How is anorexia nervosa treated?

Updated: Jun 10, 2019
  • Author: Bettina E Bernstein, DO; Chief Editor: Caroly Pataki, MD  more...
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Anorexia nervosa is difficult to treat because of the shame, denial, and lack of insight concomitant with the disorder. [101] Medical management is directed toward correcting and preventing the disease’s complications. Reestablishing normal eating patterns is crucial to restoring the patient’s health. [102]

Hospital admission may be indicated for patients who are extremely ill, have cardiac dysrhythmias, or have severe metabolic abnormalities. Most patients will be admitted to medical facilities for refeeding, referred to psychiatric facilities and counseling if medically stable, or be managed on an outpatient basis. [103, 104]

Outpatient treatment should be undertaken only with very close monitoring, such as weekly weight measurement with the patient wearing only a gown.

As with all psychiatric and behavioral emergencies, care must be taken to prove and document competency upon discharge. Many patients with anorexia nervosa may have additional psychopathology, which may leave them incapacitated during an anorexic crisis. If doubt remains, the patient must be admitted for more thorough psychiatric and physiologic monitoring or be discharged in the care of a competent caretaker. [100]

Transfer to an inpatient psychiatric facility may be the disposition for patients who are medically safe for discharge but who require aggressive inpatient psychiatric treatment of their disorder.

Research has found a correlation between low BMI in anorexia nervosa and altered physical activity patterns providing an implication that restriction on physical activity might help restore a healthy BMI. [105]

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