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August 28, 2017

Anorexia & Statistics for Success After Inpatient Treatment

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For many individuals who struggle with the eating disorder anorexia nervosa, intensive treatment is needed to intervene with the most severe and problematic symptoms associated with this potentially fatal disease.

Acute treatment interventions are often provided within inpatient hospitalization and can be instrumental in providing medical and psychiatric stabilization. Inpatient eating disorder treatment for anorexia nervosa is often the first step in the recovery process, with an individual often progressing to less acute levels of treatment once stabilized with inpatient care.

Understanding Inpatient Eating Disorder Treatment

Individuals with anorexia nervosa are at high risk for several life-threatening conditions as a result of the associated behaviors, including irregular heart rhythms, risk for heart failure, severe dehydration, kidney failure, fainting, weakness, gastrointestinal problems, anemia and increased risk for suicide.

Inpatient hospitalization can serve as an effective intervention for providing stabilization, though it is not intended to provide long-term support or address the underlying issues related to eating disorder development. Most inpatient eating disorder treatment stays are short-term, ranging from two weeks to several weeks for anorexia nervosa, depending on weight restoration needs and medical/psychiatric stability [1].

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Inpatient hospitalization for anorexia nervosa provides 24/7 supervision and medical monitoring, including supervision of all meals and snacks. Medical interventions that may be utilized might include but are not limited to:

  • IV hydration
  • Bed rest
  • Feeding tubes, including NG tubes

In some instances, if a patient is severely malnourished due to anorexia nervosa, feedings via tube feeds or TPN may be initiated, either voluntary or under the force of legislation. This also requires constant medical supervision and monitoring due to the risks involved.

Specialized inpatient eating disorder treatment units may offer additional therapeutic interventions, such as psychotherapy, nutritional counseling, and individual/family therapy. Discharge planning is an essential component of inpatient treatment, as this supports the continuum of care for anorexia treatment to successfully bridge an individual in recovery to their next phase of treatment.

Relapse and Recovery Statistics

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Measuring success after inpatient treatment for anorexia nervosa is often dependent on how relapse and recovery are defined. Currently, research literature has varying definitions of relapse, remission, and recovery from anorexia nervosa, which can make it more difficult to understand if a person has responded well from treatment interventions, such as inpatient treatment.

Some definitions of relapse are dependent on weight or BMI measures, whereas other research defines relapse as a 15 percent loss of average body weight after achieving normal body weight [2]. In other situations, relapse from anorexia nervosa can be partial if there is a recurrence of psychological symptoms but sustained weight, or vice versa.

Research has also demonstrated that a large proportion of individuals relapse in the process of recovering from anorexia nervosa, and the majority of studies report statistics of relapse rates greater than 25 percent [3]. Relapse rates for anorexia nervosa tend to be particularly high within the first year following treatment, with particularly risk of relapse occurring as early as 3 months post-treatment [4].

The overall lack of a consensus guidelines for eating disorder relapse and recovery in the eating disorder community make it more difficult to measure the effectiveness and success of certain treatment interventions, such as inpatient treatment. While inpatient treatment for anorexia nervosa may be effective in medical and psychiatric stabilization, it may be more challenging to understand the productiveness of inpatient treatment alone.

Focusing on Comprehensive Care for Anorexia Nervosa

In most situations, comprehensive care is the best approach for anorexia nervosa treatment, which may include a range of eating disorder treatment levels, from inpatient to outpatient care. Connecting with an eating disorder professional who can assess an individual and determine the most appropriate level of care for anorexia treatment can help in determining an individualized course of action for treatment.

Woman struggling with anorexia sitting by the oceanSuccess in anorexia recovery is highly individualized and typically defined by a variety of factors. Having professional support throughout anorexia recovery, particularly in the treatment phases and the first year following treatment, can help ensure that a person has the resources needed through any of the struggles or challenges that they may be facing.

If you have been struggling with anorexia nervosa and are unsure about the most effective form of treatment for your recovery, consider connecting with an eating disorder specialist today. No matter what your journey has been, there is absolutely hope for recovery and healing from anorexia nervosa.


Crystal Headshot 2About the Author: Crystal Karges, MS, RDN, IBCLC is a Contributing Writer for Eating Disorder Hope.

Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating. Combining clinical experience with a love of social media and writing. As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH and nutrition private practice.


References:

[1]: National Eating Disorder Association, “Levels of Care in Eating Disorder Treatment – A Part of the Parent, Family and Friends Network (PFN) Webinar Series”, https://www.nationaleatingdisorders.org/sites/default/files/NEDA%20Webinar%20Levels%20of%20Treatment.pdf Accessed 6 July 2017
[2]: Eckert ED, Halmi KA, Marchi P, Grove W, Crosby R. Ten-year follow-up of anorexia nervosa: clinical course and outcome. Psychol Med. 1995;25(1):143–56.
[3]: Strober M, Freeman R, Morrell W. The long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse, and outcome predictors over 10-15 years in a prospective study. Int J Eat Disord. 1997;22(4):339–60.
[4]: Khalsa, Sahib S, et al. What happens after treatment? A systematic review of relapse, remission, and recovery in anorexia nervosa. Journal of Eating Disorders 2017 5:20.


The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on August 28, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on September 28, 2017.
Published on EatingDisorderHope.com

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