Developing Dolphins
Maudsley Model​

Eating Disorders

Eating disorders often start off as a mental health problem, but due to the impact on physical wellbeing they can quickly turn into a physical health problem too. The pervasiveness affects the sufferer, their family and friends. This complexity requires a great deal of patience and compassion.

There are three key types of eating disorders whereby psychotherapeutic approaches are most beneficial. These are:

Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder

* Feeding disorders are not discussed here as the presentation and treatment plan is different.

The diagnostic differences between Anorexia Nervosa and Bulimia Nervosa can be somewhat academic about weight.

However, both conditions have symptoms of a fear of weight gain and restricted eating, and they can both have symptoms of binge eating and compensatory behaviour such as purging, laxative use and excessive exercise.

People can often move between the two diagnoses at different phases of their life. It is also not uncommon for people who think they have Binge Eating Disorder to have Bulimia Nervosa. This is why we use the Oxford University Psychologist, Fairburn’s transdiagnostic approach to help us understand the three conditions and guide treatment.

Binge Eating Disorder is characterised by binge eating which is distressing and associated with a sense of it being out of control. Compensatory behaviours are not present unlike the other presentations discussed above.

Due to the physical implications of an eating disorder, it can be important to include medical doctors in treatment teams along with psychotherapists.

Depending on the individual circumstances of people and their age the following treatment approaches are preferably used:

• Cognitive Behavioural Therapy for Eating Disorders
• Family Based Therapy for Anorexia Nervosa
• Maudsley Model of Anorexia Nervosa Treatment for Adults
• Cognitive Behavioural Therapy Guided Self Help.

CBT is recommended as the first attempted approach for Binge Eating Disorder, please meet with a clinician who can confirm this diagnosis before sharing useful self help reading.

If these approaches are not acceptable or have been ineffective previously then alternative approaches can be considered such as:

• Interpersonal Therapy
• Dialectical Behaviour Therapy
• Psychodynamic Therapy
• Adolescent and Parent Treatment

“You alone can recover but you cannot do it alone.” (Treasure, 2010)

Support for loved ones is a valuable resource for recovery.

‘Developing Dolphins: The Maudsley Model’ group for parents and caregivers aims to build skills and confidence in guiding a loved one through recovery. This group enables caregivers to share their difficulties and experience a sense of connectedness and develop an understanding of eating disorders and learn how to support their loved one. The accompanying carer's book is:

- Treasure, J., Smith, G., & Crane, A. (2017). Skills-based caring for a loved one with an eating disorder: The new Maudsley method. Routledge.

Expert guidelines on prioritising interventions for eating disorders which are used at Us Therapy are:

• Australia/ NZ: https://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/eating-disorders-cpg-and-associated-resources
• USA: https://www.appi.org/Products/Eating-Disorders/American-Psychiatric-Association-Practice-Guidelin
• UK: https://www.nice.org.uk/guidance/ng69/chapter/Recommendations#treating-anorexia-nervosa

Contact us for help today.