Behavioral Management for Anorexia Nervosa.

A 23 -year-old woman with anorexia nervosa visits her internist. Her height is 5 ft 6 in. (168 cm), and her weight is 104 lb (47 kg), with a body-mass index (the weight in kilograms divided by the square of the height in meters) of 16.8. The internist has seen her every 3 weeks since she returned home from college, nearly a year earlier, to monitor her weight and medical status. After maintaining a normal weight of 132 lb (60 kg) throughout high school, the patient began restricting her food intake and exercising excessively during her second year at college. Her resident advisor referred her to a student health counselor whom she saw regularly, but her weight remained at approximately 99 lb (45 kg). Returning home after graduation, the patient consulted an eating-disorder specialist, who assembled a team (consisting of a nutritionist, an internist, and a psychiatrist) to provide outpatient care. The treatment goals included weight gain, but the change in her weight has been minimal. At her psychiatrist's recommendation, the patient is considering an inpatient behavioral-treatment program. Copyright © 2009 Massachusetts Medical Society.All rights reserved.