Diuretics: Treatment and rehabilitation

Last modified: Sunday, 31. May 2009 - 1:55 pm

Treatment for diuretic abuse starts with addressing the roots of the physical or psychological problems. There are a number of rehabilitation programs available for the treatment of eating disorders such as bulimia, anorexia, and binge eating disorder (BED). Programs are usually residential, or inpatient, meaning that the patient lives in the hospital or other rehabilitation facility for the length of treatment (several weeks to several months).
The first goal of rehabilitation from any eating disorder is to stabilize both weight and self-destructive behavior such as diuretic abuse and binge eating. Patients with anorexia may be severely malnourished, and could have additional related health problems such as impaired kidney function and dehydration that need immediate medical attention. They may also require intravenous feeding.
Patients need to relearn healthy nutrition, meal management, and exercise patterns. Taking regularly scheduled meals, meeting with a registered dietitian, and participating in classes on appropriate nutrition and fitness will help to establish good habits. Overweight individuals being treated for binge eating disorder may also learn new healthy and realistic strategies for weight loss in this environment.
Equally important is the effective treatment of eating disorders and associated diuretic abuse is to address the emotional motives and distorted thinking behind the patient’s behavior. Individual or group psychotherapy or cognitive-behavioral therapy can help the patient work through self-esteem and self-image problems. Studies show that cognitive behavioral therapy has a 40-50% success rate with bulimia nervosa and BED patients. Family therapy may also be part of the treatment program.
The goal of cognitive-behavioral therapy (CBT) is to teach the patient new behaviors by exposing the irrational thoughts that trigger the old, self-destructive behaviors of anorexia or bulimia. Once the disordered thinking is changed, the behavior will follow. Learning how to recognize the thoughts and emotions surrounding eating disordered behavior, and rehearsing the new and desirable behaviors (such as avoiding situations and places that trigger the old behavior), is a key part of long-term recovery and relapse prevention with CBT.
If the patient has a pre-existing mood disorder, such as depression or anxiety disorder, antidepressant medication may also be prescribed. Studies have shown that the selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and sertraline (Zoloft) are effective in people with bulimia and anorexia. These medications reduce depression by increasing levels of serotonin, a neurotransmitter.
Eating disorders can be chronic conditions that need life-long vigilance and attention. A 1999 Harvard Medical School study of 246 women with eating disorders found that one-third of patients relapsed, or returned to eating disordered behaviors, following initial full recovery from both bulimia and anorexia.
Athletes who abuse or misuse diuretics for purposes of performance enhancement or making weight face special treatment challenges. Weight loss and an excessively low percentage of body fat may be praised by coaches, trainers, and teammates, making behavioral changes even more difficult. In addition, obsessive exercise and workout routines may be rewarded in sports and competition rather than questioned. A treatment strategy that includes education of not just the athlete, but also the people around him or her, is essential.

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