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How to Treat Anorexia Nervosa?


Medical Treatment:
Treatment for adults
  • Several talking treatments are available to treat anorexia. The aim of these treatments is to help you understand the causes of your eating problems and feel more comfortable with food so you can begin to eat more and reach a healthy weight.
  • You may be taken following talking treatment. If you feel one is not right for you or is not helping, you can talk to your doctors about trying a different kind of therapy.
Cognitive behavioral therapy (CBT)
  • It usually involves weekly sessions for up to 40 weeks (9 to 10 months) and 2 sessions a week in the first 2 to 3 weeks if you are offered CBT.
  • CBT involves talking to a therapist who works to create a personalized treatment plan with you. Will help you to:
    • Cope with your feelings
    • Understand nutrition and the effects of starvation
    • Make healthy food choices
  • They will ask you to practice these techniques on your own, measure your progress, and show you ways to cope with difficult feelings and situations in order to keep up with your new eating habits.
Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)
  • To understand what causes your eating disorder, MANTRA involves talking to a therapist. It focuses on what is important to you and when you are ready, it helps you change your behavior.
  • If you think it would be helpful, you can involve your family or caregivers.
  • You should be offered 20 sessions. The first 10 should be weekly, with the next 10 scheduled to appropriate you.
Specialist supportive clinical management (SSCM)
  • SSCM involves discussing to a therapist who will help you understand what is causing your eating disorder. You will learn about nutrition and how your eating habits cause your symptoms.
  • Twenty or more weekly sessions should be offered. Your therapist will set a target weight for you and help you reach it over the course of 20 weeks.
Focal psychodynamic therapy
  • Focal psychodynamic therapy should include attempting to understand how you relate your eating habits to what you think and 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).
Diet advice
  • You will probably be given advice on healthy eating and your diet during your treatment. However, this advice alone will not help you recover from anorexia, so you will need to have talking therapy as well as dietary advice.
  • You may also be advised by your doctors to take vitamin and mineral supplements so that you get all the nutrients you need to be healthy.
Treatment for children and young people
  • Family therapy is usually given to children and young people. CBT or adolescent-focused psychotherapy may also be offered to you. CBT will be very similar to the CBT offered to adults.
Family therapy
  • Family therapy involves talking to a therapist with you and your family, exploring how you have been affected by anorexia and how your family can help you get better.
  • Your therapist will also help you find ways to manage difficult feelings and situations to stop you from relapsing into unhealthy eating habits once your therapy ends.
  • You can have the sessions with your family or with the therapist on your own. Sometimes, in a group with other families, family therapy is offered.
  • You will usually be offered 18 to 20 sessions over a year, and your therapist will regularly check that the schedule is still working for you.
Adolescent-focused psychotherapy
  • Usually, adolescent-focused psychotherapy involves up to 40 sessions and usually lasts between 12 and 18 months. In the beginning, you will have more sessions to give you more support.
  • The therapist will help you:
    • Cope with your fears about gaining weight
    • Understand what you need to do to be healthy
    • Understand the effect of under-eating
    • Understand what is causing your anorexia and how to stop it
Diet advice
  • If you have anorexia, you may not be getting all the vitamins and energy that your body needs to grow and develop properly, which is particularly important as you reach puberty.
  • Your doctor will give you advice on the best foods to eat to stay healthy during your treatment. They will probably also advise you to take vitamin and mineral supplements.
  • They will also be going to discuss your diet with your parents or caregivers so they can support you at home.
Bone health
  • Anorexia may make your bones weaker, which may make you more likely to develop a condition called osteoporosis. This is more likely if your weight has been low in children and youth for a year or more, or in adults for two years or more.
  • Therefore, your doctors might suggest that you have a special type of X-ray called a bone density scan to check your bones health.
  • Girls and women are more likely to become weaker bones than men, so your doctor may prescribe medicine to help protect your bones from osteoporosis.
Medication
Antidepressants should not be offered as the only treatment for anorexia. But in combination with therapy, you may be offered an antidepressant such as fluoxetine (Prozac) to help you manage other conditions like:
  • Anxiety
  • Depression
  • 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 while they are being treated. Usually, you will have clinic appointments and then be able to go home.
  • If you have serious health complications, you may be admitted to hospital. 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 do not have enough support at home doctors are worried that you might harm yourself or are at risk of suicide
Compulsory treatment
  • Occasionally, someone with anorexia may refuse treatment even though they are severely ill and their life is at risk.
  • In these cases, doctors may decide, as a last resort, to admit the person to a hospital for compulsory treatment under the Mental Health Act. This is sometimes known as "sectioning" or being sectioned.