Inpatient management of anorexia nervosa and bulimia

The principles guiding the inpatient treatment of adolescents with anorexia nervosa or bulimia are no different than those guiding the treatment of adolescents with cystic fibrosis, leukemia, or depression. The patient is treated first and foremost as an adolescent, avoiding reinforcement of the sick role. Biologic, psychologic, and social needs must all be considered. Further, the family must be included in the treatment, since the vast majority of patients will be returning to their families after discharge from the hospital. Hospitalization may be required for a number of reasons. Regardless of the indications for admission to the hospital, a consistent, individualized, positively reinforcing plan for evaluation and treatment needs to be developed and executed. By so doing, the hospital team is in a unique position to help the patient and the family develop more healthy patterns of acting and interacting.