Food is the Best Medicine

April 13th, 2011

I attended a very interesting presentation yesterday by Dr. Steven Karp entitled, “Medication Trends: Are They Helping or Hurting Our Clients?” Dr. Karp spoke at the quarterly meeting of the Phoenix Chapter of the International Association of Eating Disorder Professionals, and his presentation included an overview of popular medications used in the treatment of eating disorders. He began by listing all the drugs currently approved by the FDA for treatment of eating disorders. It was a very short list: only one drug, Prozac, and then only for the treatment of bulimia! Fluoxetine, or Prozac, has been shown to help reduce the frequency of binging and purging, but is not recommended for anorexics in early recovery since it may promote weight loss. There is no FDA-approved medication for the treatment of anorexia.

“Food is the best medication for anorexia in the early stages of treatment,” said Dr. Karp, who lamented that many doctors who are unfamiliar with eating disorders may practice “intuitive prescribing”, based on suppressing symptoms rather than treating the underlying causes of the behavior. For example, since anorexics experience considerable anxiety about eating, they might be prescribed an anti-anxiety medication even though it’s of limited utility and may actually hinder recovery.

Dr. Karp described the use of medication in the treatment of eating disorders as a “counter-intuitive practice”, since victims may be unable or unwilling to to speak frankly about the severity or true nature of their illness. Because a doctor’s mission is to relieve suffering, he or she may become an unwitting enabler by patching over symptoms and allowing eating disorder victims to continue living comfortably with their illness.

“Emotional pain guides both therapist and client to the identification of underlying issues that must be resolved,” according to Karp. Anesthetizing the patient with psychotropic medications may provide temporary relief from symptoms but can delay or prevent long-term recovery. Psychotherapy combined with nutritional support remains the foundation of effective eating disorder treatment.

The International Association of Eating Disorder Professionals has two chapters in Arizona and holds quarterly informational seminars in both Tucson and Phoenix. For more information, visit their web site at iaedp-az.org.

3 Responses to “Food is the Best Medicine”

  1. jrust says:

    One of the things that happens at most treatment centers is that medication is prescribed as soon as the patient admits for treatment.

    My thought on medication is that we need to find out what kind of patient we’re working with. We need to get to know the patient and her/his history. Some people with severe psychiatric conditions absolutely need medication. Perhaps people who have a history of deep depression may benefit from medication. It might be for the person who is suffering from PTSD, someone who is bi-polar, someone with OCD or any disabling phobias.

    The point is that medication must be used moderately and thoughtfully. It definitely has it’s place in any treatment program. I do agree with him on not prescribing medication for anorexics because it does dull or eliminate their appetites. Their primary medicine needs to be food!

    Use of medication is one of the philosophical differences between Mirasol and other medical model programs.

  2. michelle says:

    My daughter is not refusing food she can’t get to 3,000 calories they are asking us to gain. She eats 2000 – 2200, she is full and can’t eat more and keeps losing weight

  3. jrust says:

    Has your daughter had structured care? I believe that when they are resistant to eating more, this is where the psychological part enters the scene. Curing an eating disorder is about so much more than just gaining the weight. What is her current height and weight? I can help, but I need just a little more information.

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