The Eating and Nutrition Disorders (DNA) are characterized by behaviors that alter the consumption or absorption of food, compromising physical health and psychosocial well-being.

They have different names (such as Anorexia, Bulimia, Binge Eating) and different symptoms, but share a high risk to health.

• The mood becomes unstable, frequent crying, heightened anger, family tension increases, and communication becomes problematic. 

• Disturbed nighttime rest with actual insomnia. 

• Suicidal thoughts, demonstrative acts, or self-harming behaviors, such as inflicting wounds or burns, but more often scratches, abrasions, burns, and similar.

• Heart arrhythmias or chest pain, severe abdominal pain.

• Loss of consciousness, fainting. 

• Breathing difficulties, fatigue.

• Swelling in the legs (edema), tingling sensations (paresthesia).

The role of the family is fundamental.

If you suspect that a family member may be suffering from an eating disorder, it is important to report it to the doctor and subsequently collaborate with the care team.

The family doctor or pediatrician can act as an intermediary with the services of the regional DNA network. 

In DNAs, it is not about willingness to heal, but about illness: there are subjective times in the care process. 
It is necessary to seek help in specialized centers for the treatment and care of nutrition and eating disorders. Specialized services address therapy from various aspects: psychological, psychiatric, nutritional, and rehabilitative, aspects that must necessarily integrate for healing. 

To treat nutritional and feeding disorders, assistance is divided among

Struttura pubblica per prevenzione, cura, riabilitazione dei cittadini che presentano disturbi alimentari. Si occupa di
•    primo accesso al sistema;
•    accoglienza e di inizio della relazione terapeutica con i pazienti; 
•    indicazioni diagnostiche e terapeutiche.

Day-care or Semi-residential Center for Eating Disorders (ED)

This type of center is for patients who struggle to change their eating habits through standard outpatient therapy but have a supportive family environment. It caters to:

• underweight patients who cannot regain weight;

• patients who are not underweight but have frequent bingeing and self-induced vomiting episodes;

• patients with long-term ED who do not respond to standard outpatient treatment.

The semi-residential facility develops a Personalized Therapeutic Rehabilitation Plan (PTRP) for each patient, based on the Individual Treatment Plan (PTI) prepared by the referring outpatient clinic.

A long-term care center designed for five specific situations:

1. Patients who do not respond to outpatient treatment;

2. Physical risk resulting from specific behaviors that make outpatient/semi-residential/Day Hospital treatment inappropriate;

3. Psychiatric risk that makes outpatient/semi-residential/Day Hospital treatment inappropriate;

4. Psychosocial difficulties that make outpatient/semi-residential/Day Hospital treatment inappropriate;

5. Continuation of rehabilitative treatment after hospital discharge, when outpatient/semi-residential/Day Hospital care is still premature.

Hospitalization depends on:

• the severity of symptoms

• the predominance of psychiatric or medical/nutritional symptoms

• the stage of the illness

Care pathways vary to ensure maximum effectiveness for each patient.

For patients at risk of life-threatening organic or psychiatric conditions, intensive interventions are required. Day Hospitals can be activated when needed.

These treatment paths may involve:

1. hospitalization in an internal medicine/nutritional or pediatric unit, or in dedicated ED beds, with sub-intensive “rescue” nutritional rehabilitation (for adults and minors);

2. hospitalization in a psychiatric or child neuropsychiatric unit, in dedicated beds;

3. admission to a Day Hospital specialized in Eating Disorders (for adults or minors).

To identify the services in the Lazio region, you can consult

1. DNA Ambulatories Lazio Region 

2. Table of accredited Semi-Residential Services by the Lazio Region

3. Table of accredited Residential Services by the Lazio Region  

To identify services throughout the national territory, consult the MAP of the Higher Institute of Health