Anorexia treatments include talk therapy, guidance from physicians and dietitians and sometimes hospitalization.
Anorexia treatment includes medical care, nutrition counseling and psychological therapy. A primary care physician normally coordinates the patient's care although this is sometimes performed by the mental health provider. The goal of such treatment is to reverse the effects of the complications of anorexia, establish healthy eating habits and restore a sense of self-worth. Anorexia is an emotional disorder characterized by an aversion to food and an inability to maintain a healthy body weight. Anorexics are obsessed with body weight and equate their self-worth with how thin they are, believing they are overweight even when they are skeletally thin.
The onset of anorexia frequently occurs after a traumatic event and is commonly accompanied by other emotional problems. According to the University of Maryland Medical Center, this disorder is most common in teenagers and affects up to 3 percent of adolescents. It is rare for anorexia to develop in preadolescents or people over the age of 40 years. Children with anorexia are also more likely to have psychological disorders, such as depression and obsessive-compulsive disorder (OCD). Complications such as electrolyte imbalance, heart failure, starvation and suicide can make anorexia life-threatening. The restricting form of anorexia is characterized by dieting, excessive exercise and fasting. The binge/purge form of this disorder may also be called bulimia and is marked by attempts to lose weight after eating. These methods include the abuse of diuretics, enemas, laxatives and self-induced vomiting.
Some symptoms of anorexia nervosa are common to other psychological disorders such as depression and OCD. These include a lack of enjoyment in life, obsessive behavior and a severely distorted body image. Antidepressants should be used as part of a multidisciplinary approach for the treatment of anorexia that also includes dietary changes and psychological counseling. Patients should disclose the medications they are taking before starting an antidepressant as these drugs can have serious interactions with other medication. The Food and Drug Administration (FDA) has also recommended that patients taking antidepressants be observed for signs of suicide, especially when beginning treatment or changing dosages.
Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants commonly used for the treatment of anorexia, according to Seton Family of Hospitals. Fluoxetine (Prozac) is an SSRI that is effective in reducing the binge-purge cycles of bulimia, does not require changes to the diet and has a low risk of overdose. The side effects of fluoxetine can include anxiety, loss of appetite, diarrhea, dizziness, drowsiness, dry mouth, headaches, irritability, loss of sexual desire and nausea. Studies have shown that the side effects of fluoxetine are less severe than those of tricyclic antidepressants.
Tricyclic antidepressants must also be started in low doses and increased gradually to determine the patient's tolerance. The side effects of tricyclic antidepressants include blurred vision, constipation, drowsiness, dry mouth and stomach upset. Some of these patients may also gain weight and lose sexual desire.
Anorexics must adhere to a healthy meal plan and may also need to supplement their diet with vitamins and minerals to correct any existing malnutrition. A qualified dietician or nutritionist can develop specific meal plans with calorie requirements that will allow patients to meet their weight goals. Some patients may also require their vital signs to be monitored, especially fluid and electrolyte levels. Severe cases of anorexia may require the patient to be fed through a nasogastric tube that is placed through the nose and into the stomach.
According to National Institutes of Health, anorexics may require hospitalization if their body weight is more than 30 percent below their ideal body weight. Other signs that a hospital stay might be required include problems with the patient's heart rate, low potassium levels and weight loss that continues in spite of proper treatment. Anorexics may also need to be hospitalized if they are experiencing mental difficulties, such as severe depression or suicidal thoughts.
A psychiatrist or therapist will determine the patient's mental state once they are physically stable. The mental health care provider should consult with the patient as well as friends and family members to determine the need for a day treatment program or a psychiatric hospitalization as well as the type of therapy the patient should receive. This may include individual therapy, group therapy and even therapy for family members.
The initial goal of individual therapy should be to get the patient to recognize that they have an eating disorder. The long-tem goals will be to improve the patient's self-esteem and teach coping mechanisms for dealing with stress. Cognitive behavioral therapy (CBT) is a type of talk therapy that is commonly used although there is no clear evidence that it is more effective than other forms of therapy. Group therapy allows an anorexic to talk to other patients with eating disorders, although these sessions can result in competitions to be the thinnest person in the group. Informal support groups can also be helpful. Family therapy allows concerned family members to resolve conflicts and provide support for the patient, which is especially important for younger patients who still live at home. Family therapy can also be helpful for addressing any factors in the home environment that may contribute to the patient's anorexia.
The health care provider should monitor the patient's weight and other vital signs carefully and frequently for signs of a relapse. The therapist should encourage the patient to pursue recreational activities that are not related to maintaining a certain weight or appearance. An anorexic must also work to change destructive eating habits and develop better ways of dealing with control issues. Therapists will often ask loved ones to assist in the anorexic's recovery process. Friends and family members should not focus on the patient's condition or food and weight issues and the subject of anorexia should not be discussed during meals. This practice will allow mealtimes to be used for social interaction and relaxation. The therapist may also recommend that parents ensure that their anorexic child adheres to the established meal plan until that child is able to assume responsibility for his or her own eating habits.