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.