What treatments are available for anorexia nervosa?

What treatments are available for anorexia nervosa?

Recovery from anorexia nervosa is possible. In long term studies of people with this illness, about one-half fully recover, many have intermittent periods of recovery and relapse, and a small percentage continue to experience a more chronic form of anorexia nervosa with ongoing symptoms of this and other eating disorders. It is still unknown exactly how to predict who will have a short-lived course of this illness and for whom it will be a more chronic and debilitating illness.

Fortunately, most of the complications experienced by persons with anorexia nervosa are reversible when they restore their weight through engagement in treatment. People with this disorder should be diagnosed and treated as soon as possible because eating disorders are most successfully treated when diagnosed early. Some patients can be treated as outpatients, but others may need medical hospitalization to stabilize their dangerously low weight through “re-feeding” treatment.  This may include the use of feeding tubes, intravenous fluids, and structured diets with supervised meals. Weight gain is usually gradual: one to three pounds per week is considered safe and desirable. Given the large overlap between medical and psychiatric symptoms of anorexia nervosa, coordination of care between different medical and mental health professionals is of upmost importance.

A variety of psychotherapeutic approaches are used to help people with anorexia nervosa. Individual therapy is a standard treatment for this illness. Dialectical behavioral therapy (DBT) can help to teach coping skills and cognitive behavioral therapy (CBT) can be used to change unhealthy thoughts and behaviors. Group therapy is often advised to create a safe environment where people can share their experiences with others. Family therapy is important—particularly if the individual is living at home and is a child or young adolescent—and is specifically useful in mobilizing family support for this complex illness.

Unfortunately there is no medication that can cure anorexia nervosa. In fact, many psychiatric medications have been studied and have been found to be unhelpful in the treatment of this complex illness. In general, certain psychiatric medications may be useful in treating isolated symptoms of anorexia nervosa, but this is beyond the scope of this review and should be discussed at length with one’s treating physicians. While not indicated for anorexia nervosa itself, medication treatment of coexisting anxiety, depression, and other mental illnesses can very helpful for people with anorexia nervosa.

Families and friends can be most helpful in encouraging their loved ones to seek treatment for this complex mental illness. With coordinated treatment and the support of family and friends, most people with Anorexia Nervosa can expect to see a decrease in their symptoms as they go on to live meaningful lives.