From the Guidelines
The recommended treatment for anorexia nervosa is an eating disorder-focused psychotherapy, which should include normalizing eating and weight control behaviors, restoring weight, and addressing psychological aspects of the disorder. This approach is supported by the American Psychiatric Association practice guideline for the treatment of patients with eating disorders, published in 2023 1. The guideline recommends that adults with anorexia nervosa be treated with an eating disorder-focused psychotherapy, and that adolescents and emerging adults with anorexia nervosa who have an involved caregiver be treated with eating disorder-focused family-based treatment.
Key components of the treatment plan include:
- Individualized goals for weekly weight gain and target weight, as recommended by the APA 1
- Normalizing eating and weight control behaviors
- Restoring weight
- Addressing psychological aspects of the disorder, such as fear of weight gain and body image disturbance
- A coordinated multidisciplinary team approach, incorporating medical, psychiatric, psychological, and nutritional expertise 1
The treatment setting and specific interventions may vary depending on the individual's needs and circumstances. However, the overall goal of treatment is to promote recovery and improve quality of life, while minimizing the risks of morbidity and mortality associated with anorexia nervosa. According to the APA guideline, treatment should be tailored to the individual's specific needs and circumstances, and should involve a comprehensive and coordinated approach 1.
From the Research
Treatment Options for Anorexia Nervosa
The treatment for anorexia nervosa typically involves a combination of psychological, nutritional, and medical interventions. Some of the recommended treatment options include:
- Cognitive-behavioral therapy (CBT) 2, 3, 4, 5
- Family-based treatment for adolescents 6
- Psychodynamic therapy 3
- Nutritional counseling 2
- Antidepressant medications 2, 6
- Multidisciplinary, team-based approach 6
Effectiveness of Treatment Options
Studies have shown that:
- Combined cognitive-behavioral, psychopharmacological, and nutritional therapy can improve body mass index (BMI), eating disorder symptoms, and depression in patients with anorexia nervosa 2
- Focal psychodynamic therapy and enhanced cognitive behavior therapy can be effective in improving weight gain and reducing eating disorder psychopathology in adult outpatients with anorexia nervosa 3
- Intensive cognitive behavioral therapy can be effective in improving BMI and reducing eating disorder psychopathology in adolescents and adults with anorexia nervosa 4
- Inpatient cognitive behavior therapy can be effective in improving weight, eating disorder, and general psychopathology in patients with severe anorexia nervosa 5
Importance of Multidisciplinary Approach
A multidisciplinary, team-based approach is crucial in the treatment of anorexia nervosa, as it allows for the coordination of medical, nutritional, and psychological interventions 6. This approach can help to address the complex physical and emotional needs of patients with anorexia nervosa, and can improve treatment outcomes.