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Anorexia Nervosa

Prevention & Treatment

Monday, Aug. 27, 2007; 7:44 PM

Copyright Harvard Health Publications 2007

Prevention

Table of Contents

There is no way to prevent anorexia nervosa. It's helpful to detect the problem as early as possible, so it's important for parents and health care professionals to be aware of the issue.

Treatment

The first goal is to make sure the person with anorexia nervosa is not in danger. Treatment should correct any problems with body fluids and salts, and doctors should make sure the heart, liver and kidneys are functioning. Hospitalization may be necessary in the most severe cases.

Behavior therapy has the best chance of helping the person move her weight into a safe range. This is especially important when the weight is dangerously low. The greatest challenge is often the patient, who cannot acknowledge the problem. Health care professionals try to define the problem in a way the person can accept, then work with the person toward common goals.

Overall, anorexia nervosa is best treated with a combination of psychotherapy and medication.

Once the person acknowledges the problem, a variety of therapy techniques can be helpful. A nutritionist can plan a healthy eating program that promotes slow weight gain. Cognitive behavior therapy encourages the person to recognize flawed thoughts about body image, food and dieting, and helps to control anxiety about eating.

Family therapy may be important, both to support and educate family members and to examine negative interactions in the family. For example, family members can be taught to avoid unproductive power struggles about food.

Later, when symptoms are under better control, the person with anorexia nervosa may want to understand the meaning of the symptoms, including how they may have affected important relationships, limited emotional growth and altered self-concept. It may also be possible to look at what underlying problems may have led to the eating disorder in the first place.

There is some evidence that antidepressant medications can help in treating anorexia. Antidepressants and other medications may be effective for people who have symptoms of depression, anxiety or obsessive-compulsive disorder. However, no medication can make a person with this disorder want to eat or gain weight.

A person's thinking about food can become distorted enough that it is considered psychotic, and in those cases, treatment may include an antipsychotic medication. Some of the newer antipsychotic drugs, such as olanzapine (Zyprexa), have a side effect that, in this case, is a benefit - weight gain.

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