Treatment of Anorexia Nervosa:
After the diagnosis of Anorexia Nervosa, the goal is to prevent the associated complications that can lead to organ damage or even death. Treatment begins by addressing the underlying metabolic conditions. It is imperative that these be addressed slowly to avoid the re-feeding syndrome.
Re-feeding syndrome is life-threatening and results in heart failure, decreased phosphate, and dangerous changes in potassium, sodium and magnesium. It is essential that a physician and nutritionist collaborate so that re-feeding can occur without fear of re-feeding syndrome occurring.
Cardiac failure is most worrisome within the first 2 weeks of re-feeding. The heart cannot take the sudden increased metabolic demand that occurs with eating after a long period of starving. Therefore, it is essential that re-feeding occur slowly and with a daily weight gain of 0.2-0.4 kg to reduce the risks of developing this syndrome.
Addressing the psychological component of anorexia nervosa is essential to treating this disease. Speaking with a psychiatrist to determine an individualized therapy treatment plan that will focus on the underlying issues will allow for sustained recovery. Involving the patient and their loved ones is a key factor in successful treatment. Family and loved ones can offer support and keep an eye on the patient for relapses in behavior.
Pharmacotherapy can also be useful in individual cases. There have been studies that have shown that the use of Fluoxetine in these patients has offered some benefit. Olanzapine, with adjunct therapy, has also been shown to be useful in treatment. Each patient is different, so an individualized treatment plan must be established to maximize the probability of a successful recovery.
Prognosis of Anorexia Nervosa:
The prognosis varies. There is only an approximately 50% chance of patients maintaining long term recovery. There is a significant percentage of patients that still remain emaciated or thin; while the other percentage become overweight. Suicide is a major concern in patients who are suffering from this disease.
Patients who have the disease after age 11 and prior to adulthood have a more favorable outcome than those who were younger than age 11 or who develop the disease in adulthood. Prognosis is based on the age of onset, the length of symptoms, underlying dysfunctional family relationships and inpatient care.
Each individual is different and thus care must be individualized. With the appropriate intervention and treatment, patients can recover. It is imperative to remember this is a lifelong disease that must be continually treated through therapy. Treating the underlying issues will help to prevent the recurrence or development of anorexia nervosa.