It is difficult to recover from anorexia nervosa without support. The prescription of drugs, the establishment of nutritional care and the proposal to undertake psychotherapy can then be considered to treat anorexia nervosa. Sometimes, specialized hospitalization may be necessary.

Medication management

Studies have shown that fluoxetine (Prozac®), an antidepressant, is effective in combating depression often associated with anorexia but also in helping anorexics maintain a normal weight obtained after hospitalization.

Anxiolytics (benzodiazepines) may be prescribed in certain cases, in particular to reduce the anxiety that invades people with anorexia before meals.

Finally, other drugs may be prescribed after medical evaluation on the physiological consequences of undernutrition and purging lines (deficiencies, digestive, renal, cardiac, endocrine disorders, etc.).

Nutritional care

This support is very important and effective in addition to drug treatment and psychotherapy. The coordinating doctor of the multidisciplinary team that accompanies the person suffering from anorexia nervosa will set many objectives to be achieved, including weight gain via a renitrution program adapted to the person’s needs and in which the latter will be invited to invest. .

Nutritional therapy will allow the anorexic person to relearn how to eat: resume a balanced diet, learn about taboo foods (sugar, butter, etc.), eat slow sugars again to avoid crises, get used to eating meals again while sitting at the table, 4 per day, in reasonable amounts. Information related to weight and diet will be provided and explained, such as the theory of natural weight. With this therapy, we try to change the relationship that the patient has with food. Finally, this method is also interested in the compensatory bleeding behaviors that the patient used to use. It therefore also aims to enable him to lose the habit of using methods such as laxatives if this were the case by providing him with theoretical information which will explain the ineffectiveness of such behaviors.

Psychotherapeutic support

Psychotherapies are offered for the most part, individually or in groups, but they all have the objectives: to improve the perception and self-esteem of the person with anorexia and to work on certain conflicts. 

Most of them concern the person who suffers from anorexia but they can also be addressed to the family (parents, spouses, siblings) of the patient, directly affected by this disease.   

Behavioral and Cognitive Therapies (CBT)

They are very effective in treating the symptoms of anorexia since it involves getting the person to observe their pathological behaviors (purging behaviors) and their dysfunctional thought patterns concerning diet, weight, self-esteem. self and body image. The goal of TBI is not to find the causes or the origin of the disorder but to act on it.

Systemic family therapy

This therapy is called “systemic” because it considers the family group as a system and a set of interdependent elements. In this case, the family would not be made up of independent elements (parents / children), but of entities which influence each other.

Systemic family therapy studies the modes of communication and the different interactions within the family in order to subsequently try to improve internal relationships. When one member of a family is affected by a disease like anorexia, the other members will be affected. For example, meal times can be particularly difficult for the family to manage. The actions and words of each other can be helpful or on the contrary harmful for the patient. It is not a question of making each other feel guilty, nor of making them guilty of anorexia, but of taking into account their suffering and making everyone move in the right direction for them but also for the patient.

Psychodynamic psychotherapy

This psychotherapy is inspired by psychoanalysis. It is widely used in order to support the person in the search for conflicts (personal, interpersonal, conscious and unconscious,…) which can be at the origin of the appearance of eating disorders.

Interpersonal psychotherapy

This short therapy, mainly used to treat depression, has been proven to help people with eating disorders. During interpersonal psychotherapy, the subject will not be food but the person’s current interpersonal difficulties which inevitably have consequences on his eating behavior.

Hospitalization

Sometimes, specialized hospitalization may be necessary to increase the chances of recovery of the patient, after failure of outpatient treatment, in cases of severe weight loss and when significant health problems are detected.

Depending on the establishment, conventional specialist hospitalization or day hospitalization may be offered. For the latter, the person will go to the hospital every day of the week for treatment and will return to their home in the evening.

In a service specializing in the management of eating disorders, the patient receives care provided by a multidisciplinary team (doctor, nutritionist, psychologist, etc.). Treatment often includes refeeding, nutritional rehabilitation, psycho-educational support and psychotherapy follow-up. 

In some cases, the most serious, the medical team may decide to use nasogastric tube feeding (tube that allows entry through the nasal cavities into the stomach) or intravenous hyperalimentation.