Anorexia Nervosa

This clinical review (Jane Morris and Sara Twaddle BMJ 2007;334:894-8) takes a refreshing look at anorexia nervosa management. Evidence for the benefits of various treatments is poor because engaging this group in treatment is difficult and engaging them in research is harder still. As a GP the take home messages were:

• It's common (0.3% prevalence in young women) and has the highest mortality of any psychiatric disorder.
• It takes years to recover - so there are no quick fixes.
• Rapid changes in weight are dangerous, as are substance misuse, deliberate overdose and misuse of prescribed insulin.
• Medication has little benefit, side effects risk is high.
• Involving the family in the management can be helpful.

Usefully the article references several possible sources of additional educational support for patients, carers and health professionals.