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Treatment - Anorexia nervosa

Treatment for anorexia involves a combination of talking therapy and supervised weight gain. It's important to start treatment as early as possible. This will reduce the risk of serious complications and increase your chances of recovery.

You can recover from anorexia, but it may take time. Recovery will be different for everyone.

Treatment for anorexia is different for adults and those under the age of 18.

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. You can then 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 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.

Find out more about cognitive behavioural therapy (CBT)

CBT-E

CBT-E is a form 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 should be weekly, with the next 10 scheduled to suit you.

Diet advice

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. These will give you the nutrients you need to be healthy. They may also recommend referring you to a dietitian for more specialised advice and support.

Medicine

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:

  • anxiety
  • depression
  • social phobia

Antidepressants are rarely prescribed for children or young people under the age of 18.

Find out more about antidepressants

Treatment for children and young people

Children and young people may receive family therapy. They may be offered CBT, CBT-E or adolescent-focused psychotherapy.

CBT and CBT-E for young people are similar to CBT and CBT-E for adults.

Family-based treatment

Systemic family therapy is often used for treating adolescents with anorexia. Family-based treatment (FBT) is the most widely used 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.

Your parents or family will work together to achieve some goals. For example, restoring normal weight and eating patterns.

Find out more about family-based therapy from Bodywhys

Diet advice

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, your GP will give you advice about the best foods to eat to stay healthy. They will also talk to your family or carers about your diet so they can support you at home. They may also recommend referral to a dietitian for more specialised advice and support.

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

Your GP may suggest you have a special type of x-ray called a bone-density scan. This checks 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.

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 your local 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 the support you're receiving at home is not enough to help you recover
  • your 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.

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 last resort in these cases, doctors may decide to admit the person to hospital for compulsory treatment. This is called "involuntary admission".

Find out more about 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.

Further support

Contact Bodywhys for further information and support


Content supplied by the NHS and adapted for Ireland by the HSE

Page last reviewed: 1 September 2022
Next review due: 1 September 2025