The treatment for anorexia nervosa usually involves a multidisciplinary team of health professionals to address the various aspects of the condition. This may include a dietician, psychiatrist, psychologist, specialist nurse or counselor, as well as a pediatrician for children or adolescent patients.
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Acute care
Hospitalization may be required in severe situations where the life of the individual is in danger due to complications of the condition, such as arrhythmias or electrolyte imbalances.
The vital signs can then be monitored and appropriate interventions carried out if they are required. In severe cases, nasogastric tube feedings may be required to help to address malnutrition and the immediate effects of insufficient dietary intake. Patients with suicidal thoughts or attempts should be admitted to the psychiatric health ward to work through related issues.
Dietary management
Restoring a healthy weight is the first step in the treatment of anorexia nervosa. This helps to rebuild strength in the body and recover from the condition.
A nutritionist or dietician is often involved in helping patients work out their ideal weight goals and devise a dietary plan to make progressions. This often comprises specific meal plans and energy requirements to meet healthy body weight goals.
It is important to also to address problematic behaviors that are preventing patients from eating normally, such as compulsive vomiting after binge eating. In this instance, a psychologist or other health professional specialized in mental health may be able to help address the underlying issues and precipitate changes in the patient's behavior.
Psychological therapy
Family-based therapy is currently the only treatment for adolescents with anorexia that is supported by scientific evidence. Many individuals in this age group can find it difficult to understand the gravity of the condition, as well as how to make healthy food and lifestyle choices to support their recovery. In family-based therapy, the patient's parents and other family members play an essential role in assisting the patient's decision-making process and helping the adolescent to regain weight with an appropriate diet.
Cognitive analytic therapy (CAT) addresses unhealthy thoughts and behavior patterns that developed in the past by reformulating the events, recognizing their impact on the condition, and revising methods to break the unhealthy habits.
Cognitive-behavioral therapy (CBT) can help to address abnormal eating patterns and behaviors to support healthy weight gain. Additionally, CBT can also help to improve body image and thoughts about self-esteem and worth.
Interpersonal therapy (IPT) explores negative issues and anxiety that are associated with the relationships that the individual has with other people and how these can be addressed.
Focal psychodynamic therapy (FPT) focuses on specific unresolved conflicts from the past that may be affecting current body image and dietary patterns and how these can be managed more appropriately.
Breaking the cycle of anorexia's driven behavior
Pharmacological management
Dietary and psychological treatment techniques are the mainstay in the management of anorexia nervosa. There are no medications that are currently approved for the treatment of this condition as a result of the lack of efficacy in helping patients to regain weight.
However, antidepressants and other psychiatric medications are often used in patients with anorexia to address mental health disorders that are associated with or are the cause of the condition.
Barriers to treatment
Many patients with anorexia nervosa are unwilling to undergo treatment for the condition, as they do not comprehend the severity of the associated complications and may not believe treatment is required. Rather than an illness, individuals with anorexia may view their body weight as a choice and have difficulty understanding why they should change their dietary and lifestyle habits. Some patients also have an overwhelming fear of gaining weight.
To address these issues, a trusting patient-practitioner relationship is essential. During the diagnostic process, patients should be made aware of the potential risks and any concerns they have about the treatment. It is also important that patients have a strong support network to help them through the entire recovery process.
Alternative treatments
In some cases, non-conventional medicine may be used in the treatment of anorexia nervosa. These methods are less well studied but may be effective for some individuals to reduce the anxiety that might be related to the condition.
Some of these alternative treatments include:
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Further Reading