Treatment for Anorexia
by: Jeanne Rust, PhD
Mirasol Eating Disorder Treatment Center
Treatment for Anorexia
Treatment of anorexia nervosa involves three components:
- restoring healthy weight
- resolution of psychological issues related to the eating disorder
- eliminating behaviors or thoughts that lead to disordered eating and potential relapse
In many anorexia treatment centers, patients are routinely given antidepressants, anti-psychotics or mood stabilizers, even though medications are of limited efficacy in the treatment of anorexia and co-occurring disorders such as anxiety and depression.
Different forms of psychotherapy, including individual, group and family-based, can help address the psychological reasons for the illness. There are four types of psychotherapy that are used in anorexia treatment centers:
- cognitive behavioral therapy
- family therapy
- individual psychotherapy
- relapse prevention
Cognitive Behavioral Therapy
Cognitive therapy explores the critical and unhealthy thoughts underlying anorexia. The focus is on self-awareness, challenging distorted beliefs, improving self-esteem and developing a personal identity.
The distorted beliefs, values, and behaviors or cognitive distortions of the patient are more than just symptoms and can assume primary importance in the maintenance of the eating disorder. A requirement for full recovery is to change these cognitive distortions. For this reason, Christopher Fairburn in 1981 developed a cognitive-behavioral model of treatment for anorexia nervosa and bulimia nervosa. Fairburn's model utilizes behavioral interventions and formal cognitive restructuring.
A few of the cognitive distortions a patient may develop and that will be addressed in an anorexia treatment center are:
- I do not need treatment. If I see a therapist or go to treatment, I will get fat.
- I am fat (even though I weigh 90 pounds).
- I am not allowed to eat anything until after 9:00 pm. If I do, I will be out of control.
- Once I begin to eat normal foods, I will lose control and not be able to stop.
- If I eat any fat, it will go right to my thighs.
- I love to wear tank tops to the mall because people stare at me. I know that they are just jealous because I look so good.
- I feel more powerful when I do not eat.
- I like the way I feel when I am thin.
- I can keep people at a distance.
- I am more confident and capable when I am thin.
Behavioral therapy promotes healthy eating behaviors through the use of rewards, reinforcements, self-monitoring, and goal setting. It teaches the client to recognize anorexia triggers and deal with them using relaxation techniques and coping strategies. Cognitive behavioral therapy is regarded as the "gold standard" in the treatment of anorexia. And while it is highly effective, the addition of experiential and physiological therapies dramatically increases its effectiveness.
Family Therapy
Family therapy examines the family dynamics that may contribute to anorexia or interfere with recovery. It often includes some therapy sessions without the anorexic patient — a particularly important element when the person with anorexia denies having an eating disorder. Some studies suggest that family-based therapies in which parents assume responsibility for feeding their adolescent promote gain weight and improve eating habits and moods. This is called the "Maudsley Method", and it has been shown to be effective in the treatment of younger, non-chronic patients.
Individual Psychotherapy
Individual psychotherapy plays an important part in the treatment process in anorexia treatment centers mainly in helping the patient explore developmental issues. Group therapy allows anorexics to talk with each other in a supervised setting, and helps to reduce the isolation many of them may feel. Group members can support each other through recovery and share their experiences and advice.
Relapse Prevention
As in any kind of treatment center, particularly anorexia treatment centers, relapse prevention is of utmost importance. Ideally, the patient could attend 30-90 days in a transformation living program where the emphasis is on coping strategies rather than on weight restoration.
Jeanne Rust, PhD, is the founder and CEO of Mirasol, a holistic, integrative, bulimia and anorexia treatment center in Tucson, Arizona. Her pioneering work in the use of holistic and complementary interventions for eating disorder treatment has been featured in The Chicago Tribune, USA Today, The San Francisco Chronicle, Time magazine in the United States and Flair magazine in Canada.
