Eating Disorders - Treatment for Anorexia

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All should be skilled in treating eating disorders. Studies have found that people treated by such specialists have a lower mortality rate than those treated only as psychiatric patients.

Measuring Body Mass Index

The body mass index (BMI) is the measurement of body fat. It is derived by multiplying a person's weight in pounds by 703 and then dividing it twice by the height in inches.

A healthy BMI for women over age 20 is 19 - 24.
Those over 24 are considered to be at risk for health problems related to obesity.
Those under 17.5 are considered to be at risk for health problems related to anorexia. (However, young teenagers can have lower BMIs without necessarily being anorexic.)

For example, a woman who is 5'5" and weights 125 pounds has a healthy BMI of 21. A woman at the same height who weighs 90 pounds would have a dangerously low BMI of 15.

Restoring Normal Weight and Nutritional Intervention

Nutritional intervention is essential. Weight gain is associated with fewer symptoms of anorexia and with improvements in both physical and mental function. Restoring good nutrition can help reduce bone loss, and raising the level of energy available to the body by balancing food intake and exercise can normalize hormonal function. Restoring weight is also essential before the patient can fully benefit from additional psychotherapeutic treatments.

Goals for Weight Gain and Good Nutrition. One approach to weight gain involves the following steps:

The weight-gain goal, usually 1 - 2 pounds a week, is strictly set by the doctor or health professional. This goal is absolute, no matter how convincingly the patient (or even family members) may argue for a lower-weight goal.

Patients who are severely malnourished may need to begin with a calorie count as low as 1,500 calories a day, however, in order to reduce the chances for stomach pain and bloating, fluid retention, and heart failure.

Eventually, the patient is given foods containing as many as 3,500 calories or more a day.

More calories than normal may be required to put on weight. In some cases, severe dieting has caused the metabolism to adapt to malnutrition and resist the effects of overfeeding. Some anorexic patients also may naturally have a higher metabolism than other individuals.

Dietary supplements may be needed. Zinc supplementation has been shown to help increase body mass. Patients should receive calcium plus a multivitamin. Oral phosphates are also useful.

Although eating is the problem, discussions of the disorder are never held during meals, which are times for relaxed social interaction.