Anorexia Nervosa Medications

What Is Anorexia Nervosa?

Anorexia nervosa is a serious and potentially life-threatening eating disorder characterized by a severe distortion of body image and an obsessive fear of weight gain.¹ This condition leads individuals to maintain a significantly low body weight through excessive dieting, fasting, or excessive exercise.¹

Central to this disorder is an intense preoccupation with food, body weight, and shape, often accompanied by a relentless pursuit of thinness.¹ Anorexia nervosa significantly impacts both physical health and psychological health.¹

Symptoms of anorexia nervosa include:

• Extreme restriction of food intake
• Intense fear of gaining weight, despite being underweight
• Distorted body image or self-esteem heavily influenced by perceptions of body weight and shape
• Denial of the severity of low body weight
• In females, absence of menstrual periods
• Thinning of the bones (osteopenia or osteoporosis)
• Mild anemia and muscle wasting
• Brittle hair and nails, dry or yellowish skin
• Growth of fine hair all over the body (lanugo)
• Severe constipation
• Low blood pressure, slowed breathing and pulse
• Damage to the structure and function of the heart
• Brain damage
• Multiorgan failure

How Medication is Used to Treat Anorexia Nervosa

Medication for eating disorders is often used as part of a comprehensive treatment plan for anorexia nervosa, particularly when addressing co-occurring issues like anxiety or depression. These medications can help manage symptoms that exacerbate or contribute to the eating disorder, though they are not a standalone solution for anorexia itself.

Providers typically consider medication when psychological therapies alone are insufficient, or when individuals face severe psychological distress or comorbid conditions. The goal is to stabilize the individual’s condition to enable more effective engagement with other therapeutic interventions, such as nutritional counseling and psychotherapy.

Effectiveness of Medication for Anorexia Nervosa

Current research on the efficacy of medication for anorexia nervosa presents mixed results. While some medications may alleviate co-occurring symptoms like depression or anxiety, they show limited effectiveness in directly treating anorexia nervosa or in promoting weight gain.^{2, 3}

There’s no medication yet proven to treat the core symptoms of anorexia nervosa effectively. This underscores the importance of comprehensive, multi-faceted treatment approaches for this complex disorder.

Common Anorexia Nervosa Medications

For anorexia nervosa, medications are primarily prescribed to address co-occurring mental health issues rather than the eating disorder itself. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are commonly used to treat underlying depression and anxiety, conditions that often coexist with anorexia.

Additionally, antipsychotics and mood stabilizers may be prescribed to help with severe anxiety and resistance to weight gain. These medications aim to stabilize mood and reduce distress, thereby supporting patients as they engage in other aspects of their eating disorder treatment, such as psychotherapy and nutritional rehabilitation.

Common medications prescribed for anorexia nervosa include:

Antidepressants

Antidepressants are used in anorexia nervosa treatment to alleviate symptoms of depression and anxiety, which often accompany the eating disorder.⁴ Addressing co-occurring conditions can help reduce the psychological barriers to recovery, such as obsessive thoughts about weight and food, supporting the overall treatment process and improving the individual’s ability to engage in therapy and nutritional rehabilitation.³

Antipsychotics

Antipsychotics are sometimes used in anorexia nervosa treatment to address severe anxiety, agitation, and resistance to gaining weight.^{2, 4} These medications can help in reducing the intensity of obsessive thoughts about body image and food, and in some cases, promote weight gain.⁵ This makes them a useful adjunct in the treatment of individuals who are particularly resistant to other interventions.

Mood Stabilizers

Mood stabilizers are occasionally used in treating anorexia nervosa, particularly when patients exhibit bipolar-like symptoms or severe mood fluctuations. By stabilizing mood swings, these medications can help reduce emotional distress and impulsivity, factors that can exacerbate eating disorder behaviors. Their use is tailored to individual needs, supporting patients to engage more effectively in comprehensive treatment plans.

Side Effects & Risks of Anorexia Medications

Common side effects of antidepressants, often prescribed for anorexia nervosa, include nausea, insomnia, fatigue, and sexual dysfunction. These medications can also lead to increased anxiety or agitation in some individuals.

Antipsychotics used in some anorexia nervosa cases may cause drowsiness, weight gain, and sometimes tremors or restlessness. Long-term use can lead to an increased risk of metabolic syndrome. Individuals should be aware of these potential risks and have regular check-ups to monitor their health while on these medications and communicate with their healthcare provider.

Why a Multidisciplinary Approach is Important

In treating eating disorders like anorexia nervosa, medication plays a role within a comprehensive treatment plan. While medication can alleviate symptoms like anxiety or depression, therapy approaches such as Cognitive-Behavioral Therapy-Enhanced (CBT-E) and Dialectical Behavior Therapy or DBT for eating disorders are essential to address underlying psychological issues. Group therapy for eating disorders also offers peer support and shared experiences.

Nutritional support is another crucial component, guiding patients toward a healthy relationship with food. Additionally, digital resources like eating disorder apps can provide ongoing support and tools for self-management. This multi-faceted approach ensures a holistic treatment, addressing the disorder from various angles for more effective recovery.

Anorexia Nervosa Medication Management Challenges

Managing medication in individuals with anorexia nervosa can be challenging due to compliance issues. Patients may resist taking medication, stemming from a fear of weight gain or a desire to maintain control over their body.⁴ This resistance can impede the effectiveness of the treatment plan.

Additionally, the physical health impacts of anorexia nervosa, such as gastrointestinal issues and altered metabolism, can affect medication efficacy. The body’s weakened state may not respond to medications as expected, necessitating careful monitoring and adjustments by healthcare providers to ensure both safety and effectiveness.

Where to Find Professional Help for Anorexia Nervosa

Finding a therapist specializing in eating disorders can be streamlined using an online therapist directory. These directories allow you to filter for therapists with specific expertise in eating disorders, ensuring you find someone with the right experience and approach for your needs.

If you suspect you need medication, it’s crucial to consult an in-person or online psychiatrist. Psychiatrists have the authority to prescribe medication and can work alongside your therapist to provide a comprehensive individualized treatment plan for your eating disorder.