Anorexia Nervosa (cont.)
How is anorexia treated?
Anorexia may be treated in an outpatient setting or hospitalization may be necessary. For an individual with severe weight loss that has impaired organ function, hospital treatment must initially focus on correction of malnutrition, and intravenous feeding or tube feeding that goes past the mouth may be required. A gain of between
1 to 3 pounds per week is a safe and attainable goal when malnutrition must be corrected. Sometimes weight gain is achieved using schedules for eating, decreased physical activity, and increased social activity, either on an inpatient or outpatient basis.
The overall treatment of anorexia, however, must focus
on more than weight gain. There are a variety of treatment approaches dependent
upon the resources available to the individual. Because of increasing insurance
restrictions, many patients find that a short hospitalization followed by a day
treatment program is an effective alternative to longer inpatient programs. Most
individuals, however, initially seek outpatient treatment involving
psychological as well as medical intervention. It is common to engage a
multidisciplinary treatment team consisting of a medical-care provider, a dietician or nutritionist, and a mental-health-care provider.
Different kinds of psychological therapy have been
employed to treat people with anorexia. Individual therapy, cognitive behavior
therapy, group therapy, and family therapy have
all been successful in the treatment of anorexia. In adolescents, research shows
that the Maudsley model of family therapy can be particularly effective in
treating this disorder in this population. In contrast to many past approaches to treatment, the Maudsley model approaches the family of the individual with anorexia as part of the solution rather than part of the reason their loved one has the disorder. With ongoing specific guidance from the professional mental-health
team, this approach has the family actively help their loved one eat in a more
healthy manner.
Any appropriate treatment approach addresses underlying issues of control, perfectionism, and self-perception. Family dynamics are explored. Nutritional education provides a healthy alternative to weight management for the patient. Group counseling or support groups often assist the individual in the recovery process. The ultimate goal of treatment should be for the individual to accept herself/himself and lead a physically and emotionally healthy life.
While no medications have been identified that can definitively reduce the compulsion to starve themselves, olanzapine (Zyprexa, Zydis) is a medication that is also used as a mood stabilizer and to treat schizophrenia that may be useful in treating anorexia. This is thought to help increase weight and to manage some of the emotional symptoms like anxiety and depression that can accompany anorexia. Some of the selective serotonin reuptake inhibitor (SSRI) antidepressant drugs have been shown to be helpful in weight maintenance after weight has been gained and in controlling the mood and anxiety symptoms that may be associated with the condition.
Next: What is the prognosis (outcome) of anorexia? »
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