Anorexia nervosa

Alternative Names

Treatment

The biggest challenge in treating anorexia nervosa is having the person recognize that their eating behavior is itself a problem, not a solution to other problems. However, most persons with anorexia nervosa deny that they have an eating disorder. Individuals often enter treatment when their condition is fairly advanced.

The goal of treatment is first to restore normal body weight and eating habits, and then attempt to resolve psychological issues. A hospital stay may be needed, especially if the person has lost a lot of weight.

Supportive care by health care providers, structured behavioral therapy, psychotherapy, and anti-depressant drug therapy are some of the methods that are used for treatment. Severe and life-threatening malnutrition may require intravenous feeding.

Support Groups

See: Eating disorders - support group

Outlook (Prognosis)

Anorexia nervosa is a serious and potentially deadly medical condition. By some estimates, it leads to death in 10% of cases. Experienced treatment programs have a good success rate in restoring normal weight, but relapse is common.

Women who develop this eating disorder at an early age have a better chance of complete recovery. However, most people with anorexia will continue to prefer a lower body weight and be preoccupied with food and calories to some extent. Weight management may be difficult, and long-term treatment may be necessary to help maintain a healthy body weight.

Possible Complications

Complications can be severe. A hospital stay may be needed.

Complications may include:

• Severe dehydration, possibly leading to shock
• Electrolyte imbalance (such as potassium insufficiency)
• Cardiac arrhythmias
• Severe malnutrition
• Thyroid gland deficiencies which can lead to cold intolerance and constipation
• Appearance of fine baby-like body hair (lanugo)
• Bloating or edema
• Decrease in white blood cells which leads to increased susceptibility to infection
• Osteoporosis
• Tooth erosion and decay
• Seizures related to fluid shifts due to excessive diarrhea or vomiting

When to Contact a Medical Professional

If you see that your child is restricting his or her food intake, over-exercising, or is excessively preoccupied with weight, talk to your doctor. Early intervention before abnormal patterns are established can reduce the severity of an eating disorder.

Go to the emergency room, or call the local emergency number (such as 911), if fainting, irregular pulse, seizures, or other severe symptoms develop in a person with anorexia nervosa.

References

American Psychiatric Association. Treatment of patients with eating disorders, third edition. American Psychiatric Association. Am J Psychiatry. 2006 Jul;163(7 Suppl):4-54.

Marcus MD. Eating disorders. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders; 2007:chap 238.

Morris J, Twaddle S. Anorexia nervosa. BMJ. 2007 Apr 28;334(7599):894-8.