For Adults
When treating anorexia, evidence shows that weight gain needs to come first and is the primary goal of treatment. Weight gain not only promotes physical health but also supports psychological growth, enabling the individual to think more flexibly and therefore engage better in therapy.
The NICE guidelines suggest an anorexia specific talking therapy. This kind of therapy helps you to understand the causes of your eating problems and learn new ways of thinking and behaving. The main recommended treatments for anorexia are cognitive-behavioural therapy (CBT), the Maudsley Anorexia Nervosa Treatment for Adults (MANTRA) or specialist supportive clinical management (SSCM). Treatment aims to help you feel comfortable around food, so you can eat enough to stay healthy. It’s also likely to involve helping you reach a healthy weight.
What does CBT involve?
CBT-ED is Cognitive Behavioural Therapy for Eating Disorders. You’ll usually see your therapist weekly and work through a personal treatment plan to start making changes in your behaviour. These will involve:
- Coping with feelings
- Understanding nutrition and starvation
- Helping you to make healthy food choices and manage what you eat
You should be given simple homework to help you put into practice what you have learned. You’ll also be taught how to monitor your own progress and how to cope when you find it hard to stick to your new eating habits.
What does MANTRA involve?
MANTRA is an evidence-based treatment approach that focuses on addressing the physical, psychological and social aspects of anorexia nervosa. It involves a collaborative effort between the individual with anorexia, their family or close supporters and a treatment team consisting of healthcare professionals specialising in eating disorders.
The key principles of MANTRA include:
- Involvement of the family or close supporters in supporting the individual’s recovery.
- Addressing underlying emotional issues such as low self-esteem, perfectionism and difficulties with expressing emotions.
- Restoring and maintaining a healthy weight through nutritional rehabilitation. A registered dietitian works closely with the individual to create a balanced meal plan and provide ongoing support.
- Gradual exposure to feared foods and situations to help reduce anxiety and increase flexibility in food choices and eating behaviours.
What does SSCM involve?
SSCM is a much more flexible approach to the treatment of anorexia. It utilises clinical management skills, a sustained focus on improving eating disorder symptoms and supportive therapy techniques to guide people towards meeting their own treatment goals. There’s an additional focus not just on a client’s symptoms, but on improving their enjoyment and quality of life alongside their eating disorder symptoms. Within each session, core symptoms and progress towards treatment goals are reviewed. However, other than that, the content of each session is dictated by the needs, feelings and desires of the client. The therapist facilitates, supports and encourages the client to use skills and strengths that they already have to move towards treatment goals.
Nutritional Advice
Restoration of nutritional health is an essential component of anorexia treatment. Anorexia can lead to severe malnutrition and nutritional imbalances so working with a nutritionist or dietician will help customise a meal plan that will support your physical and mental health needs. The meal plan will help establish regular and balances eating patterns. Dieticians will also monitor progress, adjusting to the meal plan as needed as well as providing up-to-date and accurate information about nutrition.
For Children
When treating anorexia, evidence shows that weight gain needs to come first and is the primary goal of treatment. Weight gain not only promotes physical health but also supports psychological growth, enabling the individual to think more flexibly and therefore engage better in therapy.
Many children and young people with anorexia find it helpful to have a talking therapy that family members or carers can take part in too and this is known as family therapy. Family Based Treatment (FT-AN) is recommended in the NICE guidelines as the first line treatment for anorexia nervosa in young people.
It involves working with a practitioner and allows you to explore how anorexia has affected you and how your family can support you in getting better. You should be able to choose whether to have therapy sessions together with your family or separately or a mixture of both.
There is also the possibility of Multi-Family Therapy where therapy is offered together with other families.
What does Family Therapy Involve?
- Thinking about how your family can help you to get better
- Learning about what happens to your body when you are starving
- Supporting your parents to help you manage your eating until you feel ready to take control again
- Working with your family to make sure they give you independence when you need it and are ready for it
- Preparing for the end of treatment
What does CBT involve?
CBT-ED is Cognitive Behavioural Therapy for Eating Disorders. You’ll usually see your therapist weekly and work through a personal treatment plan to start making changes in your behaviour. These will involve:
- Coping with feelings
- Understanding nutrition and starvation
- Helping you to make healthy food choices and manage what you eat
You should be given simple homework to help you put into practice what you have learned. You’ll also be taught how to monitor your own progress and how to cope when you find it hard to stick to your new eating habits.
What does Adolescent Focussed Therapy Involve?
Adolescent-focused therapy (AFT) is a specialised form of psychotherapy that targets the unique challenges and developmental needs of adolescents with eating disorders. It recognises the significant physical, emotional and social changes that adolescents face, such as identity formation, autonomy and unhealthy dynamics in peer relationships.
It utilises psychoeducation and CBT techniques to address the distorted thoughts, beliefs and behaviours associated with eating disorders and helps individuals identify and challenge negative thoughts about body image, weight and food, replacing them with more realistic and positive beliefs. AFT emphasises the involvement of family members and aims to improve family communication, understanding, and support in the recovery journey.
Nutritional Advice
Restoration of nutritional health is an essential component of anorexia treatment. Anorexia can lead to severe malnutrition and nutritional imbalances so working with a nutritionist or dietician will help customise a meal plan that will support your physical and mental health needs. The meal plan will help establish regular and balanced eating patterns. Dieticians will also monitor progress, adjusting to the meal plan as needed as well as providing up-to-date and accurate information about nutrition.
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