Difficulties of treatment for eating disorders and their solutions

Abstract

Treatments for eating disorders are accompanied by various difficulties. First of all, because it is necessary to manage physical conditions of eating-disorder patients because of their malnutrition, general psychiatrists tend to avoid their treatment. However, the burden which psychiatrists should shoulder when they treat eating-disorder patients will be much smaller if they entrust physical management of patients to the physicians whom patients can visit easily. There are several treatments for eating disorders and it is difficult to select one of them for one particular patient. By means of the classification of personality, namely, "reactive/conflictful type", "persistent type", "impulsive type", and that of stage of psychopathology, namely, "acute stage", "subacute stage", "chronic stage", psychiatrists can select one appropriate treatment for the patient. Moreover, eating-disorder patients appear to lack insight to their disease and motivation to be treated and psychiatrists have an impression that it is difficult to treat them, but these appearances come from the fact that their narcissism and addictive trait make them cling to the symptoms of eating disorders. It is necessary to understand their narcissism and lead them to abandon abnormalities of eating as addiction without anxiety. For the treatment for eating disorders, it is important to construct a good therapeutic relationship with patients, considering their actual situations, including physical conditions.