and more entrenched the longer the disorder goes untreated. Patients who receive early treatment have the best shot at recovery.
Part of the reason for the improved outlook is that patients can now receive therapies that have had their effectiveness scientifically evaluated. James Lock, MD, PhD, the director of psychiatric services at the Comprehensive Eating Disorders Program at Lucile Packard Children's Hospital, has led some particularly important trials of anorexia nervosa treatments. And he has shown the power of an approach that avoids hospitalizing young anorexia patients:
For teens with anorexia, the first-line treatment is something called family-based therapy, in which parents and siblings work with the patient at home to help restore normal eating habits, said Dr. James Lock, an adolescent psychiatrist at Stanford University who specializes in treating eating disorders. Treating patients at home instead of in a hospital setting is less disruptive to their lives and is thought to promote recovery.
The therapy cures about 40% of patients in three to six months, and another 40% to 50% improve but remain ill, studies have found. The remaining 10% stay the same or get worse.
Previously: Exploring the connection between food and brain function, How anorexia is striking what many consider to be an unlikely group: boys and young men and What a teenager wishes her parents knew about eating disorders