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Anorexia Treatments

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Anorexia Treatments

Anorexia nervosa is a severe eating disorder that causes a person to maintain a deficient weight by eating very little and/or exercising too much.

Treatment for anorexia nervosa includes a variety of methods that target different problems and rely on different approaches. Since anorexia can be a somewhat complicated disorder and due to individual differences, the success of treatment depends on various factors.

Anorexia Treatments, Person with anorexia, StudySmarterPerson with anorexia, freepik.com

Support and treatment of anorexia

Different types of support and treatments for anorexia exist. Also, there are different ways a person can seek help if they are suffering from it. If one seeks help and support early, the chances are higher that the condition will be treated properly. The patient will experience the best recovery possible, with the least negative side effects of a long-lasting condition.If a person believes they are suffering from anorexia but are unsure, they should see their doctor as soon as possible.The doctor can determine if it is anorexia by asking questions about their eating behaviours, how they feel, measuring their weight and body mass index, and then using various diagnostic manuals (such as the DSM 5) to determine the disorder.

They also perform blood tests to determine if there is another cause for the weight loss. Weight loss can be the result of various diseases. Therefore, we must be careful in testing to rule out such a cause.

If a patient is diagnosed with anorexia, they will be referred to an eating disorder specialist who can give them the best treatment for the best possible recovery.

Evidence-based treatment for anorexia nervosa

Medical or psychological problems can cause anorexia. Therefore, treatments may rely on research into either the biological or psychological explanation of anorexia.

The biological explanation of anorexia includes:

  1. Research on the genetic basis of anorexia nervosa using twin studies (56% concordance rates in Mz twins and 5% in Dz twins with anorexia nervosa – Holland, Sicotte & Treasure, 1988) and also specific genes associated with anorexia nervosa (e.g., a variant of EPHX2).

  2. The neuroanatomical/neurotransmitter basis of anorexia; high serotonin levels lead to anxiety and since food produces serotonin, eating less food may reduce anxiety in anorexic people. High levels of the neurotransmitter dopamine can also cause anorexia (involved in reward-motivated behaviour), leading to anxiety. Hence, anorexic people engage in avoidance behaviours (not eating food) to reduce this anxiety.

  3. Finally, the neurological basis is also among the biological explanations of anorexia. It suggests that childbirth complications may be the cause of anorexia, e.g., diabetes, premature heart problems, maternal anaemia (low iron in the blood).

Anorexia Treatments, Weight Scale Treatment Anorexia, StudySmarterWeight and scales, freepik.com/vectorjuice

The psychological explanation of anorexia includes:

  1. The suggestion is that people with anorexia have specific characteristics, e.g., being perfectionistic (which Fairburn et al. (1999) found in many anorexic patients) or having faulty schemas and/or thought processes.

  2. Such traits can lead to cognitive/behavioural mechanisms such as an ‘all-or-nothing’ approach, overgeneralisations, and catastrophising thoughts.

  3. Family systems theory is another psychological explanation for anorexia. The type of dysfunctional family associated with anorexia nervosa is called a psychosomatic family. Poor family dynamics cause psychological stress and illness to manifest in physical illness and trigger anorexia nervosa.

  4. The learning approach states anorexia can be a consequence of imitating role models, and the psychodynamic approach explains the development of anorexia with the fear of growing up and the desire to remain a child.

Anorexia nervosa treatment methods

Recovering from anorexia can be dangerous without proper treatment. It must be done in a safe manner and under medical supervision. Because anorexic people extremely restrict their diet, a dangerous condition called re-feeding syndrome (a metabolic disorder) can occur when anorexic people begin to increase their food intake.

Other harmful health consequences include bone loss, muscle weakness, anaemia, low blood pressure, infertility, etc. In addition, overcoming harmful and overwhelming thoughts and beliefs can be especially difficult for anorexic people.

The main treatments for anorexia nervosa rely on explanations. Since there are biological and psychological explanations for anorexia, we distinguish biological and psychological treatments, including cognitive behavioural therapy (CBT), drug treatments, and family therapy, which also treat bulimia. Doctors assess each patient, perform the necessary tests, create questionnaires, etc., before deciding which treatment is best for each patient.

Specific methods for treating anorexia exist, which should roughly follow this method to ensure the best recovery. We will look at psychological treatment (Cognitive Behavioural Therapy) first.

Anorexia Treatment, Food Choice Anorexia Health, StudySmarterFood choices, freepik.com/pch.vector

Psychological treatment for anorexia nervosa

Psychological treatments focus on the patient’s thought patterns and feelings and how they affect their behaviour. Cognitive behavioural therapy is one of the most successful forms of psychological treatment for various disorders, including anorexia nervosa.

Overall, anorexia can be treated psychologically:

  • CBT
  • Enhanced CBT
  • Family therapy
  • Diet advice
  • Maudsley Anorexia Nervosa treatment for adults (talking therapy)

Cognitive Behavioural Therapy (CBT)

The main goal of CBT is to help the patient develop and then maintain a healthy weight and eating behaviour. Changing eating behaviours is the main goal in treating the dietary restrictions that anorexic patients impose on themselves because of their food phobia.

Various behavioural methods are used to gradually increase the patient’s food intake, e.g., with gradual exposure, and reduce the anxiety associated with behavioural change, e.g., cognitive behavioural methods.

In addition, the patient’s overvalued and distorted beliefs that promote anorexic behaviours related to food and weight (positive and negative) are identified and challenged using various cognitive techniques.

By identifying anorexic behaviour as a way the patient copes with life, we can use treatment to identify where problem-solving is deficient and then help the patient develop and work with new problem solving and coping skills.

  • The phases of CBT treatment for anorexia nervosa are:
    1. Behavioural phase – the therapist works with the patient to create a plan to stabilise eating behaviours and eliminate symptoms. They identify dysfunctional thoughts. The therapist teaches the patient various coping strategies/tools, as emotions can sometimes be overwhelming during the process and even afterwards.
    2. Cognitive phase – as therapy progresses, cognitive restructuring techniques are introduced. Problematic thoughts and beliefs are identified and challenged, e.g., ‘I will only be happy if I lose weight.’ New thoughts and beliefs are introduced, e.g. ‘My self-worth does not depend on my weight’.
    3. Maintenance and relapse prevention phase – this final phase is about maintaining the progress made and preventing relapse, e.g. by reducing triggers. The patient can return to a happy, fulfilling life, which is the goal of CBT. Even if symptoms are not eliminated, therapy will move to other problem areas and work on holistic emotional well-being once stabilised. The therapist encourages the patient to adopt healthier and more realistic ways of thinking to develop healthier behaviours.

Enhanced CBT (CBT-E) has proven to be an effective method for treating anorexia nervosa.

Fairburn (2009) conducted an extensive study on the effectiveness of CBT for anorexia nervosa and found that 60% of patients with this disorder could be treated with CBT, and 60% of those treated had a good, effective outcome.

Family therapy

For younger anorexic patients and children, family therapy may be an option. In this process, the therapist talks with the patient and their family to determine how anorexia affects the patient and if a dysfunctional family plays a role. If so, they help the patient get appropriate family support.

Biological treatment for anorexia nervosa

Biological treatment of anorexia includes drug therapy, mainly with psychotropic drugs.

Anorexia Treatments, Drug Therapy, StudySmarterDrug Therapy, flaticon.com

Drug therapy

Several different psychiatric drugs are effective in treating anorexia nervosa. However, selective serotonin reuptake inhibitors (SSRIs) are widely studied. Since people with anorexia have high levels of anxiety and depression in the form of negative, obsessive thoughts, they have higher serotonin levels (which causes anorexia, according to the biological explanation of anorexia).SSRIs inhibit the reuptake of serotonin, thus lowering serotonin levels and treating anorexia.Although this makes sense in theory, experts have found that SSRIs do not support recovery in patients with low weight. Because SSRIs focus on the interactions of serotonin and dopamine, they may cause weight gain in patients with other disorders who take them.Therefore, they only address the symptoms of weight gain anxiety or disturbed body image, not weight gain.Another medication called olanzapine reduces anxiety and obsessive thinking. Some anorexic patients even feel they cannot function due to their rigid thinking and behaviour, which taking this medication decreases. It significantly slows down metabolism, increases appetite, and alters different homeostatic physiological functions.Bodell and Keel (2010) noted that drug therapy offers limited overall benefits in treating anorexia nervosa. Still, there are some promising preliminary results on the effects of olanzapine in the treatment of anorexia. Drug therapy is more often aimed at improving the depressive and anxious symptoms of anorexia nervosa and is also effective, but not so much for the symptoms of weight regulation/gain nor for the symptoms of harmful thoughts and beliefs.


Treatments for Anorexia - Key takeaways

  • Anorexia nervosa is a severe eating disorder that causes a person to maintain a very low weight by eating very little and/or exercising too much.
  • Both biological (genes, neurotransmitters, birth complications) and psychological (certain traits, cognitive mechanisms, dysfunctional family systems) explanations for anorexia nervosa exist.
  • Treatments for anorexia nervosa are also biological and psychological.
  • Psychological treatments for anorexia nervosa are cognitive behavioural therapy (CBT) and family therapy.
  • Fairburn (2009) found that 60% of patients with this disorder can be treated with CBT, and 60% of those treated had a good, effective outcome.
  • Biological treatment for anorexia consists of medication, such as SSRIs and olanzapine.
  • Bodell and Keel (2010) found that drug therapy has limited overall benefit in the treatment of anorexia nervosa.

Frequently Asked Questions about Anorexia Treatments

Recovering from anorexia can be dangerous without proper treatment. It must be done in a safe manner and under medical supervision. Because anorexic people extremely restrict their diet, a dangerous condition called re-feeding syndrome (a metabolic disorder) can occur when anorexic people begin to increase their food intake.


Other harmful health consequences include bone loss, muscle weakness, anaemia, low blood pressure, infertility, etc. In addition, overcoming harmful and overwhelming thoughts and beliefs can be especially difficult for anorexic people.

The main treatments for anorexia nervosa rely on its explanations. Since there are biological and psychological explanations for anorexia, we distinguish biological and psychological treatments, including cognitive behavioural therapy (CBT), drug treatments, and family therapy, which also treat bulimia. Doctors assess each patient, perform the necessary tests, create questionnaires, etc., before deciding which treatment is best for each patient.

Like anorexia, bulimia is usually treated using cognitive behavioural therapy and family therapy, which can sometimes be combined with drug therapy, such as antidepressants. 

Younger anorexic patients and children may be given the option of family therapy. In this process, the therapist talks with the patient and their family to determine how anorexia affects the patient and if a dysfunctional family plays a role. If so, they help the patient get appropriate family support.


However, this is not the most effective treatment for anorexia nervosa, but just something that can aid recovery alongside either Cognitive Behavioural Therapy (CBT) or Drug Therapy, which are the two main (and more effective) treatments of anorexia nervosa..

Fairburn (2009) conducted an extensive study on the effectiveness of CBT for anorexia nervosa and found that 60% of patients with this disorder could be treated with CBT, and 60% of those treated had a good, effective outcome.


Bodell and Keel (2010) noted that drug therapy offers limited overall benefits in treating anorexia nervosa. Still, there are some promising preliminary results on the effects of olanzapine in the treatment of anorexia. Drug therapy is more often aimed at improving the depressive and anxious symptoms of anorexia nervosa and is also effective, but not so much for the symptoms of weight regulation/gain nor for the symptoms of harmful thoughts and beliefs.


Final Anorexia Treatments Quiz

Question

What is the definition of Anorexia Nervosa?

Show answer

Answer

Anorexia nervosa is a severe eating disorder that causes a person to maintain a very low weight. This can be done by eating very little and/or exercising too much

Show question

Question

What are the 2 main areas of study that provide explanations for anorexia?

Show answer

Answer

Biological and Psychological explanations

Show question

Question

What 3 explanations does the biological explanation of anorexia include?

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Answer

Genes (twin studies and the EPHX2  gene variant), neurotransmitters (serotonin and dopamine) and neurodevelopmental (complications at birth).

Show question

Question

What 3 explanations does the psychological explanation of anorexia include? 

Show answer

Answer

Possessing certain traits (perfectionism or having faulty thought processes/schemas)

Cognitive/behavioural mechanisms ('all or nothing' approach, overgeneralisations and catastrophic thoughts) 

Family systems theory (psychosomatic family).

Show question

Question

What are the psychological treatments for anorexia nervosa?

Show answer

Answer

Show question

Question

What is the biological treatment for anorexia nervosa?

Show answer

Answer

Drug Therapy

Show question

Question

What is the first phase of CBT for anorexia nervosa and what does it include?

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Answer

1. Behavioural Phase - The therapist work together with the patient to make a plan to stabilise eating and eliminate symptoms. Different coping strategies/tools are taught to the patient since emotions can sometimes get over whelming during the process, and afterwards too. 

Show question

Question

What is the second phase of CBT for anorexia nervosa and what does it include? 

Show answer

Answer

2. Cognitive Phase - Cognitive Restructuring Techniques are introduced with the therapy's progression. Problematic thoughts and beliefs are identified, e.g. 'I will only be happy if I lose weight', are challenged. New thoughts and beliefs are introduced, e.g. 'my self worth doesn't depend on my weight'.

Show question

Question

What is the third phase of CBT for anorexia nervosa and what does it include?  

Show answer

Answer

3. Maintenance and Relapse Prevention Phase - This final stage includes maintaining the progress made and preventing relapse, e.g. by reducing triggers. This helps the patient to go back to living a happy, fulfilling life, which is the aim of CBT. Even if they're not completely eliminated, once symptoms are stabilised, the therapy will move on to other areas of concern and work on holistic emotional well being.Healthier and more realistic ways of thinking will be encouraged by the therapist for the patient to adopt so that healthier behaviours can develop.

Show question

Question

What did Fairburn (2009) find regarding the efficacy of CBT on Anorexia Nervosa?

Show answer

Answer

Fairburn (2009) conducted a very large study on the effectiveness of CBT on Anorexia Nervosa and found that 60% of patients with this disorder can be treated with CBT and 60% of those that are treated have had a good, effective outcome.

Show question

Question

What is family therapy?

Show answer

Answer

Younger anorexic patients and children may be given the option of family therapy. This involves the therapist talking to the patient and their family to identify how anorexia has affected the patient and if there's any influence from a dysfunctional family. Then to help the patient get proper family support.

Show question

Question

How does Olanzapine treat anorexia nervosa?

Show answer

Answer

Olanzapine works on reducing anxiety and obsessive thinking since some anorexic patients even feel like they can't function due to their rigid thinking and behaviour, which is lessened whilst on this drug. significantly slows metabolism, increases appetite and alters different homeostatic physiological functions. 

Show question

Question

What does SSRS stand for?

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Answer

Selective Serotonin Re-uptake Inhibitors

Show question

Question

How does SSRS treat anorexia nervosa?

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Answer

Because people with anorexia have high levels of anxiety and depression in the form of their negative, obsessive thoughts, they have a higher level of serotonin (which the biological explanation of anorexia has explained to be the cause of anorexia). This means that if SSRI's are used, they inhibit the re-uptake of serotonin and therefore, decrease its levels and treat anorexia.

Show question

Question

What did Bodell and Keel (2010) find regarding the efficacy of drug therapies in treating anorexia?

Show answer

Answer

Bodell and Keel (2010) found that overall, drug therapy has limited benefits in the treatment of Anorexia Nervosa, but there have been some promising preliminary findings of the effect of Olanzapine in treating anorexia. Drug therapy's more often target and are effective in the improvement of depressive and anxiety symptoms of Anorexia Nervosa, but not so much in the weight management/increase symptoms, and nor the harmful thoughts and beliefs symptoms.

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