title: Applying evidence-based management to anorexia nervosa.
abstract: OBJECTIVE
  This paper considers how the three principles of evidence based practice (clinical expertise, scientific evidence, and patient preference) can be applied to the complexity of treatment for anorexia nervosa AN.
  
  
  METHODS
  A narrative review of the evidence of these three domains is presented. Clinical cases are used to illustrate how the formulation and management can be put into practice at different stages of illness.
  
  
  RESULTS
  The management of anorexia nervosa is complex. First, individuals with the illness do not regard the manifestations of the illness as a source of concern rather they are embraced and integrated into their identity. This contrasts to the reaction of other people who are terrified by the overt signs of ill health. Thus engagement into treatment is problematic. Second, the core symptom restricted eating, produces malnutrition which impacts on brain, body, and the social network. Thus a mixture of psychological and physical problems gradually accumulates over the course of the illness. This means that the treatment targets increase over time.
  
  
  CONCLUSIONS
  Thus treatment has to work with motivation and readiness to change and tackle the various domains of ill health.
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
mesh_terms: D017668:Age of Onset; D000856:Anorexia Nervosa / Q000628:therapy*; D019468:Disease Management; D055317:Evidence-Based Practice; D040261:Harm Reduction; D006801:Humans; D009042:Motivation; D010347:Patient Care Planning; D057240:Patient Preference; D011613:Psychotherapy; D013997:Time Factors