Treatment for anorexia involves a combination of talk therapy and supervised weight gain.
It's important to start treatment as early as possible. This will lower the risk of health problems and increase your chances of recovery.
You can recover from anorexia, but it may take time. Recovery will be different for everyone.
Treatment depends on if you are:
Treatment for adults
Your GP can refer you to a community mental health team (CMHT) or specialist eating disorder team.
A number of specialists will work with you on your care plan, including:
- doctors
- nurses
- a psychologist
- an occupational therapist
- social workers
- dietitians
Your care plan will be based on your needs and which specialists are available in your area.
Many types of talk therapy are available to treat anorexia. The aim of these treatments is to help you understand the causes of your eating difficulties. They will make you feel more comfortable with food. You can then begin to eat more and reach a healthy weight.
The following types of talk therapy may be offered to you. Your care team can help you decide which is the most suitable.
Cognitive behavioural therapy (CBT)
CBT helps you manage difficulties by thinking in a more balanced way. It can help you recognise unhelpful patterns of thinking and 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 not eating
- 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.
Cognitive behavioural therapy (CBT)
CBT-E
CBT-E is a type of CBT. It has been created specifically for eating disorders and their 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 are usually weekly, with the next 10 scheduled to suit you.
Diet advice
During your treatment, you will be given specialist dietary advice and a meal plan to help you to get to a healthy weight for your body. This advice alone will not help you recover from anorexia. You will need to have talk therapy as well as a meal plan.
Your doctors might tell you to take vitamin and mineral supplements. These will give you the nutrients you need to be healthy.
Medicine
Antidepressants and antipsychotic medicines are sometimes used to treat anorexia.
An antidepressant in combination with therapy might be more effective.
This can help you manage mental health difficulties such as:
Antidepressants are rarely prescribed for children or young people under the age of 18.
Treatment for children and young people
A GP can refer children and young people to a community mental health team (CMHT) or specialist eating disorder team.
A number of specialists will work with them on their care plan, including:
- doctors
- nurses
- a psychologist
- an occupational therapist
- social workers
- dietitians.
Children and young people should have family therapy. They may be offered CBT, CBT-E or psychotherapy.
CBT and CBT-E for young people are similar to CBT and CBT-E for adults.
Family therapy
Family therapy is the most recommended treatment for young people with anorexia nervosa. It is called family-based treatment or therapy (FBT).
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.
You will also have time on your own with your therapist. Usually the treatment is 18 to 20 sessions over a year. During the treatment you will continue to have meetings with a doctor to check your physical health.
Your parents or family will work together to achieve some goals. For example, restoring normal weight and eating patterns.
Advice on nutritional foods
If you have anorexia, you may not be getting the vitamins and energy your body needs to grow and develop. This is especially important as you reach puberty.
During your treatment you will be given advice about the best foods to stay healthy. Your family will also be given advice about your food so they can support you at home.
If you are very unwell you may:
- be given a meal plan
- need to spend some time in hospital to help with this
Bone health
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:
- more than 1 year - in children and young people
- more than 2 years - in adults
You may need to have a special type of x-ray called a bone density scan (also known as DEXA scan). This checks the health of your bones and can be arranged by the doctor looking after you. It is usually only done after you have gained weight.
The treatment that works best for weakened bones in people with anorexia is sustained weight restoration. Osteoporosis medicines are only used in rare cases - they do not always work for people with anorexia.
Where treatment will happen
Most people with anorexia will not need a clinic overnight when they are getting treatment.
You may be admitted to your local hospital if you have serious health problems.
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 the eating disorder is too severe to be managed by the support you're receiving at home
- your doctors are worried that you might harm yourself, or are at risk of suicide
Your doctors will monitor 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.
You should be able to return home when they are happy with your weight and physical and mental health.
Involuntary admission
Someone with anorexia may refuse treatment even though they're ill and their life is at risk.
As a result of their illness, they may not be able to make medical decisions in a rational way. In such a situation, the medical team will check if they can make treatment decisions on the person's behalf.
As a last resort in these cases, doctors may decide to admit the person to hospital for compulsory treatment. This is called "involuntary admission".
Check-ups
It is important that you receive ongoing support after your treatment.
You should have weight checks and mental and physical health checks at least once a year. This will usually be done by your GP. But it can also be with an eating disorder specialist.
More support
For more information and support contact Bodywhys
Content supplied by the NHS and adapted for Ireland by the HSE