Anorexia Nervosa

What is anorexia?

Anorexia is an eating disorder that is primarily associated with restrictive eating and low weight. People with anorexia typically eat less than their body needs (either by under eating, over exercising or both). Sometimes people think that in order to have anorexia, you must be completely starving yourself. This isn’t true. Some people will skips meals, or have large delays in eating. Some people will try and avoid certain food groups (e.g. carbs, fats or sugars). Others will eat large meals, but mainly consisting of low calories foods such as veg or fruit. And some will eat all the food groups, including “treat” foods, but will have very small portions. All of these count as restrictive eating if someone is repeatedly getting fewer calories than they need.

Some people with anorexia will only restrict. However, others may binge (eat a large amount of food in short period of time) and/or purge (vomit or take laxatives). If weight is low, anorexia would be diagnosed rather than bulimia.

People with anorexia will also have some body image disturbance - whether this is a fear of weight gain, a distorted view of the body as healthy or overweight when it is not, or someone acting in a way that prevents weight gain, despite the risks of remaining under weight. Someone who is low weight may think that they don’t have body image issues, as they are happy with their body. However, if they would be fearful of gaining weight, or would act in a way to try and prevent weight gain, this would still count as body image disturbance.

What is the best treatment for anorexia?

There is less research on the effectiveness of treatment for anorexia than other eating disorders, and the research findings are more mixed. However, CBT-E has still been found to be effective for a lot of people. Other treatments recommended by the NICE guidelines include MANTRA (Maudsley Anorexia Nervosa Treatment for Adults) and Specialist Supportive Clinical Management (SSCM).

Crucially, treatment for anorexia does need to include weight regain. This is because being low weight reinforces the eating disorder, keeping it going. However, treatment always starts with helping someone understand the function of their eating disorder, working on motivation, and giving people the tools they need to make the eating disorder feel less important. Not only that, weight gain is done in a collaborative and supportive way. If you would like to discuss this further, do feel free to contact me here.