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Medical therapy in the emergency department consists of electrolyte repletion and stabilization.Multiple studies have failed to show an overall benefit for pharmacologic treatment of anorexia nervosa with psychiatric medications. However, most patients who recover will be treated with a multidisciplinary approach including medication, psychotherapy, nutritional counseling, and frequent medical evaluations.24,25 The most common class studied is SSRIs, which have been shown to be beneficial in patients with bulimia nervosa but not anorexia. However, since many patients with anorexia have concurrent mood disorders, medication may be of benefit.

There are no medicines to treat anorexia nervosa. But if you are depressed or anxious, your doctor may prescribe an antidepressant medicine. Antidepressant medicine is most proved for treating bulimia.2 For more information, see antidepressant medicines for the treatment of bulimia nervosa.

An antidepressant may help if you also have depression, an anxiety disorder, or obsessive-compulsive disorder. For more information, see one of the following topics:

1.Obsessive-Compulsive Disorder (OCD)
2.Depression
3.Depression in Children and Teens

If you have anorexia and are taking medicine, you must have regular checkups. Being malnourished or severely underweight can change the amount of medicine in your body. Too much or too little can be dangerous.

During a checkup, your doctor will note your heart rate, temperature, and blood pressure. You may also have blood tests to check the amount of medicine in your blood.

The initial goal in treating anorexia nervosa is the immediate restoration of normal weight. This is urgent for physical health and is a crucial first step in psychological recovery as well. Because people with anorexia nervosa are often sad and obsessional, it is logical to hope that SSRIs might help. Although they are widely prescribed for this purpose, research studies and the clinical experience of specialists both show that SSRIs DO NOT help low-weight patients recover. Malnutrition appears to preclude their usual benefits.

A common adage holds that food is the medicine for anorexia nervosa. Weight gain alone does often normalize mood in anorexia nervosa, but it can be hard to accomplish and frequently requires hospitalization. Although certain psychiatric medications can cause weight gain in the general population, none has had this effect with malnourished anorexic patients. Recent exciting studies suggest that olanzapine (Zyprexa) and other medications in this class may finally offer a drug that can help some low-weight anorexia nervosa patients. Olanzapine lessens anxiety and obsessional thinking, and some anorexic patients find they feel less paralyzed due to rigid thinking and behavior on this medication.

Olanzapine was originally marketed for schizophrenia, and although anorexia nervosa is not a psychotic illness, there is certainly a delusional quality about feeling fat when you are dangerously starved. Clinicians find that on olanzapine, some people with anorexia nervosa are better able to grasp their situation and engage in treatment. Low-dose, short-term use may facilitate that elusive transition from low to healthy weight for some people, speeding the initial steps to recovery and sometimes averting hospitalization.

No medications are available that effectively treat patients suffering from anorexia nervosa, but a few behavioral therapies may help prevent a relapse and offer other limited benefits, according to a new review of currently available research on eating disorders released today by HHS’ Agency for Healthcare Research and Quality. The review also found evidence that several medications and behavioral therapies can help patients suffering from bulimia nervosa and binge eating disorder.

Eating disorders are psychiatric illnesses with serious, potentially life-threatening medical consequences. Anorexia nervosa is characterized by an obsession with weight, severely restrained eating, sometimes exercising excessively, and an inability to maintain a healthy body weight. In bulimia nervosa, excessive eating is followed by efforts to compensate by vomiting, misusing laxatives or diuretics, fasting, or exercising excessively. Those who suffer from binge eating disorder eat excessively but do not purge.

This review of the scientific literature published since 1980 was conducted by AHRQ’s Evidence-based Practice Center at RTI International and the University of North Carolina at Chapel Hill. It did not find any medications effective in treating anorexia nervosa but did find several behavioral therapies that appear to offer limited help. Cognitive behavioral therapy (CBT), a form of psychotherapy that encourages patients to develop thinking patterns that will counteract their unhealthy eating behavior, helped prevent relapse in adult anorexic patients once their weight had been restored to a normal level. There was not enough evidence to determine whether CBT works during the acute phase of the illness, before a patient with anorexia nervosa has been restored to a normal weight.

The researchers concluded that family therapy does not appear to work with adults with longstanding anorexia nervosa. One study found that family therapy worked better for younger patients than for older, more chronic patients. One particular kind of family therapy, which starts by encouraging parents to oversee a young person’s nutrition, appeared to help these patients gain weight and make psychological improvements.

Both medications and behavioral therapies were found helpful in treating bulimia nervosa; however, there was no clear information about how to combine medications with behavioral treatments.