Treatment:

The biggest challenge in treating anorexia nervosa is making the person recognize that they have an illness. Most persons with anorexia nervosa deny that they have an eating disorder. People often enter treatment only once their condition is serious.

The goals of treatment are to restore normal body weight and eating habits. A weight gain of 1 - 3 pounds per week is considered a safe goal.

A number of different programs have been designed to treat anorexia. Sometimes the person can gain weight by:

• Increasing social activity
• Reducing physical activity
• Using schedules for eating

Many patients start with a short hospital stay and continue to follow-up with a day treatment program.

A longer hospital stay may be needed if:

• The person has lost a lot of weight (being below 70% of their ideal body weight for their age and height). For severe and life-threatening malnutrition, the person may need to be fed through a vein or stomach tube.
• Weight loss continues even with treatment
• Medical complications, such as heart problems, confusion, or low potassium levels develop
• The person has severe depression or thinks about committing suicide

Care providers who are usually involved in these programs include:

• Nurse practitioners
• Physicians
• Nutritionists or dietitians
• Mental health care providers

Treatment is often very difficult, and patients and their families must work hard. Many therapies may be tried until the patient overcomes this disorder.

Patients may drop out of programs if they have unrealistic hopes of being "cured" with therapy alone.

Different kinds of talk therapy are used to treat people with anorexia:

• Individual cognitive behavioral therapy, group therapy, and family therapy have all been successful.
• The goal of therapy is to change a patient's thoughts or behavior to encourage them to eat in a healthier way. This kind of therapy is more useful for treating younger patients who have not had anorexia for a long time.
• If the patient is young, therapy may involve the whole family. The family is seen as a part of the solution, instead of the cause of the eating disorder.
• Support groups may also be a part of treatment. In support groups, patients and families meet and share what they've been through.

Medications such as antidepressants, antipsychotics, and mood stabilizers may help some anorexic patients when given as part of a complete treatment program. Examples include:

• Antidepressants
• Olanzapine (Zyprexa, Zydis)
• Selective serotonin reuptake inhibitors (SSRIs)

These medicines can help treat depression or anxiety.

Although these drugs may help, no medication has been proven to decrease the desire to lose weight.

Support Groups:

See: Eating disorders - support group

Expectations (prognosis):

Anorexia nervosa is a serious condition that can be deadly. By some estimates, it leads to death in 10% of cases. Experienced treatment programs can help people with the condition return to a normal weight, but it is common for the disease to return.

Women who develop this eating disorder at an early age have a better chance of recovering completely. However, most people with anorexia will continue to prefer a lower body weight and be very focused on food and calories.

Weight management may be hard. Long-term treatment may be needed to stay at a healthy weight.

Complications:

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

Complications may include:

• Bloating or swelling
• Bone weakening
• Electrolyte imbalance (such as low potassium)
• Dangerous heart rhythms
• Decrease in white blood cells, which leads to increased risk of infection
• Severe dehydration
• Severe malnutrition
• Seizures due to fluid loss from repeated diarrhea or vomiting
• Thyroid gland problems, which can lead to cold intolerance and constipation
• Tooth decay

Calling your health care provider:

Talk to your doctor if a loved one is:

• Too focused on weight
• Over-exercising
• Limiting his or her food intake
• Very underweight

Getting medical help right away can make an eating disorder less severe.