Anorexia nervosa

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Food guide pyramid

Eating disorder - anorexia

The biggest challenge in treating anorexia nervosa is having the person recognize that the eating behavior is itself a problem, not a solution to other problems. However, most persons with anorexia nervosa deny that they have an eating disorder. Individuals often enter treatment when their condition is fairly advanced.

The goals of treatment are to first restore normal body weight and eating habits, and then to address the psychological issues.

A hospital stay may be needed if:

• The person has lost a lot of weight (below 30% of their ideal body weight for their age and height)
• Weight loss continues despite treatment
• Medical complications, such as heart rate problems, changes in mental status, low potassium levels, or mental status problems, develop
• The person has severe depression or thinks about committing suicide

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Other treatment may include:

• Antidepressant drug therapy for depression
• Behavioral therapy
• Psychotherapy
• Supportive care

Severe and life-threatening malnutrition may require feedings through a vein.

See: Eating disorders - support group

Anorexia nervosa is a serious and potentially deadly medical condition. By some estimates, it leads to death in 10% of cases. Experienced treatment programs have a good success rate in restoring normal weight, but relapse is common.

Women who develop this eating disorder at an early age have a better chance of complete recovery. However, most people with anorexia will continue to prefer a lower body weight and be preoccupied with food and calories to some extent. Weight management may be difficult, and long-term treatment may be necessary to help maintain a healthy body weight.

Complications can be severe. A hospital stay may be needed.

Complications may include:

• Appearance of fine baby-like body hair (lanugo)
• Bloating or edema
• Electrolyte imbalance (such as potassium insufficiency)
• Decrease in white blood cells which leads to increased risk of infection
• Heart arrhythmias
• Osteoporosis
• Severe dehydration, possibly leading to shock
• Severe malnutrition
• Seizures due to fluid loss from excessive diarrhea or vomiting
• Thyroid gland problems, which can lead to cold intolerance and constipation
• Tooth erosion and decay

Talk to your doctor if your child is restricting his or her food intake, over-exercising, or excessively preoccupied with weight. Getting early medical help before abnormal patterns are established can reduce the severity of an eating disorder.

Review Date: 01/20/2009
Reviewed By: Paul Ballas, DO, Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.