Part 1: Introduction to Interventions and Eating Disorders

Formal family or workplace interventions have generally been associated with alcohol or drug addiction, and this has made many professionals and families uncertain about using this method with eating disorders. This reluctance is due in part to perceived, as well as real, differences between eating disorders and other addictions, and to a lack of agreement in the field as to whether eating disorders can, or should, even be considered "addictions." It is interesting to note that the most current and comprehensive research shows a genetic link for both addictions and eating disorders, along with a growing recognition of both disorders as "brain diseases," not unlike depression or Parkinson's disease.

What is an "intervention?"

An intervention is an event where family members, with or without the help of a professional, confront the "addicted individual" with the real and often negative consequences of his or her situation and actions. As an eating-disorder treatment professional recently said to me, "It's not as if [the anorexic or bulimic] has just smashed up the car." While the harmful consequences of an eating disorder can be more subtle than some addictions, eating disorders cause immeasurable suffering for individuals and their families. Anorexia is a killer, having the highest mortality rate of all mental illnesses, including depression. Obesity, often the result of binge-eating disorder, has reached epidemic levels in this country, and bulimia comes with a laundry list of medical complications.

What do eating disorders and other addictions have in common?

Even though eating disorders do not involve dependence on a habit-forming substance, there are clearly similarities in how addictions and eating disorders affect individuals and their families. Eating disorders are characterized by persistent patterns of dysfunctional eating and dieting behavior. Associated with serious emotional, physical and social distress, they negatively impact an individual's quality of life, self-image, relationships, financial, and employment status. Eating disorders can exhaust and ultimately bankrupt parents and family members as the sufferer retreats from job or school, alienating friends and using all of his or her energy and resources to manage the disorder.

What are the goals of intervention?

Families with a loved one suffering from an eating disorder may have tried various approaches and made many unsuccessful attempts to help. They may feel helpless, hopeless or afraid and not know where to turn. When a professional therapist or interventionist trained in working with eating disorders partners with a family, there should be two goals. The first is to get the individual suffering with an eating disorder into treatment. The second goal is to move the family out of crisis and to help them set healthy boundaries for themselves.

The clinician, in collaboration with family members, implements a confidential and respectful plan to interrupt the negative physical and emotional spiral of the eating disorder. Through education, assessment, planning, and action an immediate attempt is made to move the identified individual into a clinically appropriate level of care. Families who hold a mirror up to their loved one represent the larger sense in which "confrontation" works in interventions. When family members are willing to present reality to their loved one and willing to change their own relationship to the eating disorder, the emotional impact and power of that act (interventions are rarely dry-eyed events) can move the individual to make a decision in his or her own best interest.

"The goal of the intervention," says author V.E. Johnson, is for the identified individual to "see and accept enough reality" to accept his or her need for help. If the intervention is not immediately successful, the clinician will work with the family and individual over time to motivate him or her toward greater acceptance of the need for help.

Will doing an intervention make matters worse?

No. Doing nothing makes matters worse. Nobody needs to get sicker before they get better. Intervention services are one of the best ways to motivate someone to accept help when he or she is unable or unwilling to ask for it on their own. How much worse will things have to get before you are willing to act on behalf of your loved one? Intervention is a direct call to action for all involved. Intervention combined with treatment is the best solution. Part 2 will further explore how to do an intervention with eating disorders.

Continued, click here for Part 2.