Logan Reid
Anorexia nervosa is a complex condition that involves severe calorie restriction and often a very low body weight. It is an eating disorder that can cause serious, life-threatening complications if left untreated. Hospitalization for anorexia is necessary when the physical effects of the disorder become severe, and inpatient treatment is typically used when a person needs medical stabilization. Treatment for anorexia in a hospital setting involves input from several medical and mental health professionals, including psychiatrists, physicians, therapists, and dieticians. This multidisciplinary approach aims to stabilize the patient's physical health and increase body weight and nutritional intake through the refeeding process, therapeutic intervention, and nutritional counseling.
| Characteristics | Values |
|---|---|
| Reason for hospitalisation | Medical instability |
| Type of hospitalisation | Inpatient hospitalisation |
| Treatment | Multidisciplinary approach |
| Treatment providers | Psychiatrist, medical physician, eating disorder therapists, registered dietician |
| Treatment plan | Treatment for severe or life-threatening physical conditions, refeeding, therapeutic intervention, nutritional counselling, nasogastric tube feeding |
| Duration | Short-term |
| Post-treatment | Move to a lower level of care, such as residential or inpatient treatment, partial hospitalisation, intensive outpatient treatment, or outpatient treatment |
| Patients | Children and young people are usually referred to children and young people's mental health services or a children's health team in the hospital |
| Therapy | Talking therapies, CBT, family therapy, adolescent-focused psychotherapy |
| Diet | Specialist dietary advice, meal plan, vitamin and mineral supplements |
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What You'll Learn
When is hospitalisation required?
Anorexia nervosa is a complex eating disorder that involves severe calorie restriction and a very low body weight. It causes a fear of gaining weight and a distorted body image. It is a mental health condition that impacts behaviours and attitudes toward food, eating, and body image. It commonly develops during adolescence but can affect people of any gender or age.
Hospitalisation is often required when an individual is suffering from severe physical health complications due to anorexia. These complications can become increasingly severe or even fatal if not managed effectively. Hospitalisation may also be necessary when an individual is deemed to be at significant risk of suicide. Inpatient treatment can be voluntary or involuntary when a professional has deemed hospitalisation to be in the individual's best interest.
There are no clear evidence-based guidelines for hospital admission, and clinical judgment based on expert opinion is the main driver of the decision to admit a patient for inpatient care. Acceptable indications for hospital admission include weight being less than 75% of the ideal body weight, a temperature lower than 35.5°C (95.9°F), and a heart rate of less than 45 beats per minute. Other guidelines recommend hospital admission when the heart rate is less than or equal to 40 beats per minute, and when there is hypotension and orthostatic change in pulse and blood pressure.
Hospitalisation may also be required when an individual does not have appropriate support at home or access to the necessary resources to improve their health. This is especially important for children and young people, who are usually offered family therapy as part of their treatment. Hospitalisation can provide the intensive short-term care needed to stabilise the individual's condition and address the physical and mental health consequences of the disorder.
Inpatient treatment for anorexia involves a multidisciplinary team of medical providers, dietitians, nurses, psychiatrists, and therapists who collaborate to provide the necessary care. The treatment is tailored to the individual and aims to address multiple aspects of the illness, including medical stabilisation, nutritional rehabilitation, and management of mental health conditions.
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Multidisciplinary treatment approach
Anorexia nervosa is a complex condition with mental, behavioural, and physical symptoms. It is an eating disorder that involves severe calorie restriction and often a very low body weight. It causes a fear of gaining weight and a distorted body image. Treatment for anorexia is essential due to its life-threatening complications. Hospitalization for anorexia nervosa requires a multidisciplinary treatment approach, involving collaboration between various medical and mental health specialists. Here is how a multidisciplinary treatment approach works:
Medical Physician
A medical physician is responsible for addressing the physical health complications that arise from anorexia nervosa. They first treat any severe or life-threatening physical conditions resulting from the eating disorder. This initial step is crucial in stabilizing the patient's physical health. Anorexia nervosa can cause various physical issues, such as low vital signs (pulse, temperature, and blood pressure), and it can increase the risk of developing osteoporosis due to inadequate nutrient intake. Medical physicians closely monitor the patient's health and help them restore a healthy weight gradually.
Psychiatrist
The involvement of a psychiatrist is crucial in addressing the mental health aspects of anorexia nervosa. They provide psychiatric care and support to patients, helping them understand their eating problems and underlying thoughts and worries that contribute to their disorder. Psychiatrists also assess the patient's risk of suicide, which is an important factor in determining the need for hospitalization.
Eating Disorder Therapists
Specialized therapists play a vital role in helping patients manage their behaviours and attitudes toward food and eating. They provide therapeutic interventions, such as talking therapies, to help patients feel more comfortable with food and improve their relationship with eating. These therapies can include cognitive behavioural therapy (CBT), which is offered to both adults and adolescents. Family therapy is also an option, where the patient and their family explore how anorexia has affected them and how the family can provide support during recovery.
Registered Dietician
Registered dieticians provide specialist dietary advice and create meal plans to ensure patients receive adequate nutrition and progress towards a healthy weight. They advise on the best foods to eat and often recommend vitamin and mineral supplements to compensate for any nutritional deficiencies caused by anorexia nervosa. Dieticians may also collaborate with other healthcare professionals to determine when nasogastric (NG) tube feeding is necessary.
The multidisciplinary treatment approach for anorexia nervosa in a hospital setting involves the collaborative efforts of these professionals to address the complex physical, mental, and behavioural aspects of the condition. The goal is to stabilize the patient's physical health, improve their mental wellbeing, and help them develop a healthier relationship with food.
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Stabilising physical health
Anorexia Nervosa is a complex condition that has mental, behavioural, and physical symptoms. It is an eating disorder that involves severe calorie restriction and often a very low body weight. It can cause serious and life-threatening complications, and, therefore, requires immediate medical attention.
Upon hospitalisation, the first step in treating anorexia is to stabilise the patient's physical health. This involves addressing any severe or life-threatening physical conditions that have arisen as a result of the eating disorder. The patient's vital signs, such as pulse, temperature, and blood pressure, are monitored and treated if they are found to be severely low. The patient's weight is also closely monitored, and the refeeding process is initiated to increase body weight and nutritional intake. This process is often challenging and requires therapeutic intervention and nutritional counselling to help manage behaviours and attitudes toward food and eating. It is important to ensure that the patient receives adequate nutritional support and that their meal plan is supervised by a medical professional. In some cases, nasogastric (NG) tube feeding may be necessary.
The patient's overall physical health is also assessed, and any additional medical complications are treated. For example, anorexia can weaken bones and increase the risk of developing osteoporosis, especially in children and young people. Therefore, vitamin and mineral supplements are often recommended to ensure the patient receives all the necessary nutrients for a healthy body and to support their growth and development. The patient's mental health is also addressed during this time, as anorexia is a condition that affects both the mind and the body.
The main goal of hospitalisation for anorexia is to stabilise the patient's physical health and ensure they are medically stable. Once this is achieved, the patient can be discharged or transferred to a lower level of care, such as residential or inpatient treatment, partial hospitalisation, or outpatient treatment. It is important to note that treatment for anorexia requires a multidisciplinary approach, and patients will often continue to receive support and treatment from various medical and mental health professionals during their recovery journey.
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Therapeutic intervention
Anorexia nervosa is a complex condition with mental, behavioural, and physical symptoms. It is an eating disorder that involves severe calorie restriction and often a very low body weight. It causes a fear of gaining weight and a distorted body image. Treatment for anorexia nervosa requires a multidisciplinary approach, with input from several medical and mental health professionals, including psychiatrists, medical physicians, eating disorder therapists, and registered dieticians.
- Talking Therapies: Individuals with anorexia are often offered various talking therapies, such as cognitive-behavioural therapy (CBT), individual psychotherapy, or family therapy. CBT is a common approach, typically involving weekly sessions for up to 40 weeks, with more frequent sessions in the initial stages. The goal is to help patients feel more comfortable with food and eating, addressing the underlying fears and anxieties associated with weight gain.
- Nutritional Counselling: This type of therapy focuses on helping individuals with anorexia manage their behaviours and attitudes toward food and nutrition. It involves education about healthy eating patterns, meal planning, and understanding the nutritional requirements of the body. Nutritional counselling aims to empower individuals to make healthier food choices and develop a more positive relationship with food.
- Mental Health Support: Treating the mental health aspects of anorexia is essential. Therapists and psychiatrists work with patients to address any underlying mental health conditions, such as anxiety, depression, or obsessive-compulsive disorder (OCD), which are often associated with anorexia. This may involve individual therapy, group therapy, or medication, depending on the specific needs of the patient.
- Family Involvement: Family therapy is often included as part of the treatment plan, especially for younger patients. This involves educating family members about anorexia, exploring how it has impacted the family, and developing strategies for providing support during and after treatment. Family members can play a crucial role in helping their loved one recover and maintain a healthy relationship with food.
- Support Groups and Peer Support: Connecting with others who have shared similar experiences can be incredibly beneficial. Support groups and peer support networks provide individuals with anorexia a sense of community, understanding, and hope. They offer an opportunity to share experiences, learn from others, and develop a sense of social connectedness, which can be very empowering during recovery.
- Discharge Planning: Therapeutic intervention also involves preparing individuals for life after hospital treatment. This includes developing strategies for relapse prevention, identifying triggers, and creating a plan for ongoing therapy, outpatient care, or support group involvement. The goal is to ensure a smooth transition back to everyday life and empower individuals to maintain their recovery and continue their journey towards a healthy relationship with food.
The therapeutic interventions used in the treatment of anorexia in a hospital setting are tailored to the individual's specific needs and may vary depending on the severity of the condition, the presence of other mental health disorders, and the patient's response to treatment. The overall aim is to address the complex interplay between the mental, behavioural, and physical aspects of anorexia, ensuring a comprehensive approach to help individuals recover and develop a healthier relationship with food and their body image.
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Outpatient care
Anorexia nervosa is a complex condition that has mental, behavioural, and physical symptoms. It is an eating disorder that involves severe calorie restriction and often a very low body weight. It causes a fear of gaining weight and a distorted body image. Treatment for anorexia is essential due to its life-threatening complications.
Most people with anorexia receive treatment through outpatient care services, allowing them to remain at home while treating the condition. Outpatient care is a lower level of care that individuals transition to after their condition has been stabilized through inpatient hospitalization. Outpatient treatment is suitable for individuals with anorexia who do not have serious health complications and are not at significant risk of suicide.
During outpatient care, individuals with anorexia will receive input into their treatment plan from several medical and mental health professionals, including a psychiatrist, a medical physician, eating disorder therapists, and a registered dietician. They will undergo the refeeding process, which aims to increase body weight and nutritional intake. This process requires therapeutic intervention and nutritional counselling to help manage behaviours and attitudes toward food and eating. Management of these symptoms allows for the refeeding process to be successful.
In addition to dietary advice, outpatient care for anorexia includes talking therapy to help individuals understand their eating problems and feel more comfortable with food. Cognitive behavioural therapy (CBT) is a common form of talking therapy offered, which typically involves weekly sessions for up to 40 weeks. Family therapy is also provided for children and adolescents, involving family members in therapy sessions to explore how anorexia has affected the individual and how the family can support their recovery.
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Frequently asked questions
Hospitalization for anorexia is required when the physical effects of the disorder become severe and life-threatening. Eating disorders can be deadly, and anorexia has the highest mortality rate of any mental health condition. Hospitalization is used to help stabilize a person's condition.
People with anorexia are typically admitted to the hospital when one or more of the following criteria are met:
- Body weight is severely lower than normal for the height, age, and gender of the individual.
- Vital signs such as pulse, temperature, and blood pressure are severely low.
- The individual has severe physical concerns that may be life-threatening.
- The individual is under 18 and does not have appropriate support at home or access to resources to improve their health.
- Professionals deem the individual to be at significant risk of suicide.
During inpatient treatment for anorexia, individuals receive input from several medical and mental health professionals, including psychiatrists, physicians, eating disorder therapists, and registered dieticians. First, any severe or life-threatening physical conditions are treated, and the refeeding process is initiated to increase body weight and nutritional intake. This often requires therapeutic intervention and nutritional counseling to help manage behaviors and attitudes toward food. If necessary, nasogastric (NG) tube feeding may be implemented.
Inpatient hospitalization is typically short-term due to its high cost. Once an individual's condition has been stabilized, they are moved to a lower level of care, such as residential treatment, partial hospitalization, intensive outpatient treatment, or outpatient treatment.
