When you have anorexia nervosa, you may need several types of treatment. Treatment is generally done using a team approach that includes medical providers, mental health providers and dietitians, all with experience in eating disorders. Ongoing therapy and nutrition education are highly important to continued recovery.
Here's a look at what's commonly involved in treating people with anorexia.
Hospitalization and other programs
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. Hospitalization may be required for medical complications, psychiatric emergencies, severe malnutrition or continued refusal to eat. 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.
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 or other mental health professional can work with you to develop behavioral strategies to help you return to a healthy weight. A dietitian can offer guidance getting back to regular patterns of eating, including providing specific meal plans and calorie requirements that help you meet your weight goals. Your family will also likely be involved in helping you maintain normal eating habits.
These types of therapy may be beneficial:
- Family-based therapy. This is the only evidence-based treatment for teenagers with anorexia. Because the teenager with anorexia is unable to make good choices about eating and health while in the grips of this serious condition, this therapy mobilizes parents to help their child with re-feeding and weight restoration until the child can make good choices about health.
- Individual therapy. For adults, cognitive behavioral therapy — specifically enhanced cognitive behavioral therapy — has been shown to help. The main goal is to normalize eating patterns and behaviors to support weight gain. The second goal is to help change distorted beliefs and thoughts that maintain the restrictive eating. This type of therapy is generally done once a week or in a day treatment program, but in some cases, it may be part of treatment in a psychiatric hospital.
No medications are approved to treat anorexia because none has 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.
Treatment challenges in anorexia
One of the biggest challenges in treating anorexia is that people may not want treatment. Barriers to treatment may include:
- Thinking you don't need treatment
- Fearing weight gain
- Not seeing anorexia as an illness but rather a lifestyle choice
People with eating disorders can recover. However, they're at increased risk of relapse during periods of high stress or during triggering situations. Ongoing therapy or periodic appointments during times of stress may help you stay healthy.
Alternative medicine is the use of a nonconventional approach instead of conventional medicine. Complementary medicine is a nonconventional approach used along with conventional medicine.
Alternative medicine hasn't been well-studied as a treatment for people with eating disorders, but complementary treatments may help reduce anxiety. Such treatments may help people with eating disorders by increasing a sense of well-being and promoting relaxation.
Examples of anxiety-reducing complementary treatments include:
Talk with your doctor before trying any alternative medicine. Natural doesn't always mean safe. Your doctor can help you understand possible risks and benefits before you try a treatment.