From the Guidelines
Treatment for anorexia nervosa should involve an eating disorder-focused psychotherapy, incorporating medical, psychiatric, psychological, and nutritional expertise, with individualized goals set for weekly weight gain and target weight, as recommended by the American Psychiatric Association 1. The primary goal of treatment is to restore weight, normalize eating and weight control behaviors, and address psychological aspects of the disorder.
- For adults with anorexia nervosa, eating disorder-focused psychotherapy is recommended 1, which should include normalizing eating and weight control behaviors, restoring weight, and addressing psychological aspects of the disorder.
- For adolescents and emerging adults with anorexia nervosa, eating disorder-focused family-based treatment is recommended 1, which should include caregiver education aimed at normalizing eating and weight control behaviors and restoring weight. Key components of treatment include:
- A coordinated multidisciplinary team approach, incorporating medical, psychiatric, psychological, and nutritional expertise 1
- Individualized goals set for weekly weight gain and target weight 1
- Addressing psychological aspects of the disorder, such as fear of weight gain and body image disturbance 1 It is essential to note that narcissistic personality traits may complicate eating disorder recovery, and treatment should address both conditions simultaneously.
- Long-term psychodynamic therapy or schema therapy may be beneficial for addressing narcissistic traits, focusing on developing empathy and healthier relationship patterns. However, the primary focus should be on treating the anorexia nervosa, as recommended by the American Psychiatric Association 1.
From the Research
Treatment Approaches for Anorexia Nervosa
- Cognitive Behavioral Therapy (CBT) has been shown to be effective in treating anorexia nervosa, with significant improvements in weight restoration and reduced eating disorder psychopathology 2.
- Combined family/individual therapy has also been found to be beneficial, particularly for young adults with anorexia nervosa, with high rates of weight restoration and recovery 2.
- A combination of cognitive-behavioral therapy, nutritional counseling, and antidepressant medication has been used to treat anorexia nervosa, with improvements in body mass index, depression, and anxiety 3.
Multidisciplinary Treatment
- A multidisciplinary approach, including psychological, nutritional, and medical interventions, is often recommended for the treatment of anorexia nervosa 4, 5.
- This approach may involve family-based interventions, particularly for adolescent patients, as well as individual psychotherapy and nutritional counseling 5.
- Controlled exercise, improved nutrition, and hormone treatment may also be used as part of a combined therapy approach 6.
Psychological Factors
- Anorexia nervosa is often characterized by underlying psychological factors, including poor self-esteem, melancholy, and a narcissistic personality structure 6.
- Patients with anorexia nervosa may have a distorted body image and a fear of gaining weight, which can contribute to the development and maintenance of the disorder 4, 5.
- Psychological interventions, such as CBT and family-based therapy, can help to address these underlying factors and promote recovery 2, 5.