How is anorexia treated?

How is anorexia treated?

The biggest challenge in treating anorexia is helping the person recognize and accept that they have an illness. Many people with anorexia deny that they have an eating disorder. They often seek medical treatment only when their condition is serious or life-threatening. This is why it’s important to diagnose and treat anorexia in its beginning stages.

The goals of treatment for anorexia include:

• Stabilizing weight loss.
• Beginning nutrition rehabilitation to restore weight.
• Eliminating binge eating and/or purging behaviors and other problematic eating patterns.
• Treating psychological issues such as low self-esteem and distorted thinking patterns.
• Developing long-term behavioral changes.

People with eating disorders, including anorexia, often have additional mental health conditions, including:

• Depression.
• Anxiety disorders.
• Borderline personality disorder.
• Obsessive-compulsive disorder.
• Substance use disorders.

These conditions can further complicate anorexia, so if an individual has one or more of these conditions, their healthcare team will likely recommend treatment for the condition(s) as well.

Treatment options will vary depending on the individual’s needs. A person may receive treatment through residential care (outpatient care) or hospitalization depending on their current medical and mental health state. Treatment for anorexia most often involves a combination of the following strategies:

• Psychotherapy.
• Medication.
• Nutrition counseling.
• Group and/or family therapy.
• Hospitalization.

Psychotherapy

Psychotherapy is a type of individual counseling that focuses on changing the thinking (cognitive therapy) and behavior (behavioral therapy) of a person with an eating disorder. Treatment includes practical techniques for developing healthy attitudes toward food and weight, as well as approaches for changing the way the person responds to difficult situations. There are several types of psychotherapy, including:

• Acceptance and commitment therapy: This therapy’s goal is to develop motivation to change actions rather than your thoughts and feelings.
• Cognitive behavioral therapy (CBT): This therapy’s goal is to address distorted views and attitudes about weight, shape and appearance and to practice behavioral modification (if “X” happens, I can do “Y” instead of “Z”).
• Cognitive remediation therapy: This therapy uses reflection and guided supervision to develop the capability of focusing on more than one thing at a time.
• Dialectical behavior therapy (DBT): This therapy helps you not just develop new skills to handle negative triggers but also helps you develop insight to recognize triggers or situations where a non-useful behavior might occur. Specific skills include building mindfulness, improving relationships through interpersonal effectiveness, managing emotions and tolerating stress.
• Family-based therapy (also called the Maudsley Method): This therapy involves family-based refeeding, which means putting the parents and family in charge of getting the appropriate nutritional intake consumed by the person with anorexia. It’s the most evidence-based method to physiologically restore health to an individual with anorexia who is under 18 years of age.
• Interpersonal psychotherapy: This therapy is aimed at resolving an interpersonal problem area. Improving relationships and communications and resolving identified problems may reduce eating disorder symptoms.
• Psychodynamic psychotherapy: This therapy involves looking at the root causes of anorexia as the key to recovery.

Medication

Some healthcare providers may prescribe medication to help manage anxiety and depression that are often associated with anorexia. The antipsychotic medication olanzapine (Zyprexa®) may be helpful for weight gain. Sometimes, providers prescribe medications to help with period regulation.

Nutrition counseling

Nutrition counseling is a strategy to help treat anorexia that involves the following:

• Teaching a healthy approach to food and weight.
• Helping restore normal eating patterns.
• Teaching the importance of nutrition and a balanced diet.
• Restoring a healthy relationship with food and eating.

Group and/or family therapy

Family support is very important to anorexia treatment success. Family members must understand the eating disorder and recognize its signs and symptoms.

People with eating disorders might also benefit from group therapy, where they can find support and openly discuss their feelings and concerns with others who share common experiences.

Hospitalization

Hospitalization might be needed to treat severe weight loss that has resulted in malnutrition and other serious mental or physical health complications, such as heart disorders, serious depression and suicidal thoughts or behaviors.