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Anorexia Nervosa Treatment: Here’s What to Expect

Updated: Mar 7

Anorexia nervosa is a serious and potentially life-threatening disorder. Mental health professionals characterize anorexia nervosa by a person's intense fear of gaining weight and prolonged periods of malnutrition. Though it's most common in adolescence, it can develop at any time throughout a person's life.

If you or a loved one is showing signs of anorexia nervosa, this piece can provide guidance. White Pine Center for Healing, Erie, Pennsylvania's only establishment for treating eating disorders, discusses what anorexia nervosa is, how medical professionals treat it, and the symptoms of the disorder.

What Anorexia Nervosa Is and What it Isn’t

Decades ago, many mental health professionals believed family trauma, sexual trauma, fear of sexual development, and issues with parental separation were root causes of anorexia nervosa. Though a person’s past experiences and traumas could certainly lead to an eating disorder, biological research shows that’s not the case for everyone.

In fact, recent groundbreaking studies found that family history, genetics, abnormal neurotransmitter signaling, and hormone irregularities play a significant role in the potential for a person to develop anorexia nervosa.

The DSM-5 diagnostic criteria for anorexia nervosa involves the:

  • Restriction of food intake resulting in low body weight

  • Intense fear of gaining weight or becoming fat

  • Disturbance of body image

Treatment for Anorexia Nervosa

Patients with anorexia nervosa are challenging for doctors to treat. Part of the reason is that they often have co-occurring disorders (COD). These could be psychiatric and/or substance abuse disorders such as:

  • Depression

  • Anxiety

  • Attention deficit disorder

  • Obsessive compulsive disorder (OCD)

  • Bipolar disorder

  • Drug addiction

Depending on the COD, the severity of the anorexia nervosa, and the treatment team's philosophy, the path to recovery can vary significantly for each person. Regardless of the approach and whether or not a patient is relapsing or progressing, a continuum of care is essential for providing a comprehensive range of health services that evolve with them.

Most of the time, outpatient treatment is effective, particularly when combined with a partial hospitalization program. Those with anorexia nervosa and their caregivers should look for a multi-faceted approach to treatment to ensure the treatment team is addressing the disorder comprehensively. Full-service outpatient treatment may include:

  • Medical management

  • Individualized and/or family therapy

  • Psycho-education

  • Nutritional rehabilitation

There are currently no U.S. Food and Drug Administration approved medications for anorexia nervosa. However, there are a variety of medications doctors may prescribe, especially if there is a COD.

In the last decade, medication sensitivity testing, or reference electroencephalogram (rEEG), has become a helpful tool for reducing the trial-and-error period of medications and minimizing their adverse side effects. Essentially, physicians can test a treatment by looking at a "map" of a patient's brain through a quantitative electroencephalogram (qEEG). This map will give care teams insights into whether or not a patient will respond to a specific medication.

Doctors and other mental health professionals may also recommend that a patient take natural supplements to alleviate a range of vitamin and mineral deficiencies.

Ultimately, because there are so many potential factors contributing to a person's eating disorder, treatment should aim to address as many variables as possible.

Severe Anorexia Nervosa

Doctors generally classify anorexia as severe when a person is 15-20 percent underweight. Often, patients at or beyond this severity threshold will have electrolyte abnormalities and may require inpatient treatment such as intensive medical weight management restoration and nutritional rehabilitation.

Starting Treatment

Typically, various medical professionals are involved in a patient's treatment, such as family physicians, psychotherapists, psychiatrists, eating disorder specialists, and dietitians.

The first treatment step is to receive an evaluation from a medical professional. The doctor will check to see if any medical conditions require immediate hospitalization or stabilization. They will often take urine and blood samples and record blood pressure, weight, height, and body temperature.

Signs of Anorexia Nervosa

There are a variety of clinical signs of an eating disorder. Patients with anorexia nervosa will often express feeling "fat" or that they don't like their bodies. Weight loss can go unnoticed if people with this eating disorder wear baggy, oversized clothes or lots of layers.

If you notice a loved one is overly restrictive with their food intake, skips meals, develops mealtime “rituals,” or engages in excessive physical activity, it may be time to address the behaviors with a mental health professional. Additionally, you’ll want to be on the lookout for some clinical signs of anorexia, including:

  • Arrhythmia

  • Bradycardia

  • Brittle hair and nails

  • Edema

  • Hyperkeratosis

  • Hypotension

  • Hypothermia

  • Lanugo

  • Marked weight loss

  • Osteoporosis

Decisions about inpatient versus outpatient treatment need to be individualized based on the severity of symptoms. Speak with a medical professional or mental health counselor to ensure you or a loved one receives the necessary care for complete recovery.

Risk of Anorexia Nervosa

Anorexia has a negative impact on nearly all of the body's physiological systems. Many of the risks of the disorder can become life threatening, especially hypotension (low blood pressure), osteopenia (low bone mineral density), arrhythmias (irregular heartbeat), electrolyte abnormalities (imbalance of minerals), and severe bradycardia. It's essential to seek treatment early as anorexia can have long-term consequences, such as:

  • Cardiac complications

  • Neurological damage

  • Reproductive problems

  • Skeletal problems

Seeking Treatment & Support

Anorexia nervosa is a severe illness that must be addressed quickly to minimize the chances of long-term complications. If you suspect you, your child, or another loved one has an eating disorder, reach out to White Pine Center for Healing today to consult with one of our in-house treatment experts.

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