Navigating the Complexities of Managing Severe Anorexia Nervosa in a Medical Ward: A Case Report

Anorexia nervosa (AN) is a severe, life-threatening psychiatric disorder often accompanied by significant physical health complications, requiring specialized treatment that is challenging to provide in a general medical setting. This case report presents the complex challenges encountered in managing a 49-year-old woman with severe AN of the purging subtype in a general medical ward setting. Admitted with a life-threatening low body mass index (BMI) of 7.9 and critical physical health issues, her case underscores the intricate relationship between the psychiatric and physical health aspects of AN, especially in an environment with limited specialized resources. The report details her care course, which included medical stabilization, management under the Mental Health Act (MHA), and challenges such as observation, nutritional support, and the ethical complexities surrounding patient autonomy and consent. Additionally, the case highlights systemic limitations, including the lack of specialized training for medical and nursing staff in treating severe AN, as well as the need for multidisciplinary collaboration to navigate risks associated with nasogastric (NG) feeding, refeeding syndrome, and co-occurring psychiatric issues. This report emphasizes the necessity for improved training, specialized resources, and coordinated care in treating complex cases of AN in non-specialized settings to enhance patient outcomes.