Management and treatment of feeding and eating disorders

This chapter reviews the management and treatment of feeding and eating disorders. The cornerstone of managing anorexia nervosa (AN) is refeeding, nutritional rehabilitation, and weight restoration. Evidence of efficacy is strongest for family-based psychotherapy for adolescents with AN. Other forms of psychotherapy have less evidence of efficacy. No medication has regulatory approval for the treatment of AN; agents with possible efficacy are zinc, olanzapine, and dronabinol. For bulimia nervosa, there is evidence of efficacy for cognitive behavioural therapy (CBT), interpersonal therapy (IPT), antidepressants, and topiramate. For binge eating disorder, there is evidence of efficacy for CBT, IPT, lisdexamfetamine dimesylate, topiramate, and antidepressants. Less is known about the management and treatment of pica, rumination disorder, avoidant/restrictive food intake disorder, and other specified feeding or eating disorders. As feeding and eating disorders often co-occur with medical and other psychiatric disorders, the management and treatment of these conditions must also be addressed.