The biggest challenge in treating anorexia nervosa is helping the person recognize that they have an illness. Most people with anorexia deny that they have an eating disorder. People often enter treatment only when their condition is serious.
Goals of treatment are to restore normal body weight and eating habits. A weight gain of 1 to 3 pounds per week is considered a safe goal.
Different programs have been designed to treat anorexia. Sometimes the person can gain weight by:
Increasing social activity
Reducing the amount of physical activity
Using schedules for eating
Many patients start with a short hospital stay and 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:
Mental health care providers
Treatment is often very difficult. 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:
Cognitive behavioral therapy (a type of talk therapy), group therapy, and family therapy have all been successful.
Goal of therapy is to change patients' 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 have been through.
Medicines such as antidepressants, antipsychotics, and mood stabilizers may help some anorexic patients when given as part of a complete treatment program. These medicines can help treat depression or anxiety. Although medicines may help, none has been proven to decrease the desire to lose weight.
The stress of illness can be eased by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone.
Anorexia nervosa is a serious condition that can be life-threatening. 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. 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 may include:
Decrease in white blood cells, which leads to increased risk of infection
Low potassium levels in the blood, which may cause dangerous heart rhythms
Severe lack of water and fluids in the body (dehydration)
Lack of protein, vitamins, minerals, and other important nutrients in the body (malnutrition)
Seizures due to fluid or sodium loss from repeated diarrhea or vomiting
Thyroid gland problems
When to Contact a Medical Professional
Talk to your health care provider if someone you care about is:
Too focused on weight
Limiting the food he or she eats
Getting medical help right away can make an eating disorder less severe.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013.
Becker AE, Mickley DW, Derenne JL, Kibanski A. Eating disorders: evaluation and management. In: Stern TA, Rosenbaum JF, Fava M, et al., eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 37.
Rosen DS, American Academy of Pediatrics Committee on Adolescence. Clinical report: identification and management of eating disorders in children and adolescents. Pediatrics. 2010;126:1240-53. PMID: 21115584 www.ncbi.nlm.nih.gov/pubmed/21115584.
Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.