Eating Disorders - Anorexia

Please note that the information provided on these websites is intended for educational purposes only and is not a substitute for medical advice. If you are experiencing difficulty with any symptoms listed here, please consult with a healthcare provider for proper diagnosis and treatment.

Anorexia nervosa is a serious eating disorder characterized by a persistent restriction of energy intake leading to a significantly low body weight, intense fear of gaining weight or becoming fat, and disturbance in the way in which one's body weight or shape is experienced, perceived or self-evaluated.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines the following diagnostic criteria for anorexia nervosa:

1. Restriction of energy intake: The individual persistently restricts food intake, leading to significantly low body weight for their age, sex, developmental trajectory, and physical health. This can be assessed by using the Body Mass Index (BMI).

2. Intense fear of gaining weight or becoming fat: The individual has an intense fear of gaining weight or becoming fat, even though they are underweight.

3. Disturbance in the way in which one's body weight or shape is experienced, perceived or self-evaluated: The individual has a distorted body image and an intense preoccupation with body weight, shape or size. They may deny the seriousness of their low body weight, and may experience body dysmorphia, which is a belief that their body size or shape is abnormal, even when others reassure them that they are not.

4. Restricting or binge-eating/purging type: The DSM-5 recognizes two types of anorexia nervosa:

   • Restricting type: The individual primarily restricts food intake to maintain their low body weight.

   • Binge-eating/purging type: The individual regularly engages in binge eating or purging behaviors, such as self-induced vomiting, laxative or diuretic misuse, or excessive exercise, in addition to restricting food intake.

5. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

6. The disturbance is not due to a medical condition or substance use: The symptoms are not better explained by a medical condition or substance use disorder.

It is important to note that the DSM-5 specifies that anorexia nervosa cannot be diagnosed if the individual's low body weight is due to a medical condition, such as a hormonal disorder or gastrointestinal disease. The diagnosis also cannot be made if the individual's symptoms are better explained by another mental disorder, such as depression or obsessive-compulsive disorder.

It is essential to seek professional help if you or someone you know is exhibiting symptoms of anorexia nervosa as it is a serious and potentially life-threatening condition.

Treatment for Anorexia

There are several evidence-based psychological treatments for anorexia nervosa, which are often used in combination with medical and nutritional interventions. The most common psychological treatments for anorexia nervosa are cognitive-behavioral therapy (CBT), family-based therapy (FBT), and interpersonal psychotherapy (IPT).

1. Cognitive-behavioral therapy (CBT): CBT is a structured form of psychotherapy that focuses on changing negative thoughts and behaviors related to anorexia nervosa. CBT for anorexia nervosa often involves setting goals for weight gain, challenging distorted beliefs about body weight and shape, and developing strategies to cope with anxiety and stress. CBT may also involve exposure therapy, which involves gradually exposing the individual to feared situations or foods, to help them develop more flexible and adaptive ways of coping.

2. Family-based therapy (FBT): FBT, also known as the Maudsley method, is a specialized form of family therapy that focuses on empowering parents to take an active role in their child's recovery. In FBT, parents are trained to monitor their child's food intake, support healthy eating behaviors, and gradually increase their child's autonomy around food. FBT has been shown to be particularly effective in adolescents with anorexia nervosa.

3. Interpersonal psychotherapy (IPT): IPT is a short-term psychotherapy that focuses on improving interpersonal relationships and reducing distress related to social and interpersonal issues. IPT for anorexia nervosa often focuses on resolving conflicts within relationships, improving communication skills, and increasing social support.

4. Other psychological interventions: Other psychological interventions that have shown promise in treating anorexia nervosa include dialectical behavior therapy (DBT), which focuses on developing skills for emotional regulation and distress tolerance, and cognitive remediation therapy (CRT), which involves improving cognitive flexibility and the ability to process complex information.

It is important to note that psychological treatments for anorexia nervosa are often provided as part of a multidisciplinary team approach, which may include medical professionals, registered dietitians, and other specialists. The choice of treatment will depend on the individual's unique needs and circumstances. It is recommended that individuals with anorexia nervosa seek treatment from a qualified mental health professional who has experience in treating eating disorders.

Self-Help for Anorexia

If you or someone you know is struggling with anorexia nervosa, here are ten things that can help:

1. Seek professional help: The first step in managing anorexia nervosa is to seek professional help from a qualified mental health professional. This may include a therapist, psychologist, or psychiatrist who has experience in treating eating disorders.

2. Find a support system: It is important to have a support system of family, friends, or support groups who can offer encouragement, understanding, and accountability throughout the recovery process.

3. Follow a meal plan: A registered dietitian can help create a meal plan that meets the individual's nutritional needs and supports weight restoration.

4. Avoid triggers: Avoiding triggers such as social media, specific people or situations, or other stressors that may contribute to negative thoughts or behaviors can help reduce the risk of relapse.

5. Challenge negative thoughts: Negative thoughts and beliefs about body weight and shape can be challenging to overcome, but with practice, individuals can learn to identify and challenge these thoughts using evidence-based techniques such as cognitive-behavioral therapy.

6. Engage in self-care: Engaging in self-care activities such as yoga, meditation, or spending time outdoors can help reduce stress and improve overall well-being.

7. Practice relaxation techniques: Practicing relaxation techniques such as deep breathing, progressive muscle relaxation, or guided imagery can help reduce anxiety and stress.

8. Keep a journal: Writing down thoughts, feelings, and behaviors related to anorexia nervosa can help identify triggers and patterns that contribute to negative thoughts and behaviors.

9. Identify healthy coping mechanisms: Developing healthy coping mechanisms such as exercise, creative expression, or talking with a trusted friend or family member can help manage stress and reduce the risk of relapse.

10. Stay committed to recovery: Recovery from anorexia nervosa is a long-term process that requires patience, persistence, and dedication. It is important to stay committed to recovery and to seek help if necessary to overcome any obstacles or challenges that may arise.