Addressing the medical, psychological and social aspects of eating disorders

Eating disorders can significantly impact the mind and the way we think because starvation affects how we process information. They can also impact the brain as these conditions straddle both a psychological and medical illness, and the physical complications can directly cause damage to organs.

Starvation can result in the body taking essential nutrients and energy from muscle groups including the heart. Prolonged starvation can also lead to neurons in the brain being broken down in order to preserve other specific aspects of the brain, which can decrease the grey matter volume. The grey matter of the brain plays a vital role in enabling us to function in our daily life. Therefore, it is extremely important to restore weight safely to reduce the impact starvation can have on the body.

Much of the literature shows that the damage to the brain caused by starvation is hopefully reversible. However, there are studies highlighting that impairment in the cognitive aspects of memory can continue even after weight restoration.

Early intervention for anorexia is key to the safest and fastest recovery. The NHS website, ‘people who have anorexia try to keep their weight as low as possible by not eating enough food or exercising too much, or both.’ This can make them very ill because they start to starve. An accurate assessment looking at both the medical and psychological aspects of the illness is important to ensure that the appropriate medical investigations are conducted. Tests can typically include specific blood tests and an electrocardiogram to test if the heart is affected by the condition. If there are abnormalities with these investigations, then it is important that those issues are addressed and medically monitored as part of the overall treatment plan. In addition, there can be a referral to an eating disorder dietician to look at the food intake in more detail. This includes looking at what food groups have been eliminated from the diet, challenging people’s ‘safe foods’ and identifying a meal plan that is co-constructed to stabilise weight loss and eventually help necessary weight gain.

In addition to the medical investigations, an accurate assessment will also usually include a referral to an eating disorder psychologist or psychotherapist, where the aim is to better understand the underlying psychological reasons behind the weight loss, and to help identify more appropriate coping strategies to replace aspects such as food restriction, excessive exercise or laxative use.

In my professional opinion, the most effective treatment is through a multi-disciplinary team approach so that the medical, psychological and social aspects of the illness are all attended to in a caring and compassionate manner for the safest recovery possible.