Treatment choices depend on the degree to which
anorexic behavior has resulted in physical damage and
whether the person is a danger to him or herself.
Medical treatment should be supplemented with psychiatric
treatment (see Therapies). Patients are
frequently uncooperative and resist treatment, denying
that their life may be endangered and insisting that
the doctor only wants to ‘‘make them get fat.’’
Hospital impatient care is first geared toward correcting
problems that present as immediate medical
crises, such as severe malnutrition, severe electrolyte
imbalance, irregular heart beat, pulse below 45 beats
per minute, or low body temperature.
Patients are
hospitalized if they are a high suicide risk, have severe
clinical depression, or exhibit signs of an altered mental
state. They may also need to be hospitalized to
interrupt weight loss, stop the cycle of vomiting, exercising
and/or laxative abuse, treat substance disorders,
or for additional medical evaluation.
Day treatment or partial hospitalization where
the patient goes every day to an extensive treatment
program provides structured mealtimes, nutrition
education, intensive therapy, medical monitoring,
and supervision. If day treatment fails, the patient
may need to be hospitalized or enter a full-time residential
treatment facility.
Anorexia nervosa is a chronic disease and relapses
are common and to be expected. Outpatient treatment
provides medical supervision, nutrition counseling,
self-help strategies, and therapy after the patient has
reached some weight goals and shows stability.
A nutrition consultant or dietitian is an essential
part of the team needed to successfully treat anorexia.
The first treatment concern is to get the individual
medically stable by increasing calorie intake and balancing
electrolytes.
After that, nutritional therapy is
needed support the long process of recovery and stable
weight gain. This is an intensive process involving of
nutrition education, meal planning, nutrition monitoring,
and helping the anorectic develop a healthy
relationship with food.
