Treatment for Eating Disorders
Treatment for eating disorders is provided within our dedicated Eating Disorders Department, which is part of the Psychiatric Division at Sheba Medical Center’s Rehabilitation Hospital. Our progressive center is the only facility of its kind in Israel, staffed by an experienced team of psychiatrists, psychologists, social workers, dietitians, therapists, nurses, and physical education instructors. We provide comprehensive medical consultations, laboratory testing, advanced imaging procedures, intensive treatments and complete follow-up care to help treat a variety of eating disorders.
Organized into four different divisions, integrative therapy is provided through full hospitalization, day care, outpatient services, and an information resource center. At Sheba, each individual can begin treatment for an eating disorder in any of our divisions and then transfer to a different unit, as needed. Even after transferring, the same team of medical specialists will accompany the patient, so care is continuous and personalized.
Why is it critical to treat eating disorders?
Eating disorders are complex mental conditions characterized by abnormal eating habits that impair a person’s physical, psychological, and social condition. When they are extreme or long-lasting, an eating disorder is potentially life-threatening. Because eating disorders can harm every system in the body, it is essential to seek professional help as soon as possible.
Different types of eating disorders can damage health in different ways, but all types put you at an increased risk of mortality and a severely reduced quality of life.
What types of eating disorders do we treat?
At Sheba’s Eating Disorders Department, we treat the following conditions:
Anorexia Nervosa (AN)
Anorexia is characterized by an extremely low body weight, an extreme phobia of gaining weight, and a distorted perception of one’s body weight. People with anorexia will go to any length to control their weight and shape, even if it destroys their entire quality of life. It is most common among teenagers, and occurs more frequently in girls than in boys.
Usually, the main symptom is a severe restriction of how many calories are eaten. This control over calorie intake can be done by misusing laxatives, vomiting after eating, diuretics, enemas, or diet aids. Excessive exercise is another method to which people with anorexia may turn. However, no matter how much weight is lost – the individual will still have an intense fear of weight gain.
Other physical signs and symptoms of anorexia include a very thin appearance, fatigue, insomnia, dizziness or fainting, abnormal blood counts, fingers with a bluish discoloration, hair that falls out, loss of menstruation, abdominal pain, dry skin, irregular heartbeat, low blood pressure, dehydration, and swollen arms or legs.
Emotional and behavioral signs include refusing to eat or regularly skipping meals, preoccupation with preparing food – but not eating it, adopting strict meal rituals, only eating in private, constantly looking in the mirror for perceived body flaws, covering up in layers of bulky clothing, irritability, and social withdrawal.
Anorexia nervosa has the highest risk of mortality of any mental illness. It also increases your chances of heart, kidney, and liver failure, cardiac problems, osteoporosis, anemia, low blood sugar, gastrointestinal issues, amenorrhea (loss of the menstrual cycle in women), infertility, low testosterone (in men), electrolyte imbalances, and suicide.
At its root, anorexia is not about food; it’s a life-threatening way to cope with emotional dysfunction that involves equating being thin with self-worth.
Bulimia Nervosa (BN)
Bulimia is a potentially life-threatening eating disorder that involves repeatedly eating huge quantities of food and then purging to get rid of the excess calories. Bulimia is linked to self-image, and people become obsessed with their body shape and weight.
Typically, the person has a general sense of having no control over how much they are eating. People with bulimia may use various methods to prevent weight gain, such as self-induced vomiting, misusing laxatives, diuretics, weight-loss supplements, or enemas.
Signs of bulimia include a constant worry about being fat, having a distorted and negative body image, avoiding eating in public, going to the bathroom immediately after eating (or for long periods of time), sores or calluses on the hands or knuckles, swelling in the feet and hands, and inflammation in the face from enlarged glands.
Bulimia is associated with a higher risk for dehydration and electrolyte imbalances, kidney or heart failure, digestive problems, peptic ulcers (sores in the lining of the stomach or small intestine), pancreatitis, severe tooth decay, inflammation and rupture of the esophagus, acid reflux, irregular heartbeat, and broken blood vessels in the eyes.
Binge Eating Disorder (BED) and Compulsive Eating Disorder (CED)
Bingeing and compulsive eating both involve consuming unusually large quantities of food along with a feeling of not being able to stop eating. Not the same as simply overeating on occasion, these eating disorders are defined as excessive overeating that occurs regularly – with no sense of control. Unlike anorexia and bulimia, people who binge do not compensate for the extra calories by vomiting or exercising.
Most people with BED or CED are overweight or obese. It is common to rapidly eat large amounts of food in a short amount of time, often in secret and even when you’re not hungry.
People with binge-eating disorder and compulsive eating disorder may feel embarrassed or even disgusted about their overeating habits and take measures to stop. But the urge to eat is too strong to overcome without treatment.
Bingeing and compulsive eating disorders are linked to a high risk for stomach rupture, excessive weight gain, sleep apnea, hypertension, type 2 diabetes, heart disease, depression, anxiety, and other mood disorders.
Diagnosis is made mainly by determining a person’s body mass index (BMI), which is the ratio of one’s height to weight. If a person has a BMI of over 40, weighs more than 100 pounds over his/her ideal bodyweight, or has a BMI of over 35 and suffers from obesity-related health conditions (such as type 2 diabetes or hypertension), s/he is defined as morbidly obese.
Morbid obesity can interfere with basic body functions, such as walking and breathing, and it puts you at an increased risk for hypertension, high cholesterol, type 2 diabetes, heart disease, stroke, gallbladder disease, body pain, sleep apnea, clinical depression and other mental disorders, and particular cancers.
What types of treatment do we offer?
Intensive inpatient treatment is necessary when the patient’s physical condition is critical or rapidly deteriorating. The primary goal of inpatient treatment is to stabilize and improve the patient’s physical and mental condition in order to promote a rapid return to society.
The duration of hospitalization varies depending on the individual’s needs; the average stay is 2-3 months. The daily treatment regimen is very structured, with mandatory group meetings and private psychotherapy sessions. Meals are custom-designed by a nutritionist for each patient and eaten under strict supervision in a communal dining hall. A walk every evening is part of the physical activity program, and vacations are permitted when improvement is made. Family meetings are also held at the Sheba center.
Depending on the patient’s progress, transfer from full hospitalization to our day care unit may be recommended, followed by a return to the community. This gradual step-by-step approach allows each patient to progress at his or her own pace. After discharge, follow-up meetings are held every few weeks in our outpatient clinic.
When undergoing treatment for an eating disorder, full recovery can be a long journey that involves relapses and sometimes re-admission may be advised.
At our outpatient clinic, we offer:
- Evaluations to refer patients to the most suitable treatment program
- Comprehensive follow-up services for patients after hospitalization or day care
- Reassessment of patients who may have a relapse and need another evaluation
Private and group therapy treatments are provided on an outpatient basis, along with behavioral, cognitive, psychodynamic, and educational therapies. Consultations with a dietitian are an essential part of every outpatient treatment program. Additionally, we are dedicated to forming supportive post-discharge groups for every individual.