The Mandometer® Treatment for eating disorders

What is the Mandometer® Method?

The Mandometer® Method treats eating disorders by teaching patients how to eat and recognize hunger and satiety with the help of a small computer that receives information from a small scale beneath your plate of food. The Mandometer® system allows the patient to see a rate of eating displayed on the screen that describes the rate at which normal individuals eat that amount of food and feel satiety as they eat. At the same time, the patient’s own eating speed and perception of satiety is shown on the screen. The patient then gradually learns to model its disordered pattern of eating to the normal pattern of eating. 

 

In addition to normalizing eating behavior, the patient is kept warm to avoid excessive exercise to generate warmth and to decrease anxiety after meals. There is a program to keep the patient’s educational studies current, and there is a program to foster self confidence. The treatment is carried out without the use of psychoactive drugs. 

 

All patients have a personal case manager
who takes care of them throughout the whole treatment. During the treatment, the patient meets with the same physician, teacher, dietician and nurse. After a thorough eating evaluation carried out by a senior case manager and a physician, an individual treatment plan is written with the patient. The aim of the eating evaluation is to determine a diagnosis, the degree of severity, and to exclude diagnoses unrelated to eating disorders. The remission criteria and the criteria for partial remission are explained thoroughly to the patient and their family. Blood tests are taken and a thorough physical examination is made. We then determine with the patient if hospitalization in our 24-hour care department is needed to stabilize their physiological status to avoid more serious and immediate consequences of the disorder. An individualized treatment plan that includes a meal plan, short-term and long-term goals, a body weight plan, as well as a plan for sleep, rest and physical activity are developed.  

 

Each patient decides what their short-term and long-term goals will be, together with their case manager. The patients are weighed every week but are not informed about their weight. Every sixth week, the eating behaviour, psychological symptoms and quality of life measures are assessed for each patient.

 

Possible anti-depressive drugs are decreased gradually to be completely withdrawn during the two first months of treatment.

 

There are two known risk factors for anorexia; dieting and high physical activity. In most cases the weight loss starts with low caloric, vegetarian food. Unfortunately, this can lead to nutrient deficiency. Patients suffering from an eating disorder because they eat too little should eat a variety of food to prevent this effect.
For this reason, Mandometer Clinics encourage patients to vary their diet, refrain from eating vegetarian foods during treatment, gradually eat fish and chicken and eventually also meat. Patients do best in treatment by eating various foods, but those who are on a vegetarian diet for religious or medical reasons are exempt. Children do much better in treatment on a non-vegetarian diet, they improve rapidly and they seldom relapse.

 

How many people have been treated successfully with the Mandometer® Method?

Over 800 persons have been treated to remission at our clinics.

 

At present, approximately 300 patients are being treated in Stockholm and a total of 90 individuals are waiting for treatment. 

 

Studies with our Swedish patients have shown that 90% of those who come into remission are still free of symptoms after five years and the 10% who have relapsed have significantly less serious problems than they had before the Mandometer® treatment. They are relatively easy to take into remission again; only 6% of our anorexic patients have developed bulimia, while more than 50% develop bulimia in traditional care.

 

When is an anorexic or a bulimic patient regarded as cured of her/his illness?

The following criteria must be fulfilled for a person to be considered to have reached full remission, cured, of anorexia, bulimia or unspecified eating disorder:

  • Normal eating behaviour and perception of satiety
  • Normal weight
  • Normal blood values
  • Normal psychiatric status 
  • The patient shall have returned to school or work and normal leisure activities
  • Food and weight are no longer a problem in any way
  • For bulimia nervosa: no binge-eating or vomiting since at least three months

 

75% of the patients who start Mandometer® treatment reach full remission. We also measure partial remission, when patients fulfil at least five of seven remission criteria. Treatment continues until full remission has been achieved.