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Anorexia Treatment Approach

Anorexia demands a multipronged treatment plan that addresses both the physical and psychological aspects of this disorder. Cognitive-behavioral therapy, often in combination with antidepressants, is a very effective therapeutic approach for treatment of eating disorders. Complementary and alternative methods of treatment (such as the use of herbs and mind/body medicine) are valuable adjuncts to usual ways of stimulating appetite, addressing nutritional problems, and helping the patient to develop a healthier http://www.realmentalhealth.com/eating_disorders/binge_eating_02_2.asp and to learn to deal more productively with stress.

In general, the most important aspect of treating anorexia is restoring weight and preventing starvation. For this, hospitalization may be necessary, particularly under the following circumstances:

• Continuing weight loss, in spite of outpatient treatment
• Body mass index (BMI; a measurement that takes into account a person's height and weight) 30% below normal; normal range is 19 to 24
• Irregular heart rhythm
• Severe depression
• Suicidal tendencies
• Low potassium levels
• Low blood pressure

Generally, adequate weight gain (1 to 2 pounds per week) and appropriate changes in behavior require a 10 to 12 week hospital stay. (Most insurance in the United States, however, covers only 15 days of inpatient treatment.) To avoid bloating, abdominal upset, and fluid retention, those who are severely malnourished may be started on a diet of 1,500 calories a day, gradually increasing to as much as 3,500 calories. Because anorexia triggers changes in metabolism, high caloric intake may be necessary to stimulate weight gain.

Unfortunately, there is no completely effective treatment for anorexia nervosa, and recovery can take many years. Even after some weight gain, many people with anorexia remain quite thin and risk of relapse is very high. A number of influences in the social environment may make recovery difficult:

• Friends or family who express admiration or envy of the patient's thinness
• Dance instructors or athletic coaches who put a premium on having a very lean body
• Denial on the part of parents or other family members
• A patient's persistent belief that emaciation is not only normal but attractive and/or that purging is the only way to avoid becoming overweight

Soliciting the involvement of friends, family members, and others in the treatment of the individual, with education for everyone regarding the gravity of the disease, may diminish these influences.

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Anorexia Lifestyle Changes

Treating anorexia nervosa involves major lifestyle changes. Not only must eating habits be altered, but the individual must adjust his or her self perception to no longer hold a distorted http://www.realmentalhealth.com/eating_disorders/binge_eating_02_2.asp. The following lifestyle changes may help in this process:

• Establishing regular eating habits and a healthy diet
• Developing a support system and participating in a support group for help with stress and emotional issues
• Cutting back on exercise if obsessive exercise has been part of the disease. Once sufficient weight gain has been established, controlled exercise regimens can be a positive reinforcement for appropriate eating habits and a way to reduce gastrointestinal distress.

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Reviewed: 03/2006