When someone, clinician or layperson, begins to understand the underlying thought process of anorexia, it becomes hard not to see the illness as a fundamental problem in brain function. The medical consequences of starvation make clear that anorexia is a physical illness as well, but the tortured thoughts of the disorder are the most shocking revelation.
The overall treatment plan for anorexia is a treatment team covering all the possible bases: therapist, psychiatrist, dietitian and primary care doctor. Sometimes, attention to the details of recovery and improved nutrition are enough to start reversing the course. Frequently, they are insufficient.
Consequently, it’s reasonable that patients and families turn to psychiatric medication as a possible salve for the psychological wounds inflicted by anorexia. There must surely be a medication that can reverse the nonsensical and distorted view that food is not meant to be eaten and that weight loss is paramount no matter the cost.
The psychiatric community agrees with this assumption. Despite the utter lack of success of any medication and the ignorance of an underlying biological cause of the illness, psychiatrists continue to study any medication for its utility in the treatment of anorexia. Even though all studies have thus far have been futile, desperation for more effective treatment is the driving force for continued clinical research.
As of now, the most salient fact about the cause of anorexia is that genetics account for over 70% of the likelihood that someone develops the illness. There needs to be an initial trigger of starvation in order to assess how someone is programmed to respond to a lack of food.
In our society currently, sanctioned dieting, even for children, allows many communities to serve as breeding grounds for eating disorders. The mere acceptance of dieting as a reasonable decision puts adolescents and adults at risk regularly. Prior to the practically universal acceptance of dieting, eating disorders barely existed in our communities.
Survival is the body’s primary ingrained response to starvation and surely is an adaptation that enabled ancestors not lucky enough to live with an overabundance supply of food to persist. It’s unlikely that there is a pharmaceutical fix for a longstanding genetic adaptation.
Although the crucial step to decrease anorexia and eating disorders is to stop sanctioned dieting, it’s more likely that we can create an environment that helps someone already sick to constantly question the anorexic thoughts. When a trusted clinician combined with the person’s support network repeat that the eating disorder thoughts are lies and only hurt them day after day, week after week, month after month, recovery can be possible. Yes we need more options, but medications aren’t likely to be the solution.
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