Integrative Medicine as a Therapies of Eating Disorders
Integrative medicine as “a healing-oriented discipline that takes into account the whole person body, mind and spirit including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of both conventional and Complementary, Alternative Medicine and Experiential Therapies. Eating disorders are a group of serious conditions in which you’re so preoccupied with food and weight that you can often focus on little else. The main types of eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder. Eating disorders can cause serious physical problems and, at their most severe, can even be life-threatening. Most people with eating disorders are females, but males can also have eating disorders. An exception is binge-eating disorder, which appears to affect almost as many males as females. Treatments for eating disorders usually involve psychotherapy, nutrition education, family counseling, medications and hospitalization. There are many complementary and alternative medicine (CAM) therapies for eating disorder treatment. They include herbal therapy, massage therapy, homeopathy, psychotherapy and nutrition therapy. Each CAM therapy approaches eating disorders from a different angle. Therefore, they can form part of a multi-pronged approach for eating disorder treatment.
Anorexia nervosa is a very serious illness that has a wide range of effects on the body and mind. It is also associated with other problems, ranging from frequent infections and general poor health to life-threatening conditions. Some researchers believe that it should not be approached as a simple eating disorder but as a serious condition requiring staging according to severity.
About 10 million females and one million males in the United States struggle with an eating disorder, such as anorexia nervosa or bulimia. Despite how serious and widespread eating disorders are, research funding is not abundant. Without funding, there have been few studies on how well standard-of-care eating disorder treatment works. At this time, no treatment program for anorexia nervosa is completely effective. Recovery rates vary between 23 – 50%, and relapses range from 4 – 27%. Recovery takes an average of 5 – 6 years from the time of diagnosis. Up to 30% of patients do not recover. Even after treatment and weight gain, many patients continue to display characteristics of the disorder, including perfectionism and a drive for thinness, which could keep them at risk for recurrence.
While traditional eating disorder treatment normally combines psychotherapy with nutritional counseling, some patients and their family members are exploring other options, including alternative therapy. Eating disorders are medically classified as psychological disorders that cause negative effects on the body. This makes conditions such as anorexia and bulimia ideal candidates for alternative therapy, which commonly focus on the mind-body connection. However, even fewer traditional studies are looking at how well alternative therapy works. One recently completed study looked at meditation to treat binge eating disorder.
Usually, when people turn to alternative medicine it’s to improve their health, but for people with eating disorders this isn’t always the case. Alternative medicine treatments have both negative and positive consequences when it comes to eating disorders.
Integrative medicine can be defined as “a healing-oriented discipline that takes into account the whole person body, mind and spirit including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of both conventional and Complementary, Alternative Medicine and Experiential Therapies. ” Complementary and alternative therapies used in integrative medicine can include acupuncture, chiropractic, herbal medicine, dietary supplements and others that give the clinician a wide array of treatments for difficult conditions. This is particularly true in the integrative medicine approach to eating disorders.
Eating disorders have been documented in adolescents and adults for many years. More recently, there is evidence that these disorders can also affect young children. The cornerstones of an integrative medicine model for eating disorders includes some components that are found in every approach to the treatment of eating disorders, but may be used in a unique manner. Others are more specific to the use of complementary and alternative medicine (CAM) therapies. The most important difference in this model when compared to other treatment strategies is the philosophical underpinning of integrative medicine — that is, the belief in the self-healing nature of body, mind and spirit.
The integrative medicine philosophy holds that the body, mind and spirit are able to heal with support from conventional and alternative therapies, given needed changes in lifestyle. These changes happen in concert with the therapeutic relationship the patient has with his or her therapist, physician or other healer.
The cornerstones of this integrative medicine approach can include:
- Medical treatment that focuses on reducing the risk of, detecting and treating complications of the disease and on improving overall health status.
- Nutritional therapies to improve nutritional status, help women improve their relationship with food, and improve digestion and absorption of needed nutrients.
- The use of botanical therapies to reduce side effects of pharmacological therapies.
- Body movement to help patients get back in touch with physical cues and learn healthy behaviors.
- Psychological testing to identify co-occurring diagnoses, including mood and personality disorders, and inform treatment strategies.
- Skills training, which may include the use of cognitive behavioral therapyor dialectical behavior therapy, to enable patients to cope more effectively with stressors in their lives and with situations and emotions that may trigger relapse.
- Complementary and alternative therapies, which may include massage, mind-body, chiropractic, acupuncture and energy medicine therapies.
- Prescription medications, which are used cautiously in children and adolescents and should be prescribed only to manage behavior that is life-threatening or therapy interrupting.
Alternative Medicine of Eating Disorders
- Herbal Therapy. There are thousands of herbs that act as stimulants in eating disorder treatment. They may be Indian Ayurvedic herbs, Traditional Chinese Medicine or western herbs. However, before consuming these herbs, you should let your doctor know about your intentions. Herbs can be very powerful and you should not mix your medications with herbs without consulting your doctor. Herbs that may be helpful for eating disorder treatment include Angelica Archangelica, Taraxacum Officinale, Cnicus Benedictus, Fenugreek Seed, Skull Cap, Cinnamon, Roman Chamomile and Gentiana Lutea.
- Acupuncture Acupuncture may help with the physical discomforts of your eating disorder. It can be used to ease symptoms of the digestive system, like bloating, diarrhea, and constipation. It also can begin to set your digestive system right in a more long-term way. It may be effective at getting your hormonal system back on track as well. Acupuncture has also been used successfully to treat some of the psychological companion disorders that go with eating disorders. Known for its calming effect, it has a good track record for relieving symptoms of depression and anxiety. Acupuncture has also helped people who are detoxifying from alcohol and drug addictions. If you just can’t stand the thought of needles, acupressure is an alternative form of acupuncture that uses pressure to unblock meridians.Recently, studies have started examining the exact mechanisms of acupuncture that may make it a useful eating disorder treatment. Leptin, a hormone that helps regulate metabolism, has been shown to play a role in reproductive function and a woman’s menses. One study performed in Germany showed that patients with anorexia have lower-than-normal levels of leptin, which likely contributes to the fact that anorexia patients often stop getting their periods. Researchers in China looked at how a specific acupuncture point, known as sifeng, which is located behind the fingers, may affect serum leptin levels in anorexia patients. The study showed that acupuncture can increase levels of leptin, meaning there may be some promise for acupuncture as an eating disorder treatment. In general, research is still limited on using acupuncture to treat eating disorders. But many eating disorder treatment facilities now include this alternative therapy under the rubric of comprehensive care. The reason: Many studies have shown that acupuncture can help those with generalized anxiety and depression, two conditions often diagnosed in eating disorder patients. Another study performed in China, which looked at eight randomized controlled trials, recently concluded that acupuncture could significantly reduce depression. “Patients with eating disorders are usually dealing with some kind of underlying emotional issues,” says Bianca Beldini, owner of Sacred Space Acupuncture in New York City. “Acupuncture can be a fantastic way of addressing these root issues by bringing the body into better balance.”
- Aromatherapy Aromatherapy is another alternative therapy to which the same principle — targeting the underlying root cause — applies. Aromatherapy is the use of essential oils extracted from plants for therapeutic purposes. Oils are usually massaged into the skin, and some are ingested or inhaled. Research remains somewhat limited on this alternative therapy, but it is gaining traction as studies investigate its potential uses, including the treatment of anxiety, digestive problems, and pain. As it relates to eating disorders, aromatherapy is commonly used to help address the anxiety that is often associated with anorexia and bulimia. “To effectively treat patients with eating disorders, the best oils are ones that help change their emotional connection to food,” says Beldini, who also is a certified aromatherapist. Citrus oils, such as lemon, also may be helpful because they stimulate the digestive juices.
- Naturopathy Vitamin and mineral deficiencies are common in people with anorexia or bulimia, so besides nutritional therapy, a naturopathic approach may help replenish these deficiencies. More research is needed on the specific effects of dietary supplements as an eating disorder treatment, but some commonly recommended supplements for patients with anorexia or bulimia include the following: a daily multivitamin; omega-3 fatty acids to decrease inflammation and improve immunity; coenzyme Q10 for immune system and muscular support; 5-HTP for mood stabilization; creatine for muscle support; and probiotic and L-glutamine supplements for immunity and gastrointestinal health. Patients should always talk to their physicians before taking any dietary supplements, as they may interact with medications. Patients who take antidepressants, for example, should not take 5-HTP. Besides dietary supplements, a naturopath may use herbal therapy as an eating disorder treatment. No herbs have been scientifically proven as eating disorder treatments, but the following may be helpful for patients who have anorexia or bulimia: ashwagandha for general health benefits and stress; holy basil for stress; milk thistle for liver health; grape seed for heart and blood vessel protection; and catnip to soothe the nervous and digestive systems. While there is limited research at the moment to support most alternative therapies for eating disorder treatments, these approaches might be worth discussing with your health care provider.
- Massage Therapy. Massage has long been used to produce emotional release, improve mood, and increase relaxation. Studies show that people with body image disturbances often have been deprived of nurturing touch. Researchers found that women with anorexia and bulimia responded positively when massage was added to their treatment programs. Women who received massage were less anxious and less driven to be thin than women who did not receive it. They felt better about their bodies, their mood improved, and their need for perfection decreased.Massage therapy helps to relieve your anxiety levels. Massage stimulates the endorphin levels in your brain. Apparently, endorphins play an active role in appetite control and have pain relieving properties. They are usually released when the body is under extreme stress. Massage causes endorphins to be released during your therapy sessions, thus providing you with much relaxation.
- Homeopathy. Homeopathy is introducing minute doses of a drug that in large doses would cause the disease itself. It aims to stimulate the body in building up natural defences against invaders. Homeopathy can also help to stimulate the brain to relax and de-stress and be used to affect moods. Natural health experts claim that this method is effective. However, this method usually takes a long time.
- Pyschotherapy. As eating disorders are psychological disorders, going for pyschotherapy sessions will help you with coping with your emotional stress and help you address the root of your illness. Your therapist may also recommend behavior therapy, which will then teach you new signals to deal with this emotional stress. You are taught easy relaxation ways for your body and mind.
- Yoga Yoga is a set of practices from ancient India that use body postures, breathing, and meditation to create physical health and peace of mind. The postures call on you to develop greater balance, flexibility, strength, and stamina. Yoga practice requires that you read feedback from your body in order to know how far to push in a particular posture and when to stop. If you have an eating disorder, you’ve been in a state of war with your body. Recovery requires that you and your body make peace. Yoga appears to be a good peacemaker. Developing awareness of body cues helps put you and your body back on the same page. According to a study published in Psychology of Women Quarterly, women who regularly practiced yoga were less preoccupied with physical appearance, more satisfied with the way they looked, and showed fewer disordered eating attitudes and better regulated eating than women who didn’t practice yoga.
- Meditation Meditation is a practice of focusing the mind. It comes in a variety of “brands,” any of which can be useful for becoming calmer and more centered. One particular brand of meditation, known as mindfulness meditation, has shown some promise for people with eating disorders. In other meditation practices, the aim is to clear your mind. Mindfulness, instead, has the goal of helping you create a different relationship to what is in your mind in the present moment. For example, mindfulness meditation teaches you to observe but not avoid or judge current thoughts, feelings, or emotions. For people with eating disorders, mindfulness can introduce a new way to deal with eating urges. A study at Indiana State University has already shown good results for people with binge eating disorder. Others use mindfulness meditation to help alleviate the emotional distress that goes with eating disorders.
Experiential therapies increase your awareness of being in the present moment. Practices that help you focus on your moment–by–moment thoughts, feelings and sensations ¬not only anchor you in the present, they increase your connection to yourself. If you have an eating disorder, connecting to yourself probably hasn’t felt all that rewarding. Experiential therapies may help you tune in more comfortably and effectively.
If you’re picturing the dancercise class at your gym, this isn’t it. Dance/movement therapy (DMT) uses body sensation and body movement as a source of healing for people with eating disorders. DMT therapists believe this makes perfect sense because the body is the battleground where the eating disorder occurs. Typical goals for DMT include:
- Improved body image
- Increased ability to know and express feelings
- A more solid sense of body boundaries and personal space
- Increased capacity for pleasure in movement
Dance/movement therapists must have a master’s degree and meet other requirements set by their professional organization, the American Dance Therapy Association.
Art therapy allows you to use the stuff of artistic expression—drawing or painting materials, clay, dioramas, mosaic, what-have-you—to explore your feelings and discover more about who you are. Creating an object to represent difficult feelings or hidden aspects of yourself can present some distinct advantages. For example:
- You get a little distance, as if the feeling is outside you, so exploration feels safer.
- You can experiment with ways to control or manage the feeling.
- You can explore visually how one part of you fits in with other parts and with the whole picture of you.
All of this, of course, works best when you have the support and guidance of someone who understands why it all matters. You want to work with a registered art therapist (ATR). And you want him or her to have some additional training in working with eating disordered clients.
Like art therapy, music therapy promotes healing through an expressive form that doesn’t involve talk. Music can often be the added ingredient that allows people to take risks and move their treatment forward. Music therapists assure you this requires no musical abilities. It can involve making music, writing it, hearing it, or listening to it. If you have an eating disorder, music therapy may help you
- Express yourself: You may find that the music of others brings out emotions you can’t put into words. Or you may discover that making your own music—writing songs, singing, or playing an instrument— helps you express yourself.
- Relax: Music goes right to the part of the brain that’s in charge of relaxation.
- Improve your mood: You can pair the relaxation you get from music with experiences that make you anxious, like eating or gaining weight. You can weave the sense of well-being that certain music or music-making gives you with times when your mood is low.
Find ways to participate safely with others: In a group music therapy setting, you can practice “chiming in,” taking the lead, trying something creative, getting and giving feedback, and making mistakes—all in a supportive environment.
The American Music Therapy Association (AMTA) sets the education and clinical training standards for music therapists. These standards include completion of a college level music therapy program. Professionals with the designations RMT, CMT, or ACMT have met AMTA standards and are qualified to practice music therapy.
The bad and The Good
- The badThere are numerous dietary supplements and herbal products designed to suppress the appetite or aid in weight loss, and these products may be abused by people with eating disorders. Many people with eating disorders have used such products. These products can have potentially dangerous interactions with other medications, such as laxatives or diuretics, that are commonly used by people with eating disorders. Additionally, weight-loss supplements or herbs can have serious side effects on their own, such as irregular heartbeats, tremors, hallucinations, insomnia, nausea, dizziness and nervousness. Discuss the potential risks of using dietary supplements or herbs for weight loss with your doctor.
- The good Although no alternative or complementary therapies have been conclusively found to be helpful for people with eating disorders, some research has suggested that several treatments may provide benefits, particularly for reducing anxiety.
Treatments generally considered safe that may help improve your mood and reduce stress and anxiety include:
- Chamomile tea
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