What are some possible treatments for individuals that may have anorexia?

Before your treatment begins, you will probably have an overall assessment of your health. This may be done by your GP or another healthcare professional, such as one that specialises in eating disorders.

The assessment will help your healthcare professional draw up a plan for your treatment and care. For example, they may assess:

• your overall health and any medical needs
• your social situation, such as how much support you have from family and friends
• your mood and any risks that affect you, such as whether you're at risk of harming yourself
• whether there are any physical risks as a result of anorexia that mean urgent treatment is needed

Your care plan

If you are diagnosed with anorexia nervosa, your GP will probably be involved in your ongoing treatment and care. Other healthcare professionals may also be involved in your treatment, such as:

• a specialist counsellor
• a psychiatrist (doctor who specialises in treating mental health conditions)
• a psychologist or psychotherapist
• a nurse
• a dietician (specialist in nutrition)

If a child or teenager has anorexia, a paediatrician (doctor who specialises in children) may also be involved in their treatment.

Where you are treated may depend on how mild or severe your condition is. For example, you may be treated:

• as an outpatient (this is most common)
• as a day patient or in a day unit
• as in inpatient in hospital, if your weight loss or symptoms are severe

In some areas, eating disorders such as anorexia are treated by community mental health teams, which are made up of different health and social care professionals.

In other areas, there are units that specialise in treating eating disorders. Some services that treat eating disorders also specialise in treating young people.

What to expect from anorexia treatment

It’s important to start treatment as early as possible, especially if someone has already lost a lot of weight.

Treatment for anorexia usually includes:

• psychological treatment – talking to a therapist or counsellor
• advice on eating and nutrition to help you gain weight safely

These treatments work better when combined, rather than on their own.

Your physical health will be monitored closely during your treatment. For example:

• your weight will be checked regularly
• you may have regular health checks with your GP or another healthcare professional

In children and young people with anorexia, their growth, development and weight will be monitored closely. Their height will also be checked regularly against the average for their age and sex.

Other health problems caused by anorexia will also be treated. For example, if you vomit regularly, you’ll be encouraged to stop. You’ll be given advice on dental hygiene to help prevent stomach acid damaging the enamel on your teeth. You’ll also be advised to visit a dentist regularly. If you take laxatives or diuretics, you’ll be advised to reduce them gradually so your body can adjust. Stopping them suddenly can cause side effects like nausea and constipation.

Gaining weight safely

Your care team will give you advice on how to increase the amount you eat so you can gain weight safely.

They’ll ask about your current eating habits and how much fluid you drink, as well as habits like smoking and drinking alcohol. This will determine what advice they give you, and help them identify any deficiencies in your diet, such as a lack of vitamins.

Your care team will help you to develop healthy eating habits, such as eating more, eating more healthily, and increasing the nutritional benefits you get from food.

Your body will likely need time to adjust to eating more. You may need to start by eating small amounts of food, and then gradually increasing what you eat.

You may need to take supplements, such as multivitamins or multiminerals, to adjust the chemical balance in your body. Some experts think this should be done before you start gaining weight.

You and your care team will work towards establishing a regular pattern of eating, with three meals a day and regular snacks. Your care team might agree a target weight with you, so you have a minimum healthy weight to aim for.

If your weight loss is severe, treatment in hospital may be needed to help you start to gain weight. Your health will be closely monitored to avoid any side effects, particularly in the first few days.

Types of psychological treatment

Various types of psychological treatment can be used to treat anorexia, such as:

• cognitive analytic therapy (CAT)
• cognitive behavioural therapy (CBT)
• interpersonal therapy (IPT)
• focal psychodynamic therapy (FPT)
• family therapy

These different types of psychological treatments are discussed below.

Cognitive analytic therapy (CAT)

CAT is based on the theory that mental health conditions like anorexia are caused by unhealthy patterns of behaviour and thinking, which a person has developed in their past, usually in their childhood.

Cognitive behavioural therapy (CBT)

CBT starts with the idea that thoughts, feelings, and behaviour are linked and affect one another. If anorexia is causing someone to behave in an unhealthy way, CBT helps them to change the harmful behaviour while working on changing how they think about food, eating, and weight.

Interpersonal therapy (IPT)

IPT is based on the idea that relationships with other people and the outside world in general have a range of effects on your mental health, both positive and negative. IPT explores the way you interact with other people and the relationships you have, with the goal of improving them.

Focal psychodynamic therapy (FPT)

Previous experiences, particularly from childhood, can influence the way you think and feel now in ways you’re not aware of. The aim of FPT is to help you become aware of those effects, so you can understand why you think and feel the way you do about food, eating, and weight.

Family therapy

Anorexia doesn’t just affect one person – it can also have a big impact on their family.

Family therapy involves the person with anorexia and close members of their family discussing how anorexia has affected them, and the positive changes the person and their family can make.

Learn more about talking therapies

The types of therapy available can vary depending on where you live. Although different types of therapy take different approaches, the most important part of any talking therapy is the relationship you build with your therapist.

Medication

Medication alone isn’t usually effective in reducing anorexia symptoms. For some people it can be helpful to prescribe medication in combination with psychological treatment.

Your treatment team might prescribe nutritional or vitamin supplements for you to help your overall health.

If treatment isn’t improving your symptoms, or you start to get worse, your healthcare professional may consider changing your treatment. This may include treatment in hospital if your health is seriously at risk.

Compulsory treatment

Sometimes the physical health issues caused by anorexia mean a person has to be admitted to hospital. If their life is at risk and they refuse treatment, there are some circumstances when they might be admitted under the Mental Health (Care and Treatment) (Scotland) Act 2015. This is sometimes called ‘being sectioned’.

Someone can only receive compulsory treatment if their condition is preventing them from making informed decisions about their care.

Relapsing

It’s quite common for anorexia to return after treatment – this is often referred to as relapse. It can happen, for example:

• if someone’s weight starts to fall again
• after having a baby, when a woman tries to lose the weight she gained during pregnancy
• during stressful times in a person’s life

Sometimes, anorexia can lead to another eating disorder called bulimia nervosa, where the person binge eats, then immediately makes themselves sick or uses laxatives to rid their body of the food.