[Supportive care in the management of treatment-resistant and chronic anorexia nervosa]

Abstract

Although many patients face a long and severe evolution, there is no consensus regarding the definition of chronic and/or refractory anorexia nervosa. The multiplication of treatments and therapies lead to what could be called a total resistance to treatment in these patients. Cognitive impairment in anorexia nervosa, known to be worsened by deep denutrition, is a striking issue as it could limit the ability of the patients to consent to needed care. Constrained admission ruled by French July 5th 2011 psychiatric law could be decided given the aforementioned consent issues. When care given to patients involuntarily admitted are unsuccessful, supportive and palliative care could be an alternative in chronic and refractory anorexia nervosa. The goals of care would be shifted at this point to active comfort measures and better quality of life.