ABSTRACT
Low mood; anxiety; irritability; obsessional symptoms, is particularly related to food and weight. In anorexia nervosa, medication does not usually help associated symptoms of anxiety and/or depression. These will lift as the patient's weight improves. In a 'food diary' table the patient is encouraged to document what she or he eats and when she eats it. Disordered eating, rooted in low self-esteem, can frequently be identified in primary care. Immediate, serious risks might exist and need to be addressed. The UK's National Institute for Health and Clinical Excellence recommends that most adults with bulimia nervosa should have an evidence-based, self-help programme or a trial of an antidepressant as a possible first step, and 16 to 20 sessions of cognitive behaviour therapy over four to five months. If a patient is severely ill, particularly with medical complications or suicidal ideation, in-patient treatment may be needed to save a patient's life.
