Anorexia nervosa - Treatment
Treatment for anorexia involves a combination of talking therapy and supervised weight gain. It is important to start treatment as early as possible. This will reduce the risk of serious complications and increase the chances of recovery.
You can recover from anorexia, but it may take time and recovery will be different for everyone.
Treatment for anorexia is different for adults and those under 18 years old.
For both, the GP can:
- provide assessment and treatment
- refer you to a community mental health team
Treatment for adults
Many different talking therapies are available to treat anorexia. The aim of these treatments is to help you understand the causes of your eating problems. They will make you feel more comfortable with food so you can begin to eat more and reach a healthy weight.
The following types of talking therapy may be offered to you. Talk with your GP about which type will be the most helpful for you.
Cognitive behavioural therapy
Cognitive behavioural therapy (CBT) helps you manage problems by thinking more positively. It frees you from unhelpful patterns of behaviour.
CBT involves talking to a therapist. They will work with you to create a personalised treatment plan.
They will help you to:
- cope with your feelings
- understand nutrition and the effects of starvation
- make healthy food choices
Your therapist will ask you to practice these techniques on your own. This will help to measure your progress and manage difficult feelings and situations.
CBT-E is a form of CBT that has been devised and enhanced in certain areas, and particular strategies to specifically address eating disorders and their core difficulties.
For example, distorted thinking about shape and weight or perfectionism.
Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)
MANTRA focuses on what's important to you and helps you to change your behaviour when you are ready.
You can involve your family or carers if you think it would be helpful.
This treatment usually lasts for 20 sessions. The first 10 should be weekly, with the next 10 scheduled to suit you.
Focal psychodynamic therapy
Focal psychodynamic therapy is usually offered if you don't feel any of the above therapies are right for you, or if they don't work.
This therapy will include trying to understand how your eating habits are related to what you think. It will explore how you feel about yourself and other people in your life.
You should be offered weekly sessions for up to 40 weeks (9 to 10 months).
During your treatment, you will be given advice on healthy eating and your diet. This advice alone will not help you recover from anorexia. You will need to have talking therapy as well as dietary advice.
Your GP might tell you to take vitamin and mineral supplements so you get all the nutrients you need to be healthy.
Treatment for children and young people
Children and young people may receive family therapy. They may be offered CBT or adolescent-focused psychotherapy. CBT will be very like CBT offered to adults.
Systemic family therapy is the most-recommended treatment for adolescents with anorexia nervosa. Family-based treatment (FBT) is the most-researched version of this.
FBT involves you and your family talking to a therapist. It will explore how anorexia has affected you and how your family can support you to get better.
This approach requires the parents or family coming together and working together to achieve the goal of restoring normal weight and eating patterns, as a way of banishing the eating disorder from the person.
If you have anorexia, you may not be getting all the vitamins and energy that your body needs to grow and develop. This is especially important as you reach puberty.
During your treatment, your doctor will give you advice about the best foods to eat to stay healthy. They will also talk to your parents or carers about your diet so they can support you at home.
Anorexia can make your bones weaker. This can make you more likely to develop a condition called osteoporosis. This is more likely if weight has been low for a year or more in children and young people, or 2 years or more in adults.
Your GP may suggest you have a special type of X-ray called a bone-density scan to check the health of your bones.
Girls and women are more at risk of getting weak bones than men. Your GP may prescribe you medicine to help protect your bones against osteoporosis.
Antidepressants are not the only treatment for anorexia. An antidepressant in combination with therapy might be more effective. This will help you manage other conditions such as:
- social phobia
Antidepressants are very rarely prescribed for children or young people under 18.
Where treatment will happen
Most people with anorexia will be able to stay at home during their treatment. You will usually have appointments at your clinic and then be able to go home.
You may be admitted to hospital if you have serious health complications. For example, if:
- you are very underweight and still losing weight
- you are very ill and your life is at risk
- you are under 18 and your doctors believe you don't have enough support at home
- doctors are worried that you might harm yourself or are at risk of suicide
Your doctors will keep a careful eye on your weight and health if you are in hospital. They will help you to reach a healthy weight over time and either start or continue therapy.
Once they are happy with your weight, as well as your physical and mental health, you should be able to return home.
Someone with anorexia may refuse treatment even though they're ill and their life is at risk.
In these cases, doctors may decide as a last resort, to admit the person to hospital for compulsory treatment. This is called "involuntary admission".
It is important that you receive ongoing support after your treatment.
You should have checks of your weight at least once a year, as well as of your mental and physical health. This will usually be done by your GP, but it may be with an eating disorder specialist.
Contact Bodywhys for further information and support.