Treatment of Anorexia Nervosa—New Evidence-Based Guidelines

Overview

This review in the Journal of Clinical Medicine (Resmark et al., 2019) presents the revised German S3 guideline for eating disorders as it applies to anorexia nervosa, discusses changes since the original 2011 version, and compares it with current international evidence-based guidelines.

Why it matters

Anorexia nervosa is the most severe eating disorder. It often has a protracted course and carries the highest mortality of any psychiatric illness. It is characterised by restricted energy intake leading to substantial weight loss, which can progress to cachexia and serious medical complications, and it places heavy costs on patients, their families and society.

What the guidance covers

The guideline aims to give everyone involved in care, including clinicians, patients and relatives, scientifically grounded recommendations on diagnosis and treatment. It addresses assessment, choice of treatment setting, psychotherapeutic approaches for adults and for children and adolescents, nutritional rehabilitation and management of medical complications, and the limited role of medication.

Comparison with international guidance

The authors find that many recommendations in the revised German guideline are consistent with other international guidelines. The evidence base has grown in both quality and quantity since 2011, but important gaps remain.

Research needs

Further research on eating disorders in general, and on anorexia nervosa in particular, is still needed to strengthen treatment recommendations.

A multidisciplinary condition

Anorexia nervosa affects physical and mental health at the same time, so its care usually involves several professions working together. The guideline is intended to help these teams, as well as patients and families, share a common, evidence-based understanding of treatment goals and options.

Who it is for

Psychiatrists, psychotherapists, paediatricians, general practitioners, dietitians and multidisciplinary eating disorder teams.