How are the physical problems associated with anorexia treated?
The physical problems associated with anorexia do need to be treated. Typically, they are treated with re-feeding the person back to health. Re-feeding cannot happen very rapidly. We have a syndrome called re-feeding syndrome where if somebody with anorexia is given food very quickly, they can die of a heart attack right away because the body is not accustomed to receiving a lot of food. That is why it has to be an eating disorder specialist who works with ER anorexia. Sometimes I'll have patients who get hospitalized into an emergency room because they're having bradycardia or something like that. What the ER doctors will do is they will just pump all this fluid into them to get their pulse stabilized and everything like that. My patients will get really bloated, but what is happening for them is they're getting very high risk. Their heart has slowed down so much and their body is so malnourished that they can't take a lot of anything into their body. When they go into an inpatient program, for example, the way they are nourished back to health is a very gradual increase of calories until the body knows how to handle that. Over a course of six weeks they may be bumped up to 3600 calories or something like that. After you are at that level, calorically, it takes about six weeks before you might start to show one or two pounds weight gain. The amounts that they have to eat when they are in a residential program is usually huge amounts, because the body is so wasted.
