Treatment of Anorexia nervosa

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Anorexia is a serious and complex illness and usually requires specialist medical care.

Guidelines for the treatment published by the National Institute for Clinical Excellence (NICE) in January 2004 sets the standard for NHS treatment of eating disorders in England and Wales.

The main guidelines for anorexia nervosa:

GPs should make an early diagnosis of an eating disorder so those seeking help can be assessed and receive treatment at the earliest opportunity.
Assessment should be comprehensive and include physical, psychological and social needs.
You should expect to receive most care as an outpatient. You can expect to be offered a number of psychological treatments (including cognitive analytic therapy (CAT), interpersonal psychotherapy, focal psychodynamic therapy) provided by a specialist in the psychological treatment for eating disorders.
There should be careful monitoring of your physical health to assess your physical risk. Outpatient psychological treatment should normally last at least six months.
If in-patient treatment is necessary (because you have failed to improve with outpatient treatment or there is a significant risk of suicide or self-harm) it should be in a unit experienced in eating disorders that can provide skilled implementation of re-feeding and careful physical monitoring, as well as a number of psychological treatments from a specialist with experience of treating anorexia nervosa.
If you are a teenager you should be treated in age-appropriate settings.
You should be treated near to home, to maintain social and occupational links.
If you are a teenager with anorexia nervosa, family members (including other children in the family) should be involved in your treatment and care, to directly address the eating disorder.
If you have long-term anorexia nervosa and you are not under the care of secondary care services you should be offered an annual health review from your GP.

Treatment is planned to reverse weight loss and normalise eating habits so that the person achieves a normal weight for their age and height. Treatment is usually most effective when the person positively wants to get better. However, as anorexia is often associated with very complex emotional issues, recognising the underlying causes and learning to cope with them can be the most effective way to treat the illness.

You may need medication for other illnesses that occur as a result of anorexia nervosa. Drug therapy using antidepressants may be used.

Advice can also be sought from specialist eating disorder help lines.

Occasionally a person with anorexia may become so weak that they require immediate hospitalisation. Where weight loss is so severe that there is an immediate threat to life, a doctor may use the Mental Health Act or Children Act to admit a person with anorexia into hospital against their wishes. Every effort is made to avoid this and it only happens in extreme circumstances. This is sometimes referred to as being â€˜sectionedâ€™ because a doctor will use a specific section of the Mental Health Act.

If someone is taken into hospital in this way, the hospital will manage the intake of food and fluids. This lack of control can be very distressing to someone with anorexia nervosa and will only be continued as long as healthcare professionals see it as the only way to prevent death.