Treatment often depends on how much intensive care you need, and options can range from residential care to counseling.
A strong fear of weight gain and unhappiness with body image tend to drive behaviors that come with anorexia nervosa, like restricting food, over-exercising, and sometimes purging.
Treatment for anorexia often combines multiple methods to help you address medical and mental health symptoms. For example, a treatment team for someone with anorexia might include a psychiatrist, medical doctor, dietitian, and therapist.
Anorexia recovery might also center around some key goals, like:
- helping people reach a weight that’s healthy for them
- helping people learn new eating habits
- treating any medical complications of malnutrition
- addressing mental health concerns
- preventing the recurrence of anorexia
Since each person with anorexia has a different experience, treatment approaches will look different from person to person. And there are healthcare professionals ready to offer support at each stage of the recovery process.
Therapy can be an important part of anorexia care, and there are a few approaches to it, as well. The healthcare professionals you work with may recommend a specific type of therapy based on what you need.
Some types of therapy for anorexia could include:
- cognitive behavioral therapy (CBT)
- family-based therapy
- interpersonal psychotherapy (IPT)
- dialectical behavior therapy (DBT)
- acceptance and commitment therapy (ACT)
Many of these therapies can take place in inpatient (you stay in a treatment center) or outpatient settings (you go from your home to therapy).
Cognitive behavioral therapy (CBT)
CBT is a popular treatment for anorexia. It focuses on identifying and changing thinking patterns, beliefs, and attitudes that drive behaviors.
Enhanced cognitive behavioral therapy (CBT-E) is a form of CBT that specifically addresses eating disorders and the psychology behind them. It can also be tailored to fit your specific needs.
Family involvement and having a strong support network can be key parts of treatment.
Family-based therapy for anorexia is known as the Maudsley method. It’s an outpatient treatment where parents play an active role in their child’s recovery.
The goals of the Maudsley method act as three treatment phases. They are:
- Helping the person regain any weight they need to.
- Helping the person learn new eating habits.
- Establishing a secure sense of self.
Interpersonal psychotherapy (IPT)
IPT is a leading evidence-based therapy created to help people with depression. It’s also been used to treat eating disorders because it helps people manage their symptoms in terms of their relationships with other people.
Dialectical behavior therapy (DBT)
DBT is a type of CBT originally developed for borderline personality disorder. It’s now also used to treat eating disorders and some other mental health conditions like depression and PTSD.
“Dialectical” in DBT refers to the combining of two opposites. In therapy, this means you learn to integrate acceptance and change.
One older study found that DBT helped teens with anorexia reduce their eating disorder symptoms.
Acceptance and commitment therapy (ACT)
ACT was designed to increase mental flexibility using acceptance and mindfulness strategies, along with commitment and behavior-changing strategies.
ACT uses six core values:
- cognitive defusion (learning to manage uncomfortable thoughts and feelings)
- present-moment awareness
- self-as-context (knowledge that people aren’t their thoughts and feelings)
- committed action
Though research on ACT for anorexia is ongoing, studies have found that ACT helps people manage behaviors related to eating disorders. But more research is needed to verify the long-term effects of ACT on anorexia.
The American Psychological Association doesn’t recommend medication as the main treatment for anorexia. But depending on your symptoms, medication could be part of your treatment plan.
In some cases, antidepressants such as fluoxetine (Prozac) could help prevent anorexia from coming back when you’re in recovery. Antidepressants can also help with symptoms of depression or obsessive-compulsive disorder (OCD), which may come with anorexia.
Some medications used for schizophrenia and mood disorders could also help with anorexia. For example, evidence suggests that olanzapine (Zyprexa) may help people with anorexia regain weight that’s healthy for them.
In addition, medications used to manage the medical complications of anorexia — such as anemia, constipation, and osteoporosis — may be prescribed based on your needs.
Some medications aren’t recommended for people with anorexia. One of these is bupropion (Wellbutrin), which is often used for depression and smoking cessation. Wellbutrin is
Inpatient hospitalization is the highest level of care for people with anorexia. People usually get care in a hospital setting when they have more urgent medical and mental health needs, like:
- suicidal ideation
- electrolyte imbalance
- abnormal heartbeat
- unstable vital signs
- poor growth and development
- severe binging and purging
- another diagnosis that interferes with treatment, like depression or OCD
Inpatient programs involve 24/7 care and can take place in either a medical or psychiatric setting. Which one usually depends on the person’s health status and what resources are available.
It’s typical to stay in the hospital until your immediate mental health and medical needs are met and you have a care plan set up. For some people, this might look like about 4 weeks.
After hospitalization, it’s common to transfer to:
- a residential treatment center
- partial hospitalization
- intensive outpatient care
- an outpatient program, like therapy or nutritional counseling
Your specific needs and symptoms will likely play a key role in what kind of treatment program you use.
Residential treatment takes place in a non-hospital setting but still involves 24/7 care. It’s usually recommended for people who don’t have urgent medical needs but who need more support for managing anorexia symptoms.
In residential treatment for anorexia, you might participate in:
- group therapy
- family therapy
- one-on-one therapy
- nutritional counseling
The average stay in a residential treatment center is about 80 days.
A partial hospitalization program (PHP) is a highly structured daytime program that you might go to 3 to 7 days a week while living at home.
PHP could help when you’re medically stable but still need support managing day-to-day. For example, you might still not be able to fully go back to work or school.
PHP lasts from 6 to 12 hours a day, depending on your needs. It can involve many of the same types of therapy that residential treatment centers offer.
Some partial hospitalization programs have supportive housing options for people who don’t live near the clinic.
Intensive outpatient therapy
People who are at a point in recovery that makes it easier to participate in their usual activities might still be part of an intensive outpatient program. These programs tend to offer a more flexible and cost-effective approach to care.
An intensive outpatient program often involves 3 to 5 days a week for 3 to 5 hours a day. You might receive:
- meal support
- dietary counseling
- medication management
Professional treatment is an important part of anorexia recovery, but practicing self-care along the way can support you on that journey, too.
It can be helpful to connect with others, do things you enjoy, and take care of your mind and body.
Some self-care activities you might practice during anorexia recovery include:
- joining an eating disorder support group
- focusing on good sensations, like the scent of a candle or the feeling of a favorite piece of clothing
- setting boundaries around people or habits that make recovery more difficult
- journaling your thoughts and feelings (for example, you might start by jotting down three things you love about yourself right now)
- finding the people you trust and leaning in to those relationships
Anorexia is usually diagnosed by a healthcare professional, such as a pediatrician, family practitioner, or psychiatrist. Before you get a diagnosis, you might have a physical and mental health exam.
A healthcare professional might use these criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose anorexia:
- not eating enough food to support the work your body does
- strong fear of weight gain (even if losing weight could cause health complications)
- viewing your body as larger than it is
- self-esteem or sense of self that’s tied to whether you feel good or bad about your body
- lack of recognition that not getting enough food could be causing health complications
Some people with anorexia also experience cycles of binge eating and purging, so a doctor may look for these behaviors when diagnosing anorexia, too.
It’s not easy to witness someone you love experiencing anorexia. But your care and concern can be pivotal in their life. Many people recovering from anorexia say the support of family and friends played a key role in their recovery.
Here are some ways you can help your loved one with anorexia:
- Learn about anorexia so you’re informed about what your loved one might be experiencing.
- Model a balanced relationship with food, exercise, and self-acceptance in your own life.
- If you’re approaching someone who doesn’t believe they have an eating disorder, you can start by explaining why you’re concerned.
- Be patient and supportive. Listen fully to what your loved one is saying, so they feel heard.
- Avoid talking about weight or appearance. Instead, help them focus on what they have to offer as a human being.
- Keep away from simple solutions that focus on stopping a behavior. Eating disorders tend to go deeper than the behaviors you might notice.
- Encourage your loved one to talk with a healthcare professional. Many people with eating disorders require professional treatment to recover.
- Reassure your loved one that recovery is possible and that you’re there to support them along the way.
The treatment process for anorexia varies a lot from person to person. It can have many steps based on where you are in the recovery process.
If you’re not sure where to start, you can talk with your doctor or a trusted loved one to figure out your first step toward recovery. You can also call a helpline through the Association of Anorexia Nervosa and Associated Disorders (ANAD) or the National Eating Disorders Association (NEDA).
Since anorexia is often rooted in how you see yourself, good treatment usually involves not only medical support but also mental and emotional help as well. This holistic approach is usually the best way to develop a more harmonious relationship not only with food but with yourself.