The term anorexia, or absence of appetite, is a misnomer because patients are often hungry and can be quite preoccupied with food. They may cook elaborate meals for others, hoard food, or establish intricate rituals around the food they do eat. These behaviors resemble those seen in some patients with obsessive-compulsive disorders, and may extend outside the arena of eating. Generally, patients with anorexia nervosa are very secretive and defensive about their eating habits and may deny any problems when confronted. Treatment Weight gain is the only definitive treatment for anorexia nervosa.
Treatment generally involves a team approach.
In both the in- and outpatient setting, management usually includes a dietitian for nutritional education and development of an eating plan, a psychologist, and sometimes a psychiatrist. The role of hormone therapy in the treatment of anorexia is controversial. If antidepressants are to be used, they should be begun at a low dose and titrated very slowly. Fluoxetine may be helpful in the prevention of relapse. Family therapy may be appropriate when the patient is young or has disease of relatively short duration.