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Spring 2009

New Program Treats Adults with Eating Disorders

Adults with Eating DisordersEating disorders are not limited to adolescents and young adults. Many older adults also struggle with anorexia nervosa (dangerously compulsive dieting and exercise, and intense fear of weight gain or being fat, even in the face of emaciation); bulimia nervosa (binge eating followed by behaviors such as vomiting or laxative abuse); or binge-eating disorder (binge eating without the purging).

And while the consequences may be similar — bone disease and other complications from malnourishment, for example, or life-threatening electrolyte imbalances, or significant impairment of social and family relations — the treatment needs of adults with eating disorders are different from those of adolescents.

“The psychology of adolescents and adults differs in important ways, and treatment must attend to these differences,” explains Michael Strober, Ph.D., director of the Eating Disorders Program at Resnick Neuropsychiatric Hospital at UCLA. “The social context of the illness also isn’t the same for adults as it is for adolescents, and the different nature of relationships with family members and intimates must be addressed.”

Psychological disorders tend to become more entrenched with time, he adds. Many patients have long-standing illnesses that make complete recovery difficult. Given the challenging nature of their disorder, adults seeking treatment must be highly motivated to make significant changes in their lives. “Without that level of commitment, treatment gains are likely to be minimal,” Dr. Strober says.

To be successful, a program must be comprehensive. For example, the UCLA program, which is delivered by a team of experts and has separate tracks for adults and adolescents, offers three levels of care: inpatient hospitalization for the most acutely ill patients, transitional day treatment, and an outpatient program that convenes twice a week.

The goal of such programs is to help patients normalize their eating behaviors and physical health while providing individual, group and family and/or couples therapy to address psychosocial issues and help patients develop and strengthen adaptive coping tools and relapse-prevention strategies.

Blending clinical strategies that target some of the key developmental and psychological underpinnings of this illness with strategies that help patients acquire new skill sets in managing various kinds of anxieties and insecurities is the hallmark of a successful program.

In the UCLA program, experts work with adults to help them tolerate the anxieties and challenge the fears inherent in making changes to longstanding patterns of behavior, says Cynthia Pikus, Ph.D., associate director of the Eating Disorders Program.

She emphasizes that although most adult patients are not being treated for the first time, there is reason to remain hopeful. “With a willingness to work through underlying issues and tolerate feared situations and behaviors, anxiety begins to diminish and real change can occur,” Dr. Pikus says. “With the support of a multidisciplinary team of experienced clinicians, a patient who is motivated for change can begin the process of moving toward health and well being.”

For more information, go to: http://eatingdisorders.ucla.edu/

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