Therapy goals
- Weight gain
- Avoidance of complications or secondary diseases
Therapy recommendations
Indications for inpatient treatment (hazard indicators):
- Underweight: BMI < 15 kg/m2 or below the third age percentile in children and adolescents.
- Bradycardia with heart rate < 40/min
- Blood pressure < 90 to 60 mmHg
- Fasting glucose (fasting blood sugar) < 60 mg/dl
- Potassium < 3.0 mmol/L or other severe electrolyte disturbances e.g. hypophosphatemia,
- Hypothermia (hypothermia) < 36.0 C
- Dehydration (lack of fluids)
- Other significant impairment of the function of the heart, liver or kidneys.
Other indications include: Suicidality (suicide risk), additional (comorbid) pyschic disorders, excessive urge to move, severe bulimic symptoms, low motivation to change, low self-control abilities, stressful factors in the environment (eg, family, workplace), and lack of outpatient treatment options or unsatisfactory outpatient treatment attempts in the medical history (medical history).
Treatment recommendations
- Anorexia nervosa generally cannot be treated with medication. Improvement of symptoms associated with anorexia nervosa are possible, however.
- In the context of inpatient treatment, a weight gain of 500 g to a maximum of 1,000 g per week should be aimed for; in outpatient treatment, the goal is 200 to 500 g per week. For details, see nutritional medicine.
- If necessary, antidepressants: citalopram, fluoxetine (Selective Serotonin Reuptake Inhibitor, SSRI); contraindication (contraindication): < 18 years of age.
- In case of severe hyperactivity and/or delusional weight phobia: olanzapine (antipsychotics (neuroleptics)), if necessary; contraindication: < 18 years of age.
- Osteoporosis prophylaxis (800 – 1,000 I.E vitamin D; 1,000 mg calcium).
- See also under “Further therapy“.
