As a clinician who works with eating disorders, I cannot tell you how many times I have heard the same question posed over and over again by clients and their loved ones: “Kristin, what caused this eating disorder?” There is normally a sense of desperation in this question hoping that I will somehow have the magic key that unlocks the door that has the secret cure for this eating disorder. There is a hope that we can identify the one thing that explains this entire disorder and if we can address that one experience, chemical imbalance, or personality trait, everything will get better. This person will be cured. The desperation comes from a deep desire to do anything necessary to lessen the pain. The desperation comes from a confusion around how the happy-go-lucky, careless little 5 year old girl grew up to be a 23 year old woman struggling with overwhelming emotional pain that she had figured out how to numb with an eating disorder so she didn’t have to show the world what she was actually experiencing internally.
Eating disorders, like many other mental illnesses and maladaptive coping responses, are usually caused by a complexity of factors, which means that they are also best treated with a multidisciplinary approach that addresses the various facets of what contributes to the development and maintenance of an eating disorder for each individual. We know that things like neurochemistry, brain structure, genetics, cognitive processing patterns, digestive functioning, social influences, trauma histories, and environmental factors all impact our propensity of developing an eating disorder (see What Caused My Eating Disorder). So this also means we need an intervention that addresses multiple of those contributing factors simultaneously to effectively respond to the control our eating disorders have acquired over us.
The severity of a client’s eating disorder may require a more intensive level of care than
can be provided by outpatient programs. Referral to a higher level of care is typically warranted based on at least one the following:
Lab work in eating disorders can be very complex and often confusing. Dehydration often results in hemoconcentration, which may lead to false elevations in labs and mask true abnormalities. It is important for a physician who is well-acquainted with eating disorders to interpret lab results for the eating disorder client.