How can I get proper treatment for anorexia nervosa when my current therapist and support system are unhelpful?

Getting Proper Treatment for Anorexia Nervosa

You need and deserve a multidisciplinary treatment team that includes a psychiatrist, medical specialists, nutritionist, and psychotherapist who specialize in eating disorders, not someone who tells you to "figure it out on your own." 1, 2

Finding Appropriate Care

When your current therapist and support system are unhelpful, take these steps:

1. Seek specialized care immediately:

   • Contact an eating disorder specialist or center directly
   • Ask your primary care physician for a referral to specialists
   • Call eating disorder helplines for guidance to local resources
   • Consider self-referral to an eating disorder program at a hospital

2. Required treatment team components:

   • Psychiatrist to coordinate treatment and manage medications if needed
   • Medical physician to monitor physical health complications
   • Nutritionist for meal planning and nutritional rehabilitation
   • Psychotherapist trained in eating disorder-specific therapies 1, 2

Evidence-Based Treatment Approaches

Psychotherapy Options

• Cognitive-Behavioral Therapy (CBT) is a first-line treatment that addresses:

  • Normalizing eating patterns
  • Challenging distorted thoughts about weight and body image
  • Developing healthy coping mechanisms 1

• Family-Based Treatment (FBT) is recommended if you have supportive family members who can be involved 1

• Interpersonal Therapy (IPT) may also be effective 1

• Interprofessional Enhanced Cognitive Behaviour Therapy (CBT-IE) is a newer approach where:

  • Dietitians address malnutrition and dietary restraint
  • Mental health professionals focus on cognitive and behavioral change 3

Level of Care Assessment

Your treatment setting should be determined by:

• Severity of weight loss (BMI <16 kg/m² typically requires higher level of care)
• Medical complications (cardiac issues, electrolyte abnormalities)
• Psychiatric stability (suicidality, ability to follow treatment plan)
• Previous treatment response 1, 4

Treatment options include:

1. Inpatient care: For medical stabilization, severe malnutrition
2. Residential treatment: 24-hour structured environment
3. Partial hospitalization: Daytime program with structured meals
4. Intensive outpatient: Several sessions weekly
5. Outpatient care: For medically stable patients with support 1, 2

Common Pitfalls to Avoid

• Underestimating severity: Anorexia has the highest mortality rate among psychiatric disorders (4-11%) 1, 4
• Inadequate monitoring of medical complications
• Not addressing underlying trauma or psychological issues
• Focusing solely on weight rather than normalizing eating behaviors
• Premature discontinuation of treatment 1
• Single-discipline approach: Treatment by a single provider without a team is less effective 2, 5

Taking Action Now

1. Document your concerns about your current therapist's approach
2. Research eating disorder specialists in your area
3. Contact your insurance about covered eating disorder programs
4. Reach out to national eating disorder organizations for referrals
5. Consider a self-assessment to share with new providers

Remember that early intervention is critical - prognosis is directly related to duration of illness, with only 40-50% of patients progressing to complete recovery without proper treatment 5, 6. You deserve comprehensive, specialized care for this serious condition.