Anorexia Nervosa

Tovani does not treat this with ketamine

This page is here for honesty and completeness. Ketamine is not an appropriate treatment for Anorexia Nervosa, and in some cases it is contraindicated. Below is what the condition is and the treatments that genuinely help — and where, if at all, ketamine has any narrow role (usually only for a separate co-occurring depression). If you’re in crisis, call or text 988.

The short version

●Anorexia nervosa is characterized by restriction of energy intake leading to significantly low body weight, intense fear of weight gain, and a disturbance in how body weight or shape is experienced.
●It has one of the highest mortality rates of any psychiatric illness — from medical complications and from suicide — and requires specialized, often multidisciplinary, eating-disorder care.
●First-line treatment is specialized psychotherapy and nutritional rehabilitation (e.g., family-based treatment for adolescents; CBT and other approaches for adults), with medical monitoring; medications play a limited, adjunctive role.
●Ketamine is not an established treatment for anorexia, the evidence is preliminary, and the medical fragility of these patients makes at-home ketamine inappropriate.
●Low weight, electrolyte disturbances, and cardiac risk are safety concerns that an at-home model cannot manage.
●Tovani does not treat anorexia nervosa; specialized eating-disorder care is essential, and any co-occurring depression is addressed within that care.

Clinical definition

Anorexia nervosa is defined by persistent restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, and physical health; an intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain; and a disturbance in the way one's body weight or shape is experienced, undue influence of weight/shape on self-evaluation, or persistent lack of recognition of the seriousness of the low weight. It is specified as restricting type or binge-eating/purging type. Anorexia has the highest mortality of essentially any psychiatric disorder, from medical complications of starvation (cardiac, electrolyte, bone) and from a markedly elevated suicide rate. It frequently co-occurs with depression, anxiety, and OCD. Treatment is specialized and multidisciplinary, prioritizing medical stabilization and nutritional rehabilitation alongside psychotherapy — a level of medical oversight that an at-home ketamine model cannot provide, which is part of why ketamine is not appropriate here.

How it differs from related conditions

vs. Bulimia nervosa

Bulimia involves binge eating with compensatory behaviors at normal or higher weight; anorexia centers on restriction and significantly low weight.

vs. Binge eating disorder

BED involves binges without compensatory behaviors and is not defined by low weight; anorexia is defined by restriction and low weight.

vs. Body dysmorphic disorder

BDD focuses on perceived appearance flaws generally; anorexia centers specifically on weight, shape, and eating.

vs. Depression

A common, dangerous comorbidity given anorexia's high suicide risk — treated within specialized eating-disorder care.

First-line treatments

Specialized psychotherapy

Family-based treatment (FBT) for adolescents has the strongest evidence; CBT, MANTRA, and SSCM are used for adults.

Nutritional rehabilitation

Structured refeeding and weight restoration, with careful medical monitoring for refeeding syndrome.

Medical monitoring and stabilization

Vital signs, electrolytes, cardiac status, and bone health are tracked; higher levels of care (inpatient, residential) when medically unstable.

Treating comorbidities

Depression, anxiety, and OCD are addressed within the eating-disorder treatment, with attention to suicide risk.

When standard treatments fail

Severe and enduring anorexia is managed by specialist eating-disorder services, escalating the level of care (intensive outpatient, residential, inpatient, or medical hospitalization) based on medical and psychiatric risk. Ketamine is not part of this pathway; the medical fragility and the preliminary, unestablished evidence make it inappropriate, particularly at home.

Where ketamine fits

Ketamine is not an appropriate treatment for anorexia nervosa. The evidence for ketamine in eating disorders is preliminary and not established, and — more decisively — patients with anorexia are often medically fragile, with risks around low weight, electrolyte disturbance, and cardiac function that demand close medical supervision an at-home model cannot provide. The disorder requires specialized, multidisciplinary eating-disorder care focused on nutritional rehabilitation and evidence-based psychotherapy. Where a co-occurring treatment-resistant depression is present (common, and important given the high suicide risk), it is addressed within that specialized care and its safety structure — not with at-home ketamine. Tovani does not treat anorexia.

Where this fits with Tovani

Tovani does not treat anorexia nervosa. It is a serious, potentially life-threatening illness that requires specialized eating-disorder care with medical oversight that an at-home model cannot safely provide. Eligibility screening captures eating-disorder history. Any co-occurring depression is managed within specialized care. If you or someone you know is struggling, please seek specialized help; for crisis, call or text 988.

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Frequently asked

Can ketamine treat anorexia?

No — it's not an established or appropriate treatment. The evidence in eating disorders is preliminary, and people with anorexia are often medically fragile (weight, electrolytes, heart), needing close medical oversight that an at-home model can't provide. Anorexia requires specialized, multidisciplinary eating-disorder care.

What actually treats anorexia?

Specialized psychotherapy (family-based treatment for adolescents; CBT and other approaches for adults) plus nutritional rehabilitation and medical monitoring, with higher levels of care when medically unstable. Comorbid depression and anxiety are treated within that care.

I have anorexia and depression — what about the depression?

It's important to treat, especially given anorexia's high suicide risk — but within specialized eating-disorder care and its safety structure, not with at-home ketamine. The medical fragility of anorexia changes what's safe.

Why won't Tovani treat this?

Because anorexia is a serious, sometimes life-threatening illness needing medical oversight an at-home ketamine model can't safely provide, and ketamine isn't an established treatment for it. The honest, safe answer is specialized eating-disorder care.

References

Treasure J et al. 2020, The Lancet — Review of eating disorders, including anorexia nervosa — its severity, medical risk, and the specialized, multidisciplinary treatment it requires. (PMID 32171414)
Solmi M et al. 2021, The Lancet Psychiatry — Comparative efficacy of psychotherapies for eating disorders, supporting specialized psychotherapy as first-line. (PMID 33600749)
Murrough JW et al. 2013, American Journal of Psychiatry — Ketamine RCT in treatment-resistant depression, relevant only to a co-occurring depression managed within specialized eating-disorder care. (PMID 23982301)

Last reviewed by Dr. Ben Soffer, DO on May 31, 2026. This page is educational and not a substitute for clinical evaluation. A physician determines whether ketamine therapy is appropriate for your specific situation.