Understanding The Basics Of Anorexia Nervosa Treatment

Anorexia nervosa is an eating disorder that affects over 28 million people in the United States, making it one of the most common mental health conditions. Those affected by anorexia often experience distorted body image or excessive fear of gaining weight. They may resort to dieting habits and unhealthy eating rituals to lower their weight. 

Eating disorders like anorexia have the highest mortality rate among any mental health illness, making treatment a vital step in recovery. It can be beneficial to note that recovery is often achieved with the right combination of knowledge and professional support. You're not alone, and eating disorders are treatable. 

Understanding anorexia nervosa

Anorexia nervosa is an eating disorder affecting people of all ages, genders, sizes, and backgrounds. This condition is believed to be caused by a combination of genetic, environmental, and psychological factors. Studies have shown that people with a family history of eating disorders may be more vulnerable to developing anorexia. Genetic influences and linkage to chromosomal regions have been identified, suggesting that some people may be predisposed. 

While biology can play a role in anorexia, it isn't the only factor. Environment can also be related to family history and lifestyles, such as a traumatic event or limited availability of healthy foods. Psychologically, anorexia can be rooted in feelings of low self-esteem, perfectionism, and anxiety. It can be common for people with anorexia to place a significant amount of importance on body image, which may lead them to excessively diet or restrict their food intake.

What are the symptoms of anorexia? 

Many symptoms of anorexia revolve around food, weight, and body image. While people with anorexia can have low body weight, some do not. Some people with anorexia maintain a healthy weight or gain weight while exhibiting eating disorder behaviors. For this reason, other symptoms may be a more significant indicator of the condition. 

A distorted perception of one's body shape or a constant preoccupation with food, calories, and weight loss are common indicators of anorexia. When people engage in dangerous behaviors like restricting their food intake, excessive exercise, using laxatives or diuretics, or purging, they might have an eating disorder. Purging or starving behaviors can cause severe constipation, muscle loss within the intestinal tract, bacterial infections, stomach pain after eating, nausea, and blocked intestines.

Left untreated, anorexia can have devastating effects on the body and mind. Starvation can lead to malnutrition, dehydration, and organ damage, while the psychological toll can include depression, anxiety, and suicidal thoughts. A cycle of fear and guilt can also develop as people caught in the grips of anorexia may feel stuck between wanting to recover and struggling to understand their mental illness. 

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However, anorexia can be treated through various therapies and treatment options. Medication may sometimes be prescribed to manage associated conditions like depression or anxiety. Recovery is often gradual, but it can be possible, and the physical impacts of this condition may also improve over time.  

Components of anorexia nervosa treatment

Effective treatment of anorexia may involve a holistic approach that addresses the underlying factors contributing to this condition. A combination of medical management, nutritional rehabilitation, psychological therapy, and family-based therapy can all be used to support recovery. 

Medical management 

Medical management may involve specific assessments, such as body mass index (BMI) checks and blood tests, to monitor the physical health of people with anorexia. These tests can help determine what treatments are needed or if a person is at risk for immediate medical complications. Severe physical symptoms often necessitate medical management of illnesses and electrolyte imbalances. A medical doctor, like a primary care physician or hospital practitioner, may conduct these tests, depending on one's symptom severity. 

Nutritional rehabilitation 

Nutritional rehabilitation may also be recommended for anorexia nervosa treatment. Individuals with anorexia often have a distorted relationship with food, avoiding certain foods or drastically restricting their intake. Nutritional rehabilitation involves working with a registered dietitian to establish a healthy and balanced eating plan that meets the individual's unique dietary needs. This process may be gradual and accompanied by medical management to ensure that the individual gains weight safely and healthily.

Individual therapy 

Individual therapy can help individuals address the psychological and behavioral aspects of anorexia. Eating disorders are complex conditions often involving underlying emotional, psychological, or social issues. Therapy can help individuals with anorexia identify the potential causes of their patterns, develop coping mechanisms, and learn healthy ways of managing stress. A therapist may also offer research-backed techniques for challenging eating-disorder-related thoughts, urges, and rituals. 

Family-based therapy 

Family-based therapy, or the Maudsley approach, is an evidence-based treatment for anorexia nervosa. This approach recognizes the critical role of the family in treating eating disorders and involves the family in the treatment process. Family-based therapy aims to help family members guide their loved ones to eat a balanced and healthy diet and create a supportive and nurturing environment that fosters recovery. 

Comprehensive approaches 

Anorexia often requires a comprehensive and individualized approach to treatment. With the proper medical, nutritional, and psychological interventions, individuals with an eating disorder may recover successfully and lead healthier lives. 

Alternative anorexia nervosa treatment options 

Anorexia nervosa can be a potentially life-threatening mental illness, but several extensive treatment options are available. Depending on the severity of the disorder, treatment can range from outpatient therapy to inpatient or residential care. 

Outpatient treatment 

Outpatient treatment for anorexia involves regularly scheduled appointments with a healthcare professional. This approach is often recommended for individuals with mild or moderate anorexia who are medically stable, have support at home, and are motivated to participate actively in their treatment. Outpatient treatment can include medical management, nutritional counseling, individual therapy or group therapy, and medication management.

Intensive outpatient treatment

Intensive outpatient treatment (IOP) is a step up from traditional outpatient treatment and involves more frequent appointments with healthcare professionals. IOP programs are often recommended for individuals with moderate to severe anorexia who require more structured and intensive treatment than typically offered in outpatient treatment. IOP programs usually involve multiple therapy sessions per week, medical monitoring, nutritional counseling, and medication management.

Partial hospitalization programs 

Partial hospitalization programs (PHP) are structured treatment programs that provide intensive treatment for individuals with anorexia. PHPs are usually recommended for individuals with severe anorexia who require more structured and supervised care than what is provided in IOP or outpatient treatment. PHPs can include medical management, nutritional counseling, individual therapy, group therapy, and family therapy. 

In PHP, individuals might spend some time in the hospital being monitored and working with nutritionists and doctors to develop an eating plan. Depending on their needs, they may be given a feeding tube in the hospital. 

Inpatient treatment 

Inpatient treatment for anorexia involves hospitalization or rehabilitation in a specialized unit, hospital, or eating disorder center. This approach might be recommended for individuals with severe anorexia who require around-the-clock medical monitoring, nutritional rehabilitation, and intensive therapy. Inpatient treatment can benefit individuals with medical complications, such as electrolyte imbalances or severe malnutrition.

Some inpatient programs are voluntary, meaning clients can check themselves in if they meet admission criteria. These units may act more as rehabilitation centers, where clients can move freely around the building, attend therapy groups with other clients, and receive 24/7 support from staff. 

Potential challenges during treatment 

Those living with anorexia may experience challenges or barriers during treatment that can feel discouraging. If you're experiencing the following, talk to your therapist to develop a plan to address them.

Stigma 

The stigma surrounding mental illness may impact how an individual responds to treatment. Those with anorexia may feel ashamed or embarrassed to seek treatment due to societal and cultural norms. A lack of understanding of the complexity of the disorder can also lead to individuals being hesitant to seek help or open up about what they're experiencing. 

Resistance 

Some individuals may resist treatment due to a lack of understanding of what they're experiencing. A client feeling reluctant to change their eating behaviors, experiencing low motivation, or having limited insight into their condition may not initially respond to treatment. 

If one believes they are not experiencing an illness, they might avoid family attempts for support. They could be more likely to receive intensive medical treatment, which can be distressing and traumatic for someone who doesn't believe they need it. 

Co-occurring mental illness 

People living with anorexia can have co-occurring mental health conditions, such as anxiety or depression, that complicate treatment. Studies have found that 50% to 75% of all individuals diagnosed with an eating disorder also live with depression. Co-occurring conditions might require additional treatment or medication and might interfere with recovery. However, it can be beneficial to know that anxiety and depression are also treatable mental illnesses. 

Treatment complications 

Treatment complications can also exacerbate the disorder, leading to medical problems and more severe anorexia symptoms. For example, gastrointestinal and metabolic complications can emerge during weight restoration, and overeating or binge eating can result in physical discomfort and the need for more intensive medical care.

Counseling options 

If you or someone you know is living with anorexia, it can be beneficial to understand the treatment options available to you. Online therapy can be a significant first step if you're experiencing shame or barriers to therapy. Online therapy can help you build the skills to maintain healthy eating habits, overcome stigma-related barriers, and practice self-care by providing a safe and judgment-free space.

Details from The Psychiatric Clinics of North America indicates cognitive-behavioral therapy (CBT) can effectively treat multiple eating disorders, including anorexia. In addition, the findings suggest CBT may be the most effective evidence-based treatment for bulimia nervosa. 

Through personalized treatment and self-monitoring, individuals can better understand the thoughts and behaviors associated with their eating disorder. In addition, online CBT has been associated with reduced symptoms of anxiety and depressive disorders, which frequently co-occur with eating disorders like anorexia. 

Remembering that recovery is possible may help you remain hopeful for symptom reduction. Through a platform like BetterHelp, you can choose from a growing database of licensed mental health professionals with experience in many specialties, including eating disorders and recovery.