In recent decades, there has been an ongoing trend in the prevalence of eating disorders across the country and around the world. There are many reasons why treating eating disorders is difficult, the most prominent of which include: low responsiveness to treatment, the need for a multi-professional team that specializes in eating disorders and the lack of frameworks and rehabilitation programs in the community. In addition, eating disorders are among the most complex psychiatric disorders due to their double morbidity, physical complications, and extremely high mortality rates compared to other psychiatric disorders.
A combination of psychological, genetic, cultural, personal, social, and family factors is the etiology of eating disorders. From a personal perspective, the girl’s occupation of food is frequently a means of expressing emotional difficulties in both individual and interpersonal situations, where it is difficult to express emotional pain adaptively. Engaging in food and appearance is a way to control the complex reality and create independence and separation from parents. The cultural aspect that emphasizes leanness and external appearance as a means of expressing willpower and success plays a significant role in this. Thinness serves as an ideal for beauty, excellence and perfectionism that characterizes Western culture and society. Great significance can be given to the family aspect and the influence of an invasive home environment, a multitude of conflicts in the family and more, for developing an eating disorder. Eating disorders are common in adolescence, especially around changes in appearance and body shape, combined with social difficulties and family conflicts, which aggravate the girl’s handling of food as a distraction tool.
The treatment of eating disorders requires multi-professional teamwork, which involves examining many factors and aspects: medical, nutritional, emotional, and nursing care. Those with eating disorders have low motivation for treatment and change, and so the real challenge is getting girls involved in the long process, and avoiding the recurrence of the disorder and screening symptoms that are particularly active during crises and difficult situations. The process of treatment and integration into the community, such as integrating into ambulatory treatment and returning to a healthy, independent, and normal life routine, can be difficult for those coping with eating disorders due to resistance to treatment of the disorder and prolonged hospitalizations. Dealing with the outside world and exposure to complex situations makes it difficult to function independently in society, and they respond to difficulties and obstacles with withdrawal and relapse of the disorder.
Eitan Becher (2001) outlines the significance of empathy as a means of reducing resistance among patients with eating disorders. Becher emphasizes the importance of empathizing with the patient’s difficulties and listening to their needs in cooperating. Such a close acquaintance allows for contact, alleviating loneliness.
An empathetic attitude from an outsider who is compassionate and understanding can make her feel safe.
Beit Tamar is a rehabilitative approach that takes into account the sharp and drastic transition from hospitalization to community life, and often the girls do not make the transition from overcrowded hospitalization and intensive supervision to independent community life.
Sometimes these women do not have family and social support and need an intermediate stage. This therapeutic sequence is necessary to prevent withdrawal in eating disorders characterized by the “revolving door” syndrome of repeated hospitalizations that produce resistance to change and are an obstacle to recovery.
The program is designed for girls who have been released from the hospital or are actually receiving ambulatory treatment and are in the process of wanting to recover. Thus far, there is no similar community solution adapted to this population in Israel.
A rehabilitation center is the solution for a therapeutic and supportive environment. There is no Rehab Center for eating disorders in the ultra-Orthodox sector. The Rehabilitation Center is for girls 18 years and over and offers a multi-professional package. Treatments include nutritional therapy, psychiatric treatment, psychotherapeutic treatment, nutritional therapy, and more. Until now, girls have had to choose between two poor alternatives: either go to a rehab center that is not suitable for a religious girl or stay at home without a suitable treatment package.
