Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Vitamin B1 (thiamine), particularly in its active form thiamine pyrophosphate, has a role in the treatment and support of patients with anorexia, but the justification is based on prevention and management of deficiency rather than direct treatment of the anorexic condition itself. Anorexia nervosa and other forms of anorexia can lead to severe malnutrition, including deficiencies in essential vitamins such as thiamine. Thiamine deficiency can result in serious complications, notably Wernicke’s encephalopathy—a neurological disorder characterized by confusion, ataxia, and ophthalmoplegia—which is especially a risk during refeeding in malnourished patients. Current clinical guidelines recommend thiamine supplementation in patients at risk of refeeding syndrome, which includes those with anorexia nervosa, to prevent these complications. While thiamine does not directly address the psychological or behavioral aspects of anorexia, its administration is a validated medical strategy to prevent secondary neurological and metabolic complications. A 2016 review in the Journal of Eating Disorders and other clinical resources support this preventative use. However, there is no strong evidence that thiamine supplementation reverses or treats anorexia itself; rather, its use is justified in the context of deficiency risk due to malnutrition. Thus, the scientific evidence supports its use as a supportive measure rather than a direct therapy for anorexia.

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