Anorexia and Emotions: A Treatment Approach From the Inside Out

Contributor: Jacquelyn Ekern, MS, LPC.

beach-544621_640You’ve probably noticed that loved ones who struggle with anorexia often tend to emotionally shut down: avoiding activities they used to enjoy, withdrawing from relationships and meaningful interactions with others and avoiding or denying their feelings.

We find it heartbreaking to observe formerly vibrant and lively family members or friends become a seeming shell of their former selves avoiding aspects of a human life that add beauty and depth to our existence.

Cheerleader Anorexia & Apathy

Case in point, a beautiful, bright high school girl came to my practice for outpatient counseling for Anorexia. She had been a popular and well liked honor student and cheerleader. But, over time she stopped caring about her grades or even regularly attending school.

She was eventually forced to leave the cheerleading squad because of her low weight and their fears for her health. Her reaction to this was apathetic and she seemed to not be disappointed, despite having once been very enthusiastic about cheering and being with her close friends on the squad.

Hence, a great example that often anorexia = social withdrawal + apathy towards activities + emotional avoidance.

New and Effective Therapies for Anorexia

The good news is researchers internationally are devoted to finding new and effective therapies along these lines to help those with anorexia find healing.

While more research is needed, the dedicated doctors and researchers that devote their lives and resources to this important work should be commended for advancing our understanding of the complex etiology of anorexia and providing new treatment modalities to help sufferers recover.

The Pilot Study for Psychotherapeutic Therapy

brown-518333_640For example, a recent important pilot study (a small scale, preliminary study conducted to determine multiple factors: time, cost, effect size, etc. before initiating a full scale study) reviewed in the December, 2015 issue of The International Journal of Eating Disorders, examined an outpatient psychotherapeutic therapy in treating those over 17 years of age and adults with anorexia.

EABT Therapy

The treatment involved Emotion Acceptance Behavior Therapy (EABT), which is chiefly focused on helping the individual with anorexia achieve:

  • Increased emotional awareness
  • Decrease avoidance of emotions
  • Resume fulfilling activities
  • Resume relationship participation

Three Therapeutic Segment

Emotion Acceptance Behavior Therapy (EABT) is divided into three therapeutic segments. These broadly include:

  • Phase I – Therapist and anorexia sufferer work together to develop a clear and mutually understood perspective of the individual’s illness. Recovery goals of treatment are set.
  • Phase II – Strategies are developed and implemented to help the patient develop skills of practicing mindfulness, acceptance and an ability to stay focused on the present.
  • Phase III – Successes of treatment are identified, ongoing practice of strategies are encouraged and treatment eventually ends.

Details of the Study

It is important to note a few more details of the study:

  • One to three sessions of nutritional counseling was also provided to the study participants
  • Participants initially attended therapy two times a week, then once weekly, and finally bi-weekly for the last 8 weeks of treatment
  • It was a small study, 24 participants began the study and only 13 patients completed the EABT treatment

The study resulted in some encouraging findings! When treatment ended, 69.2% of the participants were maintaining an 18.5 BMI or greater. At the three and six month follow ups, 61.5% were still at the 18.5 BMI or higher.

The Findings of the Study

brain-155188_640So, participants who completed the EABT treatment had gained weight and showed fewer psychological symptoms of anorexia. These preliminary findings were compared to other treatments geared toward anorexia, such as the Maudsley Model of Anorexia Treatment for Adults (MANTRA) and Specialist Supportive Clinical Management (SSCM).

The EABT graduates displayed greater recovery than the other two modalities, though it is important to consider the small size of the study and the short period of follow up on the recovery rates.


To wrap up, these findings give some indication that Emotion Acceptance Behavior Therapy may be a useful treatment for those struggling with anorexia.

Further research needs to occur to determine more definitive conclusions, but this is an encouraging development in our ongoing quest to develop effective treatment for anorexia nervosa from a more holistic perspective.

Community Discussion – Share your thoughts here!

What has been your experience with anorexia and Emotion Acceptance Behavior Therapy? What successes can you share regarding this method?


  1. Wildes, J., Marcus, M., Cheng, Y., McCabe, E., & Gaskill, J. (2014). Emotion Acceptance Behavior Therapy for Anorexia Nervosa: A Pilot Study. International Journal of Eating Disorders, 47(8), 870-873.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on December 2, 2015
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