Multidisciplinary Treatment of Eating Disorders—Part 1

Abstract

This article describes the structure and costs of a multidisciplinary hospital-based program for severe eating disorders. The program utilizes multiple levels of care (inpatient, partial day hospital, intensive outpatient, and traditional outpatient) to provide continuity of care during the recovery process, which often spans 2 to 3 months of intensive treatment. Details about the expectations of staff, patients, and family members are provided. Also, special protocols for refeeding, weight gain, and motivation for eating are described. The costs of treatment can be managed by greater utilization of the partial day hospital level of care, as opposed to lengthy inpatient hospitalization.

An evaluation of the effectiveness and short‐term stability of an innovative Australian day patient programme for eating disorders

“…Of the published DP programmes, all but one considered their primary treatment orientation as cognitive behavioural (Lammers et al, 2007;Zeeck et al, 2004) citing key treatment goals as a normalisation of eating behaviours, a reduction in over-evaluation of weight and shape and an identification and resolution of perpetuating factors (Lammers et al, 2007). Some studies have considered the role of eating disordered behaviours and attitudes (Peake et al, 2005) as well as maintenance factors such as perfectionism, low self-esteem and social functioning in their outcome (Gerlinghoff et al, 1998;Stewart & Williamson, 2004); however other treatment outcomes such as core beliefs, motivation to change and quality of life (QOL) have been neglected, even when these areas are delineated as targets of treatment.…”

A Dutch day treatment program for anorexia and bulimia nervosa in comparison with internationally described programs

“…Touyz, Lennerts, Freeman, and Beumont (1990) did not find any difference in the rate of weight gain in anorectic patients between those who were weighed three times a week compared to those who were weighed daily. Blind weighing has been proposed in order to diminish the obsession with weight (Stewart & Williamson, 2004a). However, more data are needed to allow unambiguous conclusions regarding the influence of weighing frequency and manner of weighing on outcome.…”

“…As intense group dynamics may occur among both patients and staff, a weekly multidisciplinary team meeting is organized to safeguard the cohesion and health of the therapeutic team. Weekly staff meetings are held in order to implement the treatment plan across all treatment modalities, establish a consensus of opinion and keep in touch with each patient's progress (Robinson, 2003;Stewart & Williamson, 2004a;Vandereycken, 1985).…”

“…In two of them the description of the day program was so limited that we decided not to integrate them in this review (Kong, 2005;Robinson, 2003). This leaves the DHP of the Toronto Hospital in Canada Kaplan & Olmsted, 1997;Piran et al, 1989), the Treatment Centre for Eating Disorders (TCE) in Munich, Germany (Gerlinghoff, Backmund, Franzen, Gorzewski, & Fenzel, 1997;Gerlinghoff et al, 1998), Our Lady of the Lake Eating Disorders Program (OLOL) in Baton Rouge, LA, USA (Stewart & Williamson, 2004a, 2004bWilliamson et al, 1998), the program of the Wesley Private Hospital in Sydney, Australia (Thornton, Beumont, & Touyz, 2002;Touyz, Thornton, Rieger, George, & Beumont, 2003), the Eating Disorders Program (EDP) in Hoffman Estates, USA (Levitt & Sansone, 2003) and the Oxford Adult Eating Disorders Service in Oxford, United Kingdom (Peake, Limbert, & Whitehead, 2005). After identifying these programs, the authors were contacted and asked to provide missing details about their program, as some information was unavailable in the open literature.…”

Promoting Optimal Collaboration Between Mental Health Providers and Nutritionists in the Treatment of Eating Disorders

“…Multidisciplinary and collaborative care for eating disorders has become standard clinical practice over the past 30 years (Becker, 2003;Henry & Ozier, 2006;Irwin, 1993;Joy, Wilson & Varechok, 2003;Kaplan, 2002;Lock, le Grange, Agras & Dare, 2001;Ruddy, Borresen, & Gunn, 2008;, 1993;Stewart & Williamson, 2004;Weiner, 1999). The American Psychiatric Association's (APA) published guidelines advise that care for eating disorders should include nutritional rehabilitation, counseling and medical monitoring (Yager disorders, particularly when non-food issues directly influence eating behaviors (Saloff-Coste et al, 1993).…”