Am Fam Physician. 2024;109(2):185-187
Author disclosure: No relevant financial relationships.
Key Points for Practice
• Anorexia nervosa is best treated by monitored renourishment with psychotherapy. Most patients without worsening symptoms can receive outpatient treatment, especially with family support.
• Bulimia nervosa is best treated with CBT and fluoxetine, 60 mg daily.
• Binge-eating disorder is best treated with CBT or interpersonal psychotherapy with antidepressant medications or lisdexamfetamine when pharmacotherapy is indicated. Lisdexamfetamine has been studied mostly in patients who have obesity.
From the AFP Editors
Eating disorders affect nearly 2% of Americans during their lifetime and are more common in women and individuals in the LGBTQ+ community. Eating disorders commonly occur in patients with diabetes mellitus, depression, anxiety, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, and attention-deficit/hyperactivity disorder, all of which increase mortality risk. These disorders can be difficult to recognize, and the American Psychiatric Association (APA) has released guidelines aimed to reduce the harm from eating disorders.
Screening
The U.S. Preventive Services Task Force reports insufficient evidence for routine screening for eating disorders in adolescents and adults. The American Academy of Pediatrics recommends asking all adolescents about eating patterns and body image. The APA recommends screening as part of an initial psychiatric evaluation.
Subscribe
From $165- Immediate, unlimited access to all AFP content
- More than 130 CME credits/year
- AAFP app access
- Print delivery available
Issue Access
$59.95- Immediate, unlimited access to this issue's content
- CME credits
- AAFP app access
- Print delivery available
