Overview
Anorexia nervosa is an eating disorder in which someone restricts their consumption of sustenance leading to a low enough body weight that health issues can arise. This can be a result of an extreme fear of gaining weight, often fueled by body dysmorphia in which someone can persistently feel overweight or in possession of too much fat even while presenting as skinny or seeing metrics establishing that they’re underweight. Anorexia has the second-highest death rate of any mental health condition, with the first being opioid overdose, as the malnutrition and mental distress associated with it can lead to fatal heart conditions and a high occurrence of suicide. It can also lead to a cessation in menstruation.
Much like substance use disorders, those with anorexia experience changes to their brain that make the disorder much more than just lifestyle choices or destabilizing insecurity. Studies show that people with anorexia have notable reductions in various parts of the brain that, and these reductions are two to four times larger than the variation of brain proportions found in individuals with other mental health conditions. This means a combination of physiological treatments and mental health interventions are deployed to address recovery from anorexia.
The most effective treatments known for adolescent anorexia involve family-based treatment (FBT), where 60% achieve full clinical remission as defined by achieving a healthy weight and normal eating patterns. Up to 87% at least achieve partial remission. This is twice as effective as individualized Adolescent-Focused Therapy (AFT). 75-90% of those who recovered through FBT maintained a healthy weight and, as applicable, regular menstruation long-term.
For adults, enhanced cognitive behavioral therapy (CBT-E) can have medium-to-large effects on reducing compulsive thoughts, restricting diet, and potential purging behaviors. Trials show that 60% of adults who undergo a 40-week protocol achieve substantial recovery; in a study evaluating virtual-first CBT-E, 50% of adults achieved at least 95% of their expected body weight. Specialist Supportive Clinical Management (SSCM) is an alternative approach that structures clinical exams, nutritional edu ation, and practical therapy focused on symptom management. The Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) is a specialized therapeutic interventions focused on cognitive and emotional aspects of one’s mind that sustain anorexia like perfectionism. Studies show that these approaches generally have similar effectiveness in long-term recovery outcomes.