Treatments and drugs

By Mayo Clinic Staff

When you have anorexia, you may need several types of treatment. If your life is in immediate danger, you may need treatment in a hospital emergency room for such issues as a heart rhythm disturbance, dehydration, electrolyte imbalances or psychiatric problems.

Here's a look at what's commonly involved in treating people with anorexia:

Medical care

Because of the host of complications anorexia causes, you may need frequent monitoring of vital signs, hydration level and electrolytes, as well as related physical conditions. In severe cases, people with anorexia may initially require feeding through a tube that's placed in their nose and goes to the stomach (nasogastric tube). A primary care doctor may be the one who coordinates care with the other health care professionals involved. Sometimes, though, it's the mental health provider who coordinates care.

Restoring a healthy weight

The first goal of treatment is getting back to a healthy weight. You can't recover from an eating disorder without restoring an appropriate weight and learning proper nutrition. A psychologist can work with you to develop behavioral strategies to help you return to a healthy weight. A dietitian can offer guidance on a healthy diet, including providing specific meal plans and calorie requirements that will help you meet your weight goals. Your family will also likely be involved in helping you maintain healthy-eating habits.

Psychotherapy

Individual, family-based and group therapy may all be beneficial.

  • Individual therapy. This type of therapy can help you deal with the behavior and thoughts that contribute to anorexia. You can gain a healthier self-esteem and learn positive ways to cope with distress and other strong feelings. A type of talk therapy called cognitive behavioral therapy (CBT) is commonly used. Therapy may be done in day treatment programs, but in some cases, may be part of treatment in a psychiatric hospital.
  • Family-based therapy. This therapy begins with the assumption that the person with the eating disorder is no longer capable of making sound decisions regarding his or her health and needs help from the family. An important part of family-based therapy is that the family is involved in making sure that healthy-eating patterns are followed. This type of therapy can help resolve family conflicts and muster support from concerned family members. Family-based therapy can be especially important for children with anorexia who still live at home.
  • Group therapy. This type of therapy gives you a way to connect to others facing eating disorders. And informal support groups may sometimes be helpful. However, be careful with informal groups that aren't led by a mental health professional. For some people with anorexia, support groups might result in competitions to be the thinnest person there.

Medications

There are no medications specifically designed to treat anorexia because they haven't been found to work very well. However, antidepressants or other psychiatric medications can help treat other mental disorders you may also have, such as depression or anxiety.

Hospitalization

In cases of medical complications, psychiatric emergencies, severe malnutrition or continued refusal to eat, hospitalization may be needed. Hospitalization may be on a medical or psychiatric ward. Some clinics specialize in treating people with eating disorders. Some may offer day programs or residential programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time. Also, even after hospitalization ends, ongoing therapy and nutrition education are highly important to continued recovery.

Treatment challenges in anorexia

Some cases of anorexia are much more severe than others. Less severe cases may take less time for treatment and recovery. One of the biggest challenges in treating anorexia is that people may not want treatment, may think they don't need it or may be concerned about weight gain. And, some people with anorexia don't see it as an illness, but instead promote it as a lifestyle choice.

Even if you do want to get better, the pull of anorexia can be difficult to overcome. Anorexia is often an ongoing, lifelong battle. Although symptoms may subside, you remain vulnerable and may have a relapse during periods of high stress or during triggering situations. For example, anorexia symptoms may go away during pregnancy only to return once your baby has been delivered. Ongoing therapy or periodic appointments during times of stress may be helpful.

Jan. 05, 2012