Anorexia Nervosa Guidelines

Updated: Feb 28, 2020
  • Author: Bettina E Bernstein, DO; Chief Editor: Caroly Pataki, MD  more...
  • Print
Guidelines

Guidelines Summary

The Royal Australian and New Zealand College of Psychiatrists released the first set of eating disorder guidelines that incorporate recommendations from the DSM-5. The guidelines focus on anorexia nervosa, but also cover bulimia nervosa, binge eating disorder, and the new disorder of avoidant-restrictive food intake disorder. [132]

Recommendations include the following:

  • Most patients with anorexia nervosa should be treated as outpatients or day patients.

  • A multi-disciplinary treatment approach incorporating consideration of nutritional, medical and psychological aspects, family-based therapies in younger patients, and specialist therapist-led manual-based psychological therapy with long-term follow-up in all age groups should be used.

  • In chronic anorexia nervosa, a harm minimization approach should be used.

  • The approach to diagnosis and treatment should be culturally informed.

Canadian practice guidelines

Canadian practice guidelines for treating children and adolescents with eating disorders were published in 2020. [133] Recommendations include the following:

  • Family-based treatment (FBT) is strongly recommended for children and adolescents with anorexia nervosa or bulimia nervosa.

  • Multi-family therapy (MFT) is a reasonable treatment option for children and adolescents with anorexia nervosa.

  • Cognitive-behavioral therapy (CBT) is a reasonable treatment option for children and adolescents with anorexia nervosa or bulimia nervosa.

  • Adolescent-focused therapy (AFP) is a reasonable treatment option for children and adolescents with anorexia nervosa.

  • Yoga, in addition to standard treatments, is a reasonable treatment option for medically stable children and adolescents with anorexia nervosa, bulimia nervosa, and other specified feeding and eating disorders.

  • Olanzapine or aripiprazole may be reasonable treatment options for certain populations of children and adolescents with anorexia nervosa if monitored carefully.

  • It is strongly recommended that the least intensive treatment environment be provided, especially for those children and adolescents with anorexia nervosa requiring a first admission to hospital and/or with a duration of illness less than 3 years.