Treatment for Anorexia

Anorexia nervosa is a life-threatening condition and cannot be left untreated. An individual with anorexia nervosa without purging (click here to go to identification) can quickly reach a dangerously low level of weight and it is usually the skeletal appearance of the individual that alerts family and friends (click here to go to clinical features and other observable clues). In cases of extremely low weight, medical intervention will be necessary and the family physician should be sought out immediately. If necessary, the individual will be hospitalised (see below). However, if the situation is recognized early enough, then a visit to the family doctor or a psychologist, who specializes in eating disorders, is a good starting point. Most people wish first to deal with the visible aspects of an eating disorder i.e. the low weight. Anorexia nervosa should never be treated by dietary input alone! It is a multi-factorial problem that requires an inter-disciplinary approach. That is, the following team of professionals should be consulted:

1.

The family physician: Your family doctor will carry out the necessary tests which may include electrolyte balances, kidney and live function tests, blood counts, etc. S/he will exclude the possibility of any medical factors that may be causing the problem. Please ask him/her for the name of a reputable psychologist who works with eating disorders.

2.

A psychologist. A psychologist can be approached directly if the problem is recognized in its early stages, (i.e. the family notice a radical drop in weight which has not yet reached dangerous proportions). S/he will assess the problem and suggest if physical tests are necessary. Anorexia nervosa cannot be solved in a few sessions and long-term therapy is usually required. The psychologist will recommend the required length of time. (Click here to find out what you can expect from the psychological evaluation). See causes to understand the kind of psychological factors that are at play with eating disorders. Do not dabble with this problem. Seek the right help as soon as possible. Psychologists who work with eating disorders work in conjunction with a dietician.

3.

A dietician. As commented above, eating disorders should never be treated from the dietary aspect alone (see causes). Dealing with the food problem without dealing with the underlying psychological factors can result in the problem becoming entrenched and difficult to treat. Dieticians who specialize in eating disorders will work in conjunction with a psychologist.

4.

A psychiatrist, if necessary. Usually the family physician and the psychologist can assess whether this problem requires the additional input of a psychiatrist.

An individual who is severely anorexic will not be allowed to exercise until a healthier weight has been achieved.

An attempt to change only the symptom is one of the reasons why people with an eating disorder constantly reappear at different help stations. Please bear in mind that there are psychological and historical causes to anorexia nervosa. It is never just about too little food!

1.	Hospitalization is necessary if you/or the person concerned between 20% to 30% below expected weight. Hospitalization may be necessary for 2 to 6 months. (See the Body Mass Index Table).
2.	Quite often they need individual and family therapy.
3.	In some cases medication may help, but has not really been found to be beneficial.

The following are tell-tale signs to watch for if you have, or know someone who has this disorder:

1.	Extreme weight loss. (See Body Mass Index Table).
2.	Extreme weight variations.
3.	Excessive exercise/excessive compliance.
4.	Physical aspects:

1.	Is there a change in appearance for the worse?
2.	Is there an increase in the number of injuries?
3.	Is there a decrease in energy?
4.	Is there an increase in mild illnesses such as colds, flus, sore throats, etc?