Treatment for Anorexia Nervosa

Anorexia nervosa is an eating disorder characterized by intense fears of weight gain, which can lead to severe underweight or even cachexia. The affected individuals perceive their body as fat, despite being underweight. Socially, they avoid eating in the presence of others, which leads to withdrawal from social life.

In Anorexia Nervosa the body weight becomes the central point of the patient’s feelings, thoughts, and actions. They perceive their body or certain parts as too fat, often grossly overestimating it.

Typically, patients achieve and maintain low weight through starvation and food refusal. Sufferers of Anorexia typically have little insight into their condition and deny the dangers of starvation. The lack of insight makes treatment of such patients particularly difficult.

In the following article, we described different aspects of the disorder, with special emphasis on treatment for Anorexia Nervosa.

Call CHMC

ICD-10 Coding and Diagnostic Criteria for Anorexia Nervosa

ICD-10: F50.0 Anorexia Nervosa

For the diagnosis of Anorexia Nervosa, certain criteria must be met:

• The sufferer’s weight is significantly below the minimum normal or expected body mass for the individual’s height and age.
• The afflicted exhibits a strong fear of gaining weight or becoming fat.
• The person has a mistaken perception of their body weight and shape, either feeling overweight overall or identifying specific parts as being too fat.
• A number of additional characteristics assist diagnosis: persons suffering from the disorder may appear very underweight, describe symptoms such as despair, withdrawal, and insomnia, and exhibit obsessive-compulsive tendencies.

People with Anorexia Nervosa can reduce their weight by avoiding high-calorie foods and taking one or more of the following measures:

• Self-induced vomiting
• Self-induced use of laxatives
• Excessive physical activity
• Use of appetite suppressants and/or diuretics

Individuals suffering from anorexia are frequently described as former “perfect children” who excelled at everything. In this way, they typically met the expectations of the achievement-oriented middle-class backgrounds they came from.

Types of Anorexia Nervosa

F50.01: Anorexia Nervosa, Restricting Type

Anorexia nervosa is defined by a skewed perception of body image and an irrational fear of weight gain, resulting in extreme food restriction and potentially fatal weight reduction. The new code, F50.010, designates mild severity anorexia nervosa, characterized by the absence of binge eating or purging behaviors. This distinction is essential for formulating focused treatment strategies and assessing progression or remission.

F50.02: Anorexia Nervosa, Binge Eating/Purging Type

This code denotes a severe variant of anorexia nervosa characterized by binge eating and purging behaviours, including vomiting or laxative abuse. Identifying a severe course of anorexia is crucial for prompt and extensive therapeutic measures, underscoring the seriousness of the disease.

F50.1: Atypical anorexia nervosa

where one or more core symptoms, like amenorrhoea or weight loss, are absent. A woman meets all criteria for anorexia nervosa except that she has regular menstruation or, despite significant weight loss, the individual’s weight stays within the normal range, meeting all anorexia nervosa criteria

Diagnosis of Anorexia Nervosa at CHMC Dubai

Diagnosing anorexia nervosa requires a thorough evaluation by a psychiatrist or psychologist. This includes taking a detailed medical history, having in-depth discussions with the patient, and conducting joint and separate conversations with the parents to understand the individual’s specific characteristics.

Certain physical and psychological criteria can indicate anorexia. Key diagnostic features include an intense fear of gaining weight and a distorted perception of body image, where individuals inaccurately view their body as larger than it is. This leads to behaviours aimed at achieving very low weight thresholds for themselves, driven by a deeply ingrained fear of becoming “too fat.”

Another defining criterion is that weight loss is always self-induced, achieved through calorie restriction, vomiting, excessive exercise, or the use of laxatives, appetite suppressants, or diuretics. For children and adolescents, a Body Mass Index (BMI) below the 10th percentile is a primary symptom. BMI, which is calculated as weight (kg) divided by height (m²), is used to assess nutritional status. BMI percentiles based on age and gender are used for children and teens to compare their weight with peers.

It is essential to rule out organic causes of weight loss or appetite loss, such as tumors or metabolic disorders. Finally, it is necessary to ensure that disordered eating behaviours are not symptoms of another mental health condition, such as adjustment disorders, borderline personality disorder, anxiety, obsessive-compulsive disorder, depression, or psychotic disorders.

Anamnesis (History-Taking)

Questions related to the following areas should be asked:

• Weight changes over recent years.
• Eating habits, binge eating, and vomiting episodes.
• Constipation, diarrhoea, fluid intake, and output.
• The symptoms include menstrual irregularities, atopic conditions, fractures, and sensitivity to cold or heat.
• Use of medications, alcohol, and other substances.

Physical Examination

The following checklists serve as guides for physical examination and laboratory analysis:

1. Vital Signs: blood pressure, heart rate, cardiopulmonary auscultation and percussion, alertness (fatigue, drowsiness).
2. Age, Weight, Height: Calculate BMI; refer to percentiles for weight and height (especially for children and adolescents).
3. Specific Clinical Findings:
4. Vital minima:
   • Reduced basal metabolic rate. The patient has hypotension, hypothermia, bradypnea, and low T3 levels.
   • Teeth:
     • Cavities (reduced saliva, acidic stomach content from vomiting, sugar consumption in bulimia) and loosening (osteoporosis in anorexia) are common symptoms.
   • Skin:
     • Dry, scaly (vitamin deficiency?), decreased skin turgor (dehydration), pressure ulcers (bedridden anorexic patients).
   • Hair:
     • Anorexia may cause hair to grow on cheeks, forearms, the back, and possibly the entire body.
     • Anorexia causes hair loss on the scalp.
     • Sex-specific hair patterns preserved, unlike panhypopituitarism.
   • Salivary Glands:
     • Sialadenosis, particularly in the submandibular or parotid glands, is characterized by painless swelling, recurrent sialadenitis, and hypertrophy.

Clinical and Neurological Observations:

• Oedema:
  • Especially on the dorsum of feet, ankles, calves, or generalized (anasarca).
  • Hypoalbuminemia plays a minor role; supportive lymphatic drainage may help during the psychological crisis phase.
• Skeletal:
  • Osteoporosis and osteomalacia—spontaneous fractures and fractures from minor trauma—cause bone pain.
  • Excessive use of laxatives has been linked to clubbing and nail deformities.
• Neurological:
  • There are symptoms such as muscle weakness, paraesthesia in the extremities, and decreased reflexes (PME).
  • Fatigue, apathy, disorientation, even coma
  • Evaluation for night blindness or dizziness.
  • Acute potassium deficiency.

Routine Laboratory Parameters (Mandatory):

• Complete blood count with differential:
  • Leukocytes (low, common, down to 2000/mcL).
  • Platelets (low, less common).
  • Erythrocytes (low, rare).
  • MCV (elevated, common; alcohol, folic acid, vitamin B12 deficiency?).
• Electrolytes:
  • Sodium, potassium, chloride, calcium, magnesium, and phosphate (can be low).
• Renal function markers:
  • Creatinine, urea (can be elevated).
• Liver function tests:
  • Transaminases: GOT, GPT (mild elevations up to 2x normal).
  • Other: Total bilirubin, alkaline phosphatase (AP), gamma-GT (mild elevations possible).
• Blood coagulation:
  • Quick test (rarely low), PTT (rarely prolonged).
• Serum protein electrophoresis:
  • Total protein, albumin, and gamma globulins are frequently low, but dehydration can cause pseudo-normal protein levels.
• Blood lipids:
  • Triglycerides (reduced), cholesterol [occasionally high (HDL normal, LDL elevated)].
• Hormones:
  • FT3, FT4, TSH (often low T3 syndrome; frequently all parameters are reduced).
• Fasting blood sugar:
  • Typically low.
• Blood gas analysis (Astrup):
  • Metabolic alkalosis (hypokalemic, hypochloremic) due to diuretic abuse.
  • Metabolic acidosis (hypokalemic) due to laxative abuse.

Treatment for Anorexia Nervosa at CHMC in Dubai

Anorexia is an illness that requires treatment. However, those affected often don’t see themselves as sick. For this reason, many seek professional help only at a late stage. If the illness is detected and treated early, the chances of full recovery are particularly high.

The first step in treatment focuses on alleviating acute symptoms. Patients are supported in gaining weight and adopting healthy eating habits. In later therapy stages, potential triggers and sustaining factors are explored. Strategies are then developed with patients to prevent relapses into disordered eating.

The method of treating anorexia depends partly on the severity of the condition. Possible options include outpatient care and partial or full inpatient treatment in a clinic.

In life-threatening situations, compulsory treatment may also become necessary. Even after successful treatment, symptoms often persist, which can lead to relapse. Follow-up care is therefore a crucial component in treating anorexia.

Psychotherapy and Medication in Treatment for Anorexia

Because of the complex interaction of physical and psychological symptoms, treatment for Anorexia Nervosa requires a multimodal approach. The treatment concept includes normalizing eating behaviour, weight rehabilitation, and psychotherapy. Involving the family is essential.

There is no specific medication for anorexia itself, but pharmacotherapy may help manage certain symptoms, such as depression or anxiety. In some cases, antidepressants, such as fluoxetine, can be helpful. However, the method of choice for Anorexia treatment is psychotherapy. It aims to prevent further conditions like depression or anxiety disorders.

Success in psychotherapy requires the patient’s willingness and long-term commitment. Addressing problematic behaviour patterns and personal issues is challenging but offers a path to positive growth, greater self-determination, and renewed joy in life.

Goals in Treatment for Anorexia Nervosa

At the beginning of treatment, goals are discussed and established with patients based on their personal life circumstances. The treatment should generally aim to:

• Restoring a healthy body weight and rehabilitating physical effects
• Improving illness awareness and boosting motivation to overcome the disorder
• Educating and advising on healthy nutrition and eating habits
• Changing body perception, attitudes, and feelings about the eating disorder
• Managing psychological difficulties
• Involving the family (support, education, counselling, and therapy)
• Preventing relapse

Symptom resolution often occurs only after extended therapeutic work. The focus should not be on deficits but rather on patient resources—highlighting healthy aspects and skills. Approaches solely targeting symptom elimination typically lack long-term success. Since the goal is to foster autonomy and reduce external control, treatment should minimize outside regulation. Therefore, we do not recommend diets with strict eating regimens.

Hospital Treatment for Severe Cases of Anorexia Nervosa

In cases of life-threatening underweight, rapid weight loss, or severe physical complications, inpatient admission may be required, even against the patient’s will. This also applies to serious psychiatric conditions and the risk of suicide or severe self-harm.

In inpatient therapy, professionals directly supervise meals, making it more effective than outpatient strategies. Additionally, it is more structured and allows for holistic treatment of the disorder.

Interaction Between Doctor and Patient with Anorexia

Anorexia may present in medical practice in the following ways:

• The patient addresses the problem herself and may have attempted treatment previously.
• The doctor identifies the eating disorder based on clear symptoms.
• Parents or concerned relatives report changes in eating behaviour or significant weight loss, often pushing for treatment even if the patient is unmotivated.

If the patient openly discusses her eating disorder, it indicates she has already taken important steps. She recognizes her condition and may have undergone previous, possibly unsuccessful, treatments and has partially overcome the shame of revealing her “abnormality.”

Establishing a Therapeutic Relationship with Anorectic Patients

Taking the patient seriously as a person and in relation to her problem is the most important message to convey. Doctors should foster an atmosphere of acceptance by discussing the symptoms openly but tactfully with the patient.

Sometimes, a doctor is informed about a patient’s eating disorder by a third party. This can pose a challenge if the consultation is prompted by parental or partner pressure, a common occurrence with underage anorexic girls. The key rule in such cases is to involve the patient in the discussion. Speak with her, not about her. Doctors should not allow questions directed at the patient to be answered by the accompanying person. If this isn’t possible with the companion present, they should be asked to leave the room temporarily.

Family Involvement of Patients with Anorexia

Parents and partners should be informed of this transparency policy. Where possible, involving the family is a key pillar of anorexia treatment. Family therapy isn’t always necessary, but simply reassuring parents that the cause of Anorexia is multifaceted and not their fault can be helpful. The family can contribute a lot to overcoming the illness.

Improving Self-Esteem and Social Skills in Anorectic Patients

A core element of psychotherapy includes cognitive-behavioural therapy (CBT). Patients are encouraged to challenge dysfunctional thoughts linked to eating disorders. A major focus is on how the patient views their body and weight, which deeply impacts self-esteem. Existing beliefs are questioned, and new, reality-based thoughts are developed.

Depending on individual needs, creative therapy, animal-assisted therapy, mindfulness, body image group work, and social-pedagogical planning may be included. Before discharge, stress tests, such as therapeutic leave to the patient’s home environment, are crucial to practice applying clinic-learned skills in daily life and build confidence for the future.

Weight Improvement and Nutritional Therapy

A key focus of therapy is treating physical damage and normalizing weight. A steady, not too rapid, weight gain is crucial for the body to properly utilize the nutrients. Rapid weight gain can be harmful and increase the risk of immediate relapse. It’s believed that fast weight gain might be an unconscious defense mechanism, with the patient addressing issues only on a surface level, not emotionally. Weight gain is supported by meal plans, nutritional counselling, and portion guides, transitioning to self-management.

The aim is to achieve a weight gain of 0.3 to 1 kg per week (in inpatient settings) to reach a weight at which menstruation resumes. Typically, the target weight corresponds to the 25th BMI percentile, reflecting the expected return of menstruation at this point. Weight is typically monitored one to two times per week. After correcting malnutrition, most physical symptoms improve.

As part of nutritional therapy, we offer the following measures to normalize eating behavior:

• Comprehensive counseling on balanced nutrition
• Creation of a structured meal plan with main meals and snacks, gradually introducing calorie-dense foods that were previously avoided
• Group activities such as cooking together and “model meals” under supervision.

Treatment for Anorexia Nervosa with Psychotherapy at CHMC in Dubai

The main methods used for treating Anorexia Nervosa are: Cognitive Behavioural Therapy (CBT) and depth psychology-based psychotherapy (also called psychodynamic therapy). Analytical psychotherapy (psychoanalysis) is applied for patients with chronic, deep-rooted issues needing long-term treatment. Other evidence-based methods in the treatment for Anorexia Nervosa are: Interpersonal Therapy and Systemic Family Therapy.

Systemic family therapy plays a key role in treating children and adolescents, where involving parents and siblings is vital. It addresses family problems and works on solutions for everyone.

Treatment for Anorexia Nervosa with Cognitive Behavioral Therapy (CBT)

In CBT, mental disorders are viewed as consequences of negative or stressful learning experiences. It is believed that problematic behaviours related to mental disorders can be unlearned through new experiences. CBT aims to stimulate both conscious and unconscious learning processes, reducing problematic behaviours and symptoms. Therapy focuses on specific eating-related issues like irregular meal patterns or avoidance of certain foods. Normal eating habits are reinforced through structured meal plans and eating diaries. CBT also questions how weight and body image affect self-perception, aiming to change distorted self-perception and unhealthy attitudes. The goal is to improve self-esteem, conflict resolution skills, and social competence.

In-Depth Psychotherapy for Patients with Anorexia

In this approach, eating disorders are seen as expressions of internal and interpersonal conflicts that stem from life experiences. Understanding these conflicts and their underlying causes helps to find healthier solutions. Life experiences often emerge in the therapeutic relationship and are processed with the therapist. This creates opportunities for new, healing experiences, allowing the symptom (the eating disorder) to no longer be needed as a solution for inner conflicts. This approach can last several years and aims to bring about profound and healing personality changes.

Treatment with Interpersonal Therapy

This method focuses on improving current life situations, such as resolving interpersonal conflicts or navigating transitions, like becoming an adult or moving from school to work.

Systemic Family Therapy for Treatment of Anorexia

Involving parents and siblings in therapy is crucial, especially for younger patients. Family issues are explored, and solutions are developed for everyone involved. Changes in family dynamics can lead to positive outcomes for the patient, while family members can also benefit from the therapy. For example, parents’ guilt, which they often carry, can be alleviated.

Therapy Conditions and Treatment Duration

Due to illness-related denial, therapy conditions must be clearly defined and monitored. For lasting recovery, outpatient psychotherapy is crucial after acute treatment or hospital discharge, typically after 6 weeks to 3 months, depending on severity. Participation in self-help groups is also recommended.

Models for the Development of Anorexia Nervosa

The following functional characteristics are important for the development and maintenance of anorexia:

• Achieving autonomy, primarily by breaking free from the strong attachment to the family and distancing from parental values and expectations.
• Developing self-confidence and self-esteem
• A cry for help seeking love, security, and recognition
• Protection from the demands of adult life
• Maintaining family homeostasis

Models for Developing Anorexia Nervosa

The causes of anorexia are diverse and cannot be attributed to a single factor, such as specific risk elements. In addition to biological influences—like genetic factors or birth complications—family dynamics, societal pressures, individual traits (such as temperament), and the social environment also play a role. The condition arises from a complex, multifactorial interplay of these elements.

Anorexia as Defense Against Sexual Desires

One psychoanalytic drive theory model views anorexia as a defence against sexual desires, a way to end the psychosexual crises of puberty and return to the seemingly idealized world of childhood. Sexual impulses are either not perceived or are associated with fear. As evidence for this theory, it is pointed out that weight loss largely strips the body of secondary sexual characteristics, reducing sexual signalling, and menstruation stops.

Anorexia as Protection of Individual’s Autonomy

Another model sees anorexia as a battle for intrapsychic and interpersonal self-assertion. The anorexic symptoms highlight the struggle for identity and control over one’s life. Often overly compliant in childhood, these individuals feel powerless over their own lives. By controlling their bodies and overcoming hunger, anorexic patients experience themselves as independent. This narrow focus on control and self-determination explains the overwhelming importance of body weight.

Anorexia as Compromise Protecting Family Harmony

A third model emphasizes an interactional or family-dynamic perspective. The family systems of anorexic men and women always show distinctive patterns. Anorexia is more common in “closely bound” families, characterized by a strong drive for harmony, an idealization of family unity, the suppression of personal needs, and a willingness to sacrifice. In this atmosphere, “temptations,” such as those posed by sexuality or food, must be rejected.

Anorexia and Family Dynamics

Anorexic women and men serve an important role as symptom bearers in maintaining family cohesion and diffusing tensions and conflicts. Parental disputes and the crossing of generational boundaries place familial responsibilities on the child, intensifying their ambivalence about growing up. Moreover, families of anorexic patients often exhibit high performance demands, rigid justice, and strong moral orientation, which prevent them from exploring adulthood.

Model of Communication Theory for Developing Anorexia

Analysis from the perspective of the communication theory on different communication styles in anorexic patients according to family dynamics:

• The first communication strategy is “denial.” Families, as previously described, tend to avoid and ignore conflicts. Anorexia perfects this denial by diverting attention from existing problems, which seem to lose importance in the face of the illness.

• The second faulty solution involves developing “utopian expectations.” Anorexic women hold the belief that achieving thinness will solve all their life’s problems. Once they are thin, they mistakenly think all other difficulties will disappear.

• The third counterproductive communication solution involves creating “paradoxes.” One such paradox is closely related to the symptom: anorexic women rigorously reject food yet obsess over it constantly. They reject their bodies but focus all thoughts and actions on them. They fear normalcy and mediocrity, yet are terrified of standing out. They have a deep fear of separation but are also afraid of closeness, particularly intimate or sexual closeness. The paradox is that the parents might expect the patient to remain a child while, on the other hand, wish her to be an independent adult.

Physical Complications of Anorexia Nervosa

Despite malnutrition and low body weight, anorexic patients are often surprisingly “healthy.” This is due to the body’s remarkable ability to adapt its metabolism. However, anorexia can still cause severe damage.

Anorexia nervosa is regularly associated with endocrine abnormalities, leading to amenorrhea in women. The amenorrhea is caused by changes in peripheral thyroid hormone metabolism and elevated levels of growth hormone and cortisol. It remains unclear whether these abnormalities are part of the underlying anorexic disorder or consequences of malnutrition.

Complications in the field of general medicine:

• Cachexia
• Hypothermia
• Bradypnea
• Acrocyanosis
• Sleep disorders
• Osteoporosis

Internal medicine:

• Cardiovascular changes/heart atrophy with bradycardia and hypotension
• Slowed heart rate, which can lead to dizziness and fainting spells
• Low pulse rate
• Kidney damage
• Hematological dysfunction with anemia and leukopenia
• Reduced kidney concentration ability with polyuria, potentially leading to kidney failure
• Susceptibility to infections
• Immune dysfunction with reduced T-cell function and decreased macrophage phagocytosis
• Gastrointestinal changes
• Electrolyte imbalances
• Peripheral edema

Dermatology:

• Atrophic, dry skin
• Yellowish skin tone
• Hair loss
• Lanugo hair growth
• Superficial scars on the back of the hand
• In extreme cases, bedsores
• Brittle fingernails and toenails
• Clubbed fingers

Dentistry and ENT (ear, nose, throat):

• Tooth enamel erosion due to frequent vomiting
• Painless swelling of the parotid gland due to frequent vomiting

Endocrinology and Gynaecology:

• Elevated adrenaline levels
• Amenorrhea
• Altered peripheral thyroid hormone metabolism
• Increased growth hormone and cortisol levels

Prognosis of Anorexia Nervosa

The chances of recovery from anorexia nervosa improve significantly if professional treatment begins shortly after the onset of the illness. However, eating behaviours and attitudes toward body image and weight often remain problematic for years, even after weight normalization.

The likelihood of recovery for individuals who develop anorexia at a young age (13 or earlier) is similar to those who experience onset during mid-to-late adolescence. On average, it takes 5–6 years to fully recover, with faster recoveries being rare. The risk of relapse is particularly high in the first two years after discharge from psychiatric care.

Many people who have successfully undergone treatment report that issues around food, weight, and body image may continue to occupy a significant place in their lives. Despite these challenges, many young patients fully overcome the illness.

Chronicity and Mortality of Anorexia Nervosa

Reliable data on the chronicity and mortality of the disorder is difficult to obtain due to numerous methodological issues. The often spectacular and bizarre nature of the disorder can lead to an overemphasis on its danger. According to solid studies, at least half of all patients fully recover, while an additional 30% recover enough to lead mostly normal lives despite the illness.

Reports on mortality rates are highly variable, with an average of 5.5%, ranging from 0% to 21%. In more than half of published studies, the mortality rate is 4% or lower. Particularly in older follow-up studies, mortality rates around 20% may be partly due to inappropriate treatment.

Prevention for Anorexia Nervosa

While the development of eating disorders cannot be entirely prevented, parents, teachers, and caregivers should support children and teens during difficult phases of life. Building self-confidence is crucial, as children with a strong sense of self are better equipped to resist eating disorders. Strengthening life skills in children and adolescents is an essential aspect of preventing mental health issues.

Today there exist targeted programs to educate people about eating disorders, aiming to prevent them or identify them early. These prevention strategies often include:

• Boosting self-esteem

• Teaching critical thinking about media and beauty standards

• Helping children manage their emotions effectively

• Encouraging a positive body image

Such programs can even be integrated into school curricula.

Information for Families

Having a family member with anorexia can be a heavy emotional burden. Parents and relatives feel helpless and struggle to cope with the situation. It’s essential for parents who feel guilty or blame themselves to learn that the illness is not their fault. Educating themselves about Anorexia can help them better understand their child and respond appropriately.

Parents are a vital resource in helping their child recover. Mistakes in handling the illness can increase pressure on the child and worsen the situation. To avoid deepening the illness, they should steer clear of discussions about food, calories, or weight. It is also unhelpful to comment on the child’s appearance or figure or to praise them for eating well or gaining weight. Such behavior might trigger in children feelings of guilt and worsen their condition.

Seeking professional support or attending self-support groups for families is also beneficial. Sharing experiences with others facing similar challenges helps families better navigate the complexities of living with someone affected by Anorexia Nervosa.

Treatment for Anorexia Nervosa. Summary

The deep-rooted fear of becoming fat, even when already underweight, characterizes the body image distortion of anorectic patients. Patients set an unusually low weight threshold for themselves. They refuse to maintain the minimum normal body weight for their age and height, with weight at least 15% or a BMI of 17.5 or less.

There is usually little insight in individuals with Anorexia Nervosa into the condition, and the associated dangers are denied. Socially, it causes problems because sufferers prefer to avoid eating in the presence of others. This leads to withdrawal from many aspects of social life, as most forms of socializing involve food in some way. Avoiding public eating often coincides with secretly hoarding or throwing away food.

Goals in Treatment for Anorexia Nervosa

The treatment of Anorexia Nervosa requires a comprehensive approach that addresses both physical and psychological aspects of the disorder. Recovery involves normalizing eating habits, achieving healthy weight restoration, and engaging in psychotherapy. Family involvement is often pivotal, particularly for younger patients.

The therapeutic process aims to promote personal growth, improve self-determination, and restore joy in life. Gradual weight gain, supported by structured meal plans and nutritional counselling, is critical to prevent relapse and ensure proper nutrient absorption.

Treatment plans must be clearly defined and monitored due to the frequent denial associated with the illness. In the second step, following the acute care, outpatient psychotherapy is essential for sustained recovery. Typically, the recovery process lasts several months.

Treatment Methods for Anorexia Nervosa

Medication is not the first choice in therapy for anorexia. However, under certain circumstances, especially in patients suffering from anxiety or depression, medication, such as antidepressants, can help manage symptoms. One of the most effective antidepressants in treatment for anorexia is Fluoxetine. However, psychotherapy remains the cornerstone of treatment, focusing on long-term commitment and addressing underlying behavioural patterns and emotional issues. Another important treatment pillar is participation in self-help groups, which provide ongoing support and guidance.

The main psychotherapy methods include Cognitive Behavioral Therapy (CBT) and depth psychology-based approaches, such as psychodynamic therapy. For patients with chronic or deeply rooted issues, psychoanalysis may be used, while Interpersonal Therapy and Systemic Family Therapy are also effective, especially for children and adolescents. Systemic family therapy addresses broader family dynamics and seeks solutions that benefit all members.