Medical Health Encyclopedia

Intravenous Feedings. Intravenous feedings may be needed in life-threatening situations. This involves inserting a needle into the vein and infusing fluids containing nutrients directly into the bloodstream. Overzealous administration of glucose solutions can trigger the so-called refeeding syndrome, in which phosphate levels drop severely and cause a condition called hypophosphatemia. Emergency symptoms include irritability, muscle weakness, bleeding from the mouth, disturbed heart rhythms, seizures, and coma.

The Role of Exercise in Recovery

The role of exercise in recovery is complex, since for those with anorexia, excessive exercise is often a component of the original disorder. However, very controlled exercise regimens may be used as both a reward for developing good eating habits and as a way to reduce the stomach and intestinal distress that accompanies recovery. Exercise should not be performed if severe medical problems still exist and if the patient has not gained significant weight.

Psychologic Approaches and Medications for Patients with Anorexia

Psychologic Therapies Used in Anorexia. Some studies suggest that for adolescents with anorexia, family therapy that employs cognitive-behavioral techniques works best. For those with late-onset anorexia, individual supportive therapy may be more effective, particularly since many people with anorexia lack a sense of self-survival. Family therapy is important for younger and older individuals. It should be noted that people with severe anorexia often have mental deficits and may not respond well to psychologic therapies until they have regained weight.

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Antidepressants. Studies have not reported many benefits from selective serotonin reuptake inhibitors (SSRIs), the antidepressants that are often useful for patients with bulimia. Some SSRIs cause weight loss. Furthermore, experts fear that the effects of starvation may intensify their side effects and reduce their effectiveness. Nevertheless, few studies have actually been conducted using SSRIs in anorexia, particularly using some of the newer drugs. Some, in fact, suggest that SSRIs may help prevent relapse in patients who have been treated and have restored weight. And a small study using sertraline (Zoloft) reported improvement in patients who were initially treated with the SSRI. These drugs may also be specifically useful for people with anorexia who also have obsessive-compulsive disorder (OCD) or similar features. More work is needed to determine if there is a possible role for these drugs.