What is the Mandometer method?
Mandometer Clinic Eating Disorder Recovery Program
The Mandometer Clinic Eating Disorder Recovery Program is a program that teaches patients how to eat normally.
Patients are retrained to attain a normal sense of fullness using a patented, computerised biofeedback device called the Mandometer.
This method is supported by thermal treatment, restriction of excessive physical activity, and social skill rebuilding to restore normal social interactions - all without the use of psychoactive drugs.
The multidisciplinary clinical team supporting the program is comprised of a medical director, paediatrician, psychiatrist, dietician/nutritionist, Eating Disorder Recovery Managers, teacher or social worker, nurses and administrative staff. The Eating Disorder Recovery Manager is at the centre of the patient's anorexia treatment and/or bulimia treatment with others supporting and assisting as directed.
After a comprehensive medical assessment administered by a doctor, an Eating Disorder Recovery Manager works with the patient and her doctor to design an individual eating disorder treatment plan.
The eating disorder treatment plan includes a detailed, customised meal program, short-and long-term goals with expected weight gain, as well as a structured daily schedule for sleep, rest and physical activities. Patients are weighed each week, although during the first 16 weeks they are not informed of their weight.
Antidepressant medications are reduced progressively under a physician's supervision during the first two months of anorexia treatment and/or bulimia treatment and eventually discontinued. Each individual decides their own short and long-term goals with the aid of their Eating Disorder Recovery Manager.
In the same way that we use aids like alarm-clocks, mobile telephones and cars in everyday life, some people need technical assistance to eat normally.
The Mandometer device is an interactive computer system that aims to retrain patients in their eating habits.
It allows the patient to remain in control while she regains normal eating patterns, without becoming overweight.
When using the Mandometer device, the patient follows several easy steps:
- She hooks the scale up to the small computer, then turns it on.
- She puts the empty plate on the scale, so that it adjusts for the weight of the plate.
- She then adds food slowly until it reaches the agreed-upon quantity.
- She begins eating, with constant feedback from the Mandometer regarding her rate of consumption, along with her level of fullness (satiety) compared to normal ranges.
Gradually, the amount of food is increased (with the patient's agreement), until the patient eats normal, healthy amounts of food.
The Mandometer takes the stress out of what used to be a very stressful time for the patient. Slowly, she re-learns how to safely eat again, feel appropriately full, gain proper nutrition and not overcompensate and become overweight.
Once the patient has fully recovered, she will no longer need the Mandometerdevice, and will go back to eating without it.
This method is supported by thermal treatment, a restriction of excessive physical activity and social skill rebuilding, which all work to restore normal social interactions.
Because eating disorders cause the body to lose its ability of keep warm, the Mandometer Treatment includes a unique warming component.
The idea is to help the patient stay warm and comfortable until the body regains its natural ability to keep warm. Plus, warming calms the patient and helps their body retain the precious calories it will need to rebuild itself to a healthy state.
After eating, patients relax and rest in special warm rooms. They also receive their own heated North Face™ jackets, which they can wear anywhere.
Mandometer Treatment program steps
Step 1 - Program information
As a first step we encourage patients and/or parents to contact out Clinical Director to discuss the program in detail and get all of their questions answered.
The Clinical Director will:
- answer your questions about anorexia treatment and/or bulimia treatment, costs, insurance, etc.;
- talk with you about your unique situation;
- tell you whether or not they feel our program would be right for you; and
- if you like, help you decide whether a formal patient assessment is an appropriate next step.
If the patient is very severe and currently hospitalised, the first priority will be to stabilise the patient's health. Our Clinical Director will discuss several 'transition strategy' options with you.
If you decide to move forward and begin anorexia and/or bulimia treatment, a two-day patient assessment at our outpatient eating disorder clinic in Melbourne is the first stage in your treatment.
Step 2 - Physician referral, insurance reimbursement and payment process
Health insurance may pay for a portion, or sometimes all, of your care. If your plan is an HMO (Mel - what is the Australian equivalent of this?), you will need a referral from your family doctor. If you do not have a family doctor, we can help you find one who has experience with eating disorder patients.
Keep in mind that while insurance companies sometimes pay for nearly 100% of our care, more often they will pay for only a portion. Furthermore, some patients have no insurance benefits available, and must pay for all services 'out-of-pocket'. If necessary, we have skilled people on staff who can work with you to locate any necessary funding. We also offer credit card billing and 3rd party payment plans.
Step 3 - On-site patient assessment (examination and evaluation)
Actual anorexia treatment and/or bulimia treatment can only begin following an intensive patient evaluation at our Clinic, which typically lasts about two days. If necessary, we will help you with travel logistics including a referral to one of several apartments or hotels in the area.
Here is what will be included in the assessment:
- review of the patient's medical records;
- a telephone consultation with the patient's doctors (when appropriate);
- thorough physical examination by our Medical Director, including necessary tests such as blood work;
- BMI calculation (Body Mass Index);
- written questionnaire;
- oral interview; and a
- live eating evaluation.
Step 4 - Presentation of your eating disorder treatment plan
At the conclusion of your two-day visit, the Clinical Director will prepare and present a detailed anorexia and/or bulimia treatment plan. It will include specific goals, timelines and estimated costs of treatment. You will know exactly what to expect going forward, should you elect to accept our recommendations and begin eating disorder treatment.
Step 5 - Eating disorder treatment commences
Our anorexia treatment and bulimia treatment programs are highly individualised depending upon each patient's needs. For example, the more motivated a patient is, the faster she will complete eating disorder treatment. However, here is how our eating disorder program works:
Eating Disorder Recovery Manager
Once a patient starts the program, she will begin working with her Eating Disorder Recovery Manager. The Recovery Manager will:
- act as the patient's advocate and partner;
- function as the center point of the patient's recovery team;
- work closely with the patient to come up with appropriate short and long-term goals;
- communicate with the patient's family, as appropriate;
- motivate and inspire the patient to take responsibility for her own life; and
- help the patient to successfully complete the program and defeat her eating disorder forever.
Other eating disorder recovery team members may include a paediatrician, internal medicine doctor, psychiatrist, nurse, nutritionist and other support staff.
Outpatient eating disorder treatment
While the Mandometer Clinic is technically a 'partial hospitalisation program', most people refer to it as an outpatient eating disorder program.
Patients usually start our program full time, visiting our Clinic 5 days a week, 8 hours a day. Patients do not stay at the Clinic overnight or on weekends.
As they progress, the time commitment is gradually lowered, so that patients can begin returning to everyday life, including school, work, recreation and social activities. Eventually, patients return to the Clinic only once a month for a couple of hours (or less).
Because most patients require housing during eating disorder treatment, the Mandometer Clinic has contracts with nearby apartments. These furnished apartments are attractive, comfortable, and within walking distance of the Mandometer Clinic. If the patient is a minor, a family member will need to stay with her.
Please note that even local patients will usually require housing for at least several months. This is because over time, anorexics and bulimics usually develop strong, negative associations and rituals within their home environment. For example, a patient may have a ritual of climbing the staircase 30 times every time she sees it. Getting away from the home environment gives patients the opportunity to break out of their negative cycles.
Anorexia / Bulimia treatment period
Our program is not a quick fix. It has taken years for the patient to develop the eating disorder, and it will take time to conquer it. However, you will see a positive change in just a few months. Many of our patients with severe eating disorders are considered free of symptoms after 4-6 months of eating disorder treatment, and most are free within 12 months of treatment.
Day-to-day life at the Mandometer Clinic
Support: New friends are a big help. New patients immediately meet others who are working to defeat anorexia and/or bulimia. The environment is very supportive, friendly and caring. In fact, lifelong friendships between patients often emerge from our program.
Rest and relaxation: Particularly during early stages of eating disorder treatment, patients need to regain their strength and energy, without a lot of physical movement. Our anorexia and bulimia treatment center is stocked with many DVDs, audio CDs, books, magazines, games and other tools to help patients pass the time as they begin their recovery from anorexia or bulimia.
Tutoring: If you are still in school or university, we may recommend that you take a break from your studies when you first come to the Mandometer Clinic. However, we provide professional teachers to help you catch up in your studies, so that when you return to school, you can jump right back into things.
Excursions: As patients begin to make progress, they are reintroduced into the real world through excursions. That means days at the beach, movies, theater, horseback riding etc. Excursions are critical in the mid to late stages of eating disorder treatment to help patients get back to normal life. They are also great rewards for a 'job well done'.
Hair and Makeup: As women and girls begin to recover from their eating disorder, they appropriately want to improve their appearance to catch up with the changes in their bodies. At the Mandometer Clinic, we help them do just that.
Work: Adult and late teen patients are encouraged to go back to work when they are ready and able.
Discharge and follow up
Patients are discharged from the program when appropriate. Mandometer Clinics follow up with patients for a period of five years following their successful completion of the program.