How a Psychiatrist Can Help with Eating Disorders

Your relationship with food has become a source of intense distress. You might be severely restricting what you eat, caught in a cycle of bingeing and purging, or find yourself eating large amounts of food in secret, feeling completely out of control. An eating disorder is not a lifestyle choice or a diet gone wrong; it is a serious and potentially life-threatening psychiatric illness that requires comprehensive medical and psychological care.

At Televero Health, we understand the complexity of eating disorders. While a psychiatrist is just one member of a larger treatment team, their role is absolutely critical. They are responsible for managing the medical and psychiatric aspects of the illness, which are often deeply intertwined.

The Role of a Psychiatrist on the Treatment Team

The standard of care for eating disorders is a multidisciplinary team approach. This means that you will likely be working with several different professionals who each bring a specific expertise. Your team might include:

• A psychotherapist who specializes in eating disorders.
• A registered dietitian who helps you to normalize your eating patterns.
• Your primary care physician (PCP) to monitor your physical health.
• And, crucially, a psychiatrist.

The psychiatrist on this team has several key responsibilities.

1. Comprehensive Diagnostic Evaluation

The first step is a thorough evaluation. An eating disorder rarely exists in a vacuum. It is incredibly common for people with eating disorders to also have co-occurring psychiatric conditions. The most common are:

• Anxiety disorders (especially OCD and social anxiety)
• Major Depressive Disorder
• Substance use disorders
• Personality disorders

A psychiatrist will perform a full diagnostic workup to identify any and all co-occurring conditions. This is essential because these other conditions can fuel the eating disorder and must be treated simultaneously for recovery to be successful.

2. Managing Medical Complications

Eating disorders take a massive toll on the physical body. Malnutrition, purging, and other behaviors can lead to serious and even life-threatening medical complications, including electrolyte imbalances, heart problems, and bone density loss. Because a psychiatrist is a medical doctor, they are trained to recognize the signs of these medical issues. They will work closely with your PCP to monitor your physical health, order necessary bloodwork, and determine if your medical status is stable enough for outpatient treatment or if a higher level of care is needed.

3. Prescribing and Managing Medication

While there is no single “magic pill” that cures an eating disorder, medication can be a very important part of the treatment plan. A psychiatrist will manage this aspect of your care. The role of medication is typically to treat the co-occurring conditions that are driving the eating disorder behaviors.

• For Bulimia Nervosa and Binge Eating Disorder, high-dose antidepressants (specifically SSRIs like fluoxetine) have been shown to be effective at reducing the frequency of bingeing and purging.
• For Anorexia Nervosa, medication is less straightforward. There is no medication that has been proven to be highly effective for the core symptoms of anorexia itself (like the drive for thinness). However, medication is often used to treat the severe anxiety and depression that almost always accompany it. Treating these co-occurring conditions can reduce the overall distress and make it easier for the person to engage in therapy.
• Medications may also be prescribed to treat other co-occurring conditions like OCD or ADHD.

4. Determining the Appropriate Level of Care

Based on their assessment of your psychiatric symptoms and your medical stability, the psychiatrist plays a key role in determining the level of care you need. If you are medically unstable or your eating disorder behaviors are out of control, they will recommend a higher level of care, such as residential treatment or inpatient hospitalization, to ensure your safety and get you stabilized.

An eating disorder is a formidable illness, but recovery is absolutely possible. A psychiatrist is an essential member of the expert team you need to help you navigate the complex medical and psychological challenges of the illness, manage your co-occurring conditions, and support you on your path back to a healthy relationship with food and with yourself.

Key Takeaways

• A psychiatrist is a critical member of the multidisciplinary team needed to treat a serious eating disorder.
• Their role includes performing a comprehensive evaluation to diagnose and treat any co-occurring conditions like anxiety or depression, which are very common.
• As a medical doctor, a psychiatrist monitors for serious physical health complications and helps to determine the appropriate level of care.
• Medication can be an important part of treatment, often by targeting the co-occurring anxiety and depression that fuel the eating disorder behaviors.

Ready to take the first step? We can help. Get started with Televero Health today.