Why is the management of patients suffering from mental anorexia regarded as difficult?

Management of patients suffering from mental anorexia (AM) is often regarded as particularly difficult. Some difficulties are inherent to the disease itself and to the interactions with the care providers; others are linked to the family context, sociological and organizational factors. Delayed access to specialized care is favored by denial of the disease, a diagnostic criterion of AM which echoes the valorization of thinness extolled by today's society. Considering AM as an intrinsic cause of difficulties for the medical teams could induce withdrawal of care providers or even the Institutions. Nevertheless it should be kept in mind that AM is the psychiatric disease with the highest mortality rate. Considering the particular complexity of management of AM, it is of special importance to develop specialized units to take care of these patients.