Depending on the severity of the ailment there are various options. The territorial assistance network is not homogeneous among the various Regions. Here’s who to contact depending on your needs
Eating disorders are not a voluntary choice, a whim or a bad habit, they are one illness real, serious and complex, which must be faced like any physical illness. Punitive and aggressive attitudes towards those who have an eating behavior disorder are useless if not to worsen the situation by increasing the person’s sense of isolation comments Stefano Erzegovesi, psychiatrist and nutritionist.
The steps to take
To get out of the disease, therefore, one is needed early diagnosis and adequate treatment, which requires intervention multidisciplinary
which involves the psychiatrist or child neuropsychiatrist for younger patients, the psychotherapist and the nutritionist explains the expert. Who is the first figure to turn to? If the symptoms have persisted for at least four weeks It is advisable to talk about it in the first place with your general practitioner or trusted paediatrician, who can help the family locate the nearest specialist center for eating disorders, informs Laura Dalla Ragione, psychiatrist and psychotherapist, who manages the network of services for eating disorders of the Umbria Local Health Authority 1. The center can generally be accessed directly, by telephone appointment, or alternatively following a prescription from the attending physician, at the cost of a ticket or free of charge, and in some cases under the intramoenia regime . If in the absent territory – points out Dalla Ragione – it is recommended not to waste time and to fix a appointment with a psychotherapist, at the counseling center or mental health centre where a medical referral is not required, and at the same time to have a specialist visit prescribed by the general practitioner or pediatrician with a expert nutritionist of eating disorders, which can immediately take charge of the patient.
Mapped centers
The online map of the Istituto Superiore di Sanit launched in January 2022 is a useful tool for researching treatment centers dedicated to eating disorders. 126 structures scattered throughout the national territory, of which 112 public and 14 private accredited with the National Health Service. With a great lack of homogeneity in the offer given that half of the centers (ie 63) are in the North. The largest number concentrated in Emilia Romagna (20) and Lombardy (15). In the central regions there are 23 structures (of which 8 in Lazio and 6 in Umbria), while between the South and the Islands there are 40 (of which 12 in Campania and 7 in Sicily). Almost seven out of ten provide access through the payment of the ticket. 33% in free mode and 11% in the intramoenia regime. The map is continually being implemented but already represents a fairly comprehensive reality. A detailed file is provided for each service with address, contacts, type of interventions offered, beds, access procedures for the first visit.
The risk of delays
Inequality in care delivery forces many families into one stressful and costly migration. Not only from the South but also from some areas of the North of the country because the distribution of services is not so widespread comments Dalla Ragione, who is also the contact person for the Ministry of Health for research projects on eating disorders. The network of services dedicated to these pathologies of the Umbria 1 Local Health Authority, which he heads and which he founded, is one of the few to be completely public and has two residential structures, four outpatient services and four day hospital services (also for children 0- 10 years). 70% of the guests in the structure come from outside the region. There are parents who rent a house to stay close to their child – he says -. The sooner we get to the diagnosis and treatment, the better the chances of recovery – he underlines -. Too many cases arrive late. This can determine complications organic and psychic with a consequent lengthening of the treatment time, the risk of making the disease chronic and, in the most serious situations, of lethal effects. The timeliness of the intervention therefore depends a lot on the presence of a network of dedicated services in the area, as established by the 2017 guidelines of the Ministry of Health, in which the Regions must absolutely invest to guarantee adequate treatment everywhere.
The four types of surgeries and where they are done
Based on the severity of the eating disorder, there are four levels of assistance of different intensity.
Il primo il outpatient service: After a clinical evaluation, which includes blood tests, nutritional and bone status, electro and echocardiogram, gastroscopy if needed, and a psychiatric evaluation for the diagnosis of any comorbidities such as anxiety disorder, borderline or obsessive compulsive, a care project that involves the whole family – explains Roberta Covezzi, head of the Modena AUSL center -. The patient agrees on a food plan, follows individual or group psychotherapy sessions and, if necessary, drug therapy. The sessions are one to three a week.
Il second level of assistancefor those who need more support, the daytime servicefive or seven days a week, for assisted meals (i.e. with the empathic support of an operator), psychotherapy, food psychoeducation activities (to overcome food phobias and dispel false myths about ingredients) and body image, art therapy and the possibility of remote schooling. Among the proposed activities there is also group counseling for parents, to inform them about the disease and relapses and help them recognize reactions, of anger or complicity, in the face of their child’s behavior, suggesting how to modify them for better interaction, explains Covezzi. Depending on the availability of resources, other services can be added to the basic offer. At the center of Ulss 4 in Portogruaro (Venice), for example, pet therapy, gardening, trips to the beach, trips to the city, music therapy, swimming pools, digital literacy are also offered, to learn how to recognize misleading messages on the web, says Pierandrea Salvo, the director of the center.
He tthird level of assistance represented by rehabilitation residences, which deliver more intensive treatments. The duration of the recovery varies from a few months to a year. Those coming from outside the region must have authorization from the ASL of residence. We host early-onset or long-lasting cases with organic complications, psychiatric pathologies, subjects with bone fractures, in artificial nutrition explains Salvo (in the center of Portogruaro there are two structures, one for minors and the other for adults).
Finally, the quarto type of intervention the hospitalization when the vital parameters (respiratory rate, heart rate, blood pressure) are altered and the patient’s life may be in danger. Some regions, such as Molise and Calabria, still lack rehabilitation facilities.
Green number
Since 2011 there is also a national toll-free number 800 180 969
active from 8 to 20 from Monday to Friday and managed directly by the Local Health Authority Umbria 1. Psychologists and nutritionists answer the phone by providing scientific information on eating problems, counseling to understand if the person has an eating disorder, psychological support for those suffers from it (but also to family and friends) and indications on specialized health structures throughout the national territory.
March 17, 2023 (change March 17, 2023 | 06:56)
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