Treatment of anorexia nervosa

Anorexia nervosa is a well-known syndrome occurring predominantly in adolescent girls, and characterised by amenorrhoea and gross weight loss due to self-induced restriction of food intake. The prognosis is poor but full recovery does occur as illustrated by long-term follow-up of 22 unselected patients, eight of whom have recovered to date. A definite treatment programme is recommended as likely to improve the prognosis. This consists of hospital admission for restoration of normal weight, combined with family intervention and continuing long-term individual psychotherapy. The hospital regime for weight restoration involves bed rest, refeeding by experienced nursing staff, and a situation where the patient has no opportuinty for avoiding weight gain but receives constant reassurance. Under these conditions restoration of full normal weight is achieved, as illustrated by 14 admissions to hospital with only one failure to acheive target weight.