Coming of Age and Refusing to Eat: Overcoming Treatment Nonadherence for Adolescents with Anorexia Nervosa

  • Victor FornariEmail author
  • Ida Dancyger


Acceptance of the diagnosis of anorexia nervosa during adolescence and the subsequent treatment of this serious disorder, as well as adherence to the therapeutic recommendations, present significant clinical challenges. This is especially true as the core symptoms of the illness are in direct conflict with the medically necessary goals of gaining weight and normalizing eating behaviors. The path to recovery is in strong opposition to the patient’s obsessional thoughts and restrictive food-related behaviors. This remains a critical matter, given the high mortality rate. Various approaches to engage the adolescent will be discussed in this chapter. We examine the five factors (social and economic factors, healthcare team and system-related factors, condition-related factors, therapy-related factors, and patient-related factors) contributing to nonadherence and offer strategies from our clinical practice and expertise, the literature, as well as some research findings.


Treatment nonadherence Anorexia nervosa Strategies to enhance adherence to treatment 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellHempsteadUSA
  2. 2.Division of Child and Adolescent Psychiatry, Department of PsychiatryNorth Shore University Hospital and The Long Island Jewish Medical Center (Including The Zucker Hillside Hospital and Cohen Children’s Medical Center)Glen OaksUSA

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