CPG for Eating Disorders

9. Treatment of Eating DisordersThe treatment of eating disorders requires multidisciplinary collaboration and can be carried outat different levels of care and health care resources (See Chapter 8, “Interventions at the differentlevels of care”).The objectives of eating disorder treatments are:1. To restore or normalise patient weight and nutritional state to healthy levels in the case ofAN (See question 9.1. of this chapter).Nutritional support can range from a base diet, if the patient presents normonutrition, orspecific diet-therapy (oral diet) if there is an associated pathology, to the administration ofartificial nutrition (enteral oral or parenteral intravenous) if there is severe energetic-proteinmalnutrition.In the outpatient, standard refeeding includes following a normal diet. In day patientmanagement, treatment is more intensive and prolonged than outpatient treatment. Whenoutpatient treatment or day patient treatment is insufficient, or if the patient presents an acuteproblem, inpatient treatment is indicated.2. To treat physical complications. This CPG does not include the specific treatment for allpotential physical complications (See Chapter 4 “Definition and Classification of EatingDisorders”).3. To provide education on healthy, nutritious eating habits. Additionally, generalrecommendations on the principles of a balanced diet with a variety and frequency of foods, ormore specific recommendations based on the type of eating disorder, can be delivered. The aimof nutritional education is to guide the patient and his/her family in terms of the behaviours thatshould be adopted and to increase the patient’s motivation to cooperate and participate intreatment (See Question 9.2. of this chapter).4. To modify/improve prior or acquired dysfunctions due to eating disorders (thoughts,attitudes, inadequate behaviour, etc. 197-199 ), as well as to increase weight, reduce/eliminate bingeeatingand purging, depression, amongst other relevant clinical variables. To this end there areseveral different treatments available:– Psychological therapies (see questions 9.3.-9.8. of this chapter).– Pharmacological treatments (see questions 9.9.-9.15. of this chapter).– Combined interventions (see question 9.16. of this chapter).The therapeutic contract includes ITP (see chapter 8, “Interventions at the different levels ofcare”) and is signed by the patient and the multidisciplinary team of health care professionalsinvolved in the care. This contract ensures that the patient has been informed and that he/she hasaccepted the ITP.CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS87