Anorexia and Bulimia Nervosa Treatment Effectiveness

Does treatment at Kartini Clinic work?

The simple answer is yes. For many families and patients Kartini Clinic's medical emphasis on prompt and adequate weight restoration, followed by intensive psychotherapy in a family-based setting, has proven to be successful even where other treatment approaches have failed. Because we provide medical stabilization as part of our program, many of our patients are treatment "failures" from other facilities and quite ill when they reach us. Fortunately, with clinical experience of more than 1600 patients we have found our program has been able to help many of them.

But rather than try to convince you with implausible claims of "95% success rates" our goal is to explain to you what we have found to work and why we think it does. In the case of eating disorders such as anorexia, we do not want to paint an overly rosy picture of treatment success or "cures." As anyone who has experienced a loved one with anorexia or suffered from it themselves can tell you, treatment can often be a long and frustrating process. But this process is one that is emphatically not without hope for a return to a rewarding and fulfilling life.

So what have we found to be effective treatment of eating disorders?

First, it is critical to understand what you are up against. This is not an illness of choice; this is a brain disorder. Parents do not cause eating disorders and children do not choose to have them. Despite what many claim (even those who have suffered from eating disorders) a person suffering from anorexia is not in control of himself or herself. This is simply another aspect of the neurological dysfunction of patients suffering from a brain disorder. They believe themselves to be fat (when anyone can see the opposite is true) and believe themselves to be in control even when it's clear they are anything but.

Second, successful treatment, especially in children but also young adults, ultimately does not depend on a patient's "willingness" to be cured when they are in the depths of the illness. Remember, this is a brain disorder. Why expect a person's conscious brain - their volitional centers of judgment and action - to function properly when this is exactly the organ of the body that is affected? Too often, in our experience, treatment programs spend countless hours "arguing with the illness," that is, trying to convince someone with a brain disorder to behave rationally. This simply does not work.

And why does this approach work where others may have failed?

Eating disorder treatment is often required over a number of years; the focus of treatment is therefore to reduce the level of treatment intensity. At Kartini Clinic our goal is to secure for patients physiological and psychological remission, and thereby to limit the most intensive (and expensive) forms of treatment such as hospitalization and 24-hour residential care. In other words, to control the symptoms of anorexia (e.g. weight loss, irrational fear of being fat, etc.) while teaching parents of young patients how to care for them at home as much as possible. For young adults the goal is to teach techniques for independent living.

Physiological and psychological remission is secured through an emphasis on outpatient care by Kartini Clinic's multi-disciplinary treatment team. While our treatment program emphasizes the medical aspects of eating disorder treatment, this does not mean we fail to address the "whole" person. In fact, the holistic nature of our treatment team is evident in its composition: it includes group, individual and family therapists, movement therapists, and hypno-therapists, as well as a licensed school teacher (for patients in our day treatment unit). Medical stabilization, body works and intensive psychological treatments are designed to gain remission and prevent the need for (re)hospitalization or residential treatment. But in order to keep the disease in remission parent involvement is critical: meals at home are supervised, activity levels are monitored, and the patient returns to Kartini Clinic for visits with the doctors, family therapists, movement therapists and other team members, as needed.

Treatment of eating disorders such as anorexia is complicated, time-consuming and often quite expensive. Kartini Clinic's program is designed to be clear about the nature of the illness, the treatment steps that are necessary to secure lasting improvements in health, and to minimize the cost of treatment by preventing the most intensive forms of it.