Sunday, June 05, 2011

Case for Inpatient Treatment of Eating Disorders

by Dr. Yong Lee, Director of Psychiatric Services at Remuda Ranch

As a psychiatrist in private practice in the community, I enjoyed engaging with my patients in problem solving. I would tell them it is a brave first step to take. You could have continued living with your problem, but you were brave enough to see that you couldn’t do it on your own. Getting better is a collaborative process. Let’s work together to find a solution to what’s bringing you in. I loved what I did. It gave me enormous satisfaction when my patients were able to overcome their depression, stabilize their panic attacks, stop their drinking, get back to work, reconcile with their spouse. Now this approach works in most clinical situations, but my patients with eating disorders were definitely a special population.

In an ideal world, we as behavioral health providers, dietitians, physicians, therapists, and counselors—all want to do what’s best for our patients, and it frustrates us when we can’t meet their needs. I’m a firm believer of practicing what you preach. If our patients are seeking help for a problem that they cannot overcome, I think there is no shame when we have to admit that are patients are not doing well in an outpatient basis and that we need help. Eating disorders, at least in my experience, cannot be well managed in isolation; it usually requires a team approach, usually involving a therapist, dietitian, primary care provider, and possibly a psychiatric provider, such as myself. A team approach is what attracted me to working at Remuda Ranch as an inpatient psychiatrist.
What I recognized, after years of practice, was when a behavior is life threatening, the priority needs to be to do whatever it takes to stop the behavior. This may involve removing the patient from factors that maybe fueling the behavior, which may include peers, school, work, and even family. This may be incredibly painful and disruptive, but the ultimate goal is to disrupt the eating disorder, not school, work, or family life. These are all good things the eating disorder threatens to destroy...finish article

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