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The first line treatment for anorexia is usually focused on immediate weight gain, especially with those who have particularly serious conditions that require hospitalization. In particularly serious cases, this may be done as an involuntary hospital treatment under mental health law, where such legislation exists. However, in the majority of cases people with anorexia are treated as outpatients with input from physicians, psychiatrists, clinical psychologists, nutritionists, dieticians and other mental health professionals.
A recent clinical review has suggested that psychotherapy is an effective form of treatment and can lead to restoration of weight, return of menses among female patients, and improved psychological and social functioning when compared to simple support or education programmes.[41] However, this review also noted that there are only a small number of randomised controlled trials on which to base this recommendation, and no specific type of psychotherapy seems to show any overall advantage when compared to other types. Family therapy has also been found to be an effective treatment for adolescents with anorexia[42] and in particular, a method developed at the Maudsley Hospital is widely used and found to maintain improvement over time.[43]
Drug treatments, such as SSRI or other antidepressant medication, have not been found to be generally effective for either treating anorexia,[44] or preventing relapse[45] although it has also been noted that there is a lack of adequate research in this area. It is common, however, for antidepressants to be prescribed, often with the intent of trying to treat the associated anxiety and depression.
Supplementation with 14mg/day of zinc is recommended as routine treatment for anorexia nervosa due to a study showing a doubling of weight regain after treatment with zinc was begun. The mechanism of action is hypothesized to be an increased effectiveness of neurotransmission in various parts of the brain, including the amygdala, after adequate zinc intake begins resulting in increased appetite.[46]
There are various non-profit and community groups that offer support and advice to people who suffer from anorexia or who care for someone who does