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Anorexia Nervosa Eating Disorder — Treatment and Symptoms

From the Greek word ‘anorexis’, meaning without appetite. Often referred to as “Anorexia”, this is a potentially life threatening mental disorder. Characteristics include behaviors of restriction and other compensatory behaviors to control and manipulate weight and body shape. Restriction can include fasting, restricting certain foods and restricting amount of food eaten.

Other compensatory behaviors include laxatives, diuretics, enemas, compulsive exercise, restricting insulin. Periods of restriction can lead to behaviors of binging. There is often an intense fear of gaining weight, poor and/or distorted body image. Guilt, shame and secrecy are often present, which fuels the restriction cycle. Anorexia Nervosa cuts across lines of gender, culture, ethnicity and socioeconomic status.

Anorexia Treatment Programs

Due to the complexity of Anorexia, a multi-disciplinary team of professionals and a multi-faceted regime is needed to set the patient on the road to healing and recovery.
Treatment plans often involve addressing the underlying influences and function of the eating disorder as well as developing support, facing fears and developing a relapse prevention plan. Also, to assist the person in facing the road to recovering their health and well-being, treatments are often individualized and tailored to meet the unique needs of every patient.
A multi-disciplinary team of professionals that are used to address eating disorders is usually made up of a therapist, dietitian, medical doctor and psychiatric provider. The team works together in providing education, support, and recommendations that best support the individual in their recovery journey. A regime of complete care will include the following:

  • Therapy – the patient will undergo various forms of psychotherapy, such as group, family and individual therapy. Therapy is vital to addressing the underlying causes of the eating disorder, developing a roadmap for recovery and a fundamental element of treatment. The various therapies will also include better-coping skills to help with emotional regulation, developing healthy relationships, food exposures and building a relationship with food and their bodies.
  • Dietitian – a dietitian will ensure that the patient’s weight stabilizes and work towards restoring and maintaining a healthy weight and BMI. The work will also include a guide to forming normal and intuitive eating habits and develop a personalized meal plan.
  • Medications – some medications may be prescribed to help with mood regulation and body image distortion to assist the patient with getting the most out of their treatment.
  • Monitoring and Medical Care – medical monitoring is important to provide education and aid in the resolution of medical concerns that were consequences of the eating disorder.

Treatment options vary from outpatient support groups to inpatient hospitalization based on the severity and needs of the individual. The first step to treatment is awareness and the willingness to get help.

Anorexia Therapy Techniques

  • Cognitive Behavioral Therapy (CBT): Cognitive Behavioral Therapy (CBT) is highly effective in treating a number of mental health disorders, including eating disorders. CBT is an integration of two originally separate theoretical approaches to understand and treat psychological disorders; the behavioral approach, and the cognitive approach. Each client will learn cognitive strategies in addition to exposure therapy, and the importance of Mindfulness-Based Awareness Training (MBAT) and how to apply it daily. Learn more about Cognitive Behavioral Therapy.
  • Exposure and Response Prevention: Exposure and Response Prevention (ERP) is a form of behavioral therapy that provides an effective treatment for individuals suffering from eating disorders. Exposures are conducted in order to ensure generalization of treatment gains. With exposure therapy, those suffering from eating disorders will be able to “habituate” to the fearful trigger, which results in decreased anxiety and increased mental health and happiness. Types of Exposures:
  • In-Vivo or Live Exposures: These are real-life experiences that provide the sufferer with a live experience of confronting that which they fear. Through clinical support and coaching from the therapists, clients are able to engage in a fear or situation while learning the skills and tools to overcome the trigger.
  • Imaginary Exposures: These exposures are done through writing and reading techniques. This is usually used when In-Vivo exposures cannot be performed.
  • Acceptance & Commitment Therapy (ACT): ACT is an empirically based psychological therapy technique that uses acceptance and mindfulness, combined with commitment and behavioral changes, to increase psychological flexibility. Through this flexibility, clients are able to come into contact with fears, anxiety, physical sensations, and memories and gain the skills to re-contextualize and accept what has transpired, which allows them to make necessary changes in their lives.
  • Psychoeducation:Education about eating disorders is one of the most important components of the initial phase of treatment. When clients and their families have a clear understanding of how eating disorders affect the brain and how it manifests itself, they are better prepared to face the challenges eating disorders present. The Gateway Institute provides critical education to help minimize unintended reinforcement, and firmly establishes tools that can help facilitate the healing process in a productive manner.
  • Mindfulness-Based Behavioral Therapy: Using the advances made in the treatment of eating disorders over the past 10 years, The Gateway Institute incorporates the most current techniques in its treatment programs. Some of these advanced treatments include Mindfulness Based Behavioral Therapy (MBBT). In our practice, we have discovered that a comprehensive treatment strategy that we refer to as Mindfulness-Based Behavioral Therapy improves treatment response. In MBBT we incorporate informal mindfulness training along with exposure and response prevention (ERP) and a writing intervention with both behavioral and mindfulness components that contribute to treatment effectiveness.
  • Behavioral Therapy Combined With Medication:Though behavioral therapy may be the most effective treatment in terms of long-term management of an eating disorder, research indicates that combining both CBT and medication may be beneficial for overall success. Medications considered for the treatment of eating disorders are usually antidepressants know as selective serotonin reuptake inhibitors (SSRI), which are often effective without severe side effects. The Gateway Institute works with skilled and experienced psychiatrists to find the right combination of medication to effectively treat eating disorders when necessary.
  • Coordinated Dietician Care: Gateway clinicians will support clients with coordinating care with their dietician to help provide the

Types of Anorexia Treatment

  • 3-Week Intensive Treatment Program for Adults: The Gateway Institute offers a 3-week eating disorder treatment program for adults utilizing the most effective approaches currently available for the treatment of eating disorders. After a thorough assessment of each client, a treatment plan is designed and tailored to meet the specific needs of each client. This plan is implemented over 3 weeks and includes 45 hours of individualized treatment.
  • 3-Week Intensive Treatment Program for Adolescents: The Gateway Institute offers a 3-week eating disorder treatment program utilizing the most effective approaches currently available for the treatment of adolescent eating disorders.
  • 3-Week Intensive Treatment Program for Children: The Gateway Institute offers a 3-week eating disorder treatment program utilizing the most effective approaches currently available for the treatment of child eating disorders.
  • Weekly Program: For clients whose symptoms do not require the Intensive Treatment Program, The Gateway Institute offers eating disorder treatment programs with weekly sessions or multiple sessions each week, depending on need.
  • Bi or Tri-Weekly Program: for those not able to do the intensive but need more support than just weekly sessions, an option would include 2-3 weekly sessions.
  • Customized Treatment Program: These options include a 3-week eating disorder intensive therapy program, weekly, bi-weekly and monthly options.

Causes of Anorexia

Much like other eating disorders, the exactly causes of anorexia are not certain. There are a combination of factors that can lead to a person suffering from an eating disorder. These include:

  • Genetics, which can cause a pre-disposition
  • Temperament
  • Perfectionism
  • Social and cultural Influences
  • Teasing and rejection
  • Abuse and Trauma
  • A desire for control
  • Poor self-esteem
  • Family stressors
  • Lack of emotion regulation
  • Life changes, Transitions, Loss
  • Being in a profession that focuses on appearances such as modeling, acting, sports, etc.
  • Obsessive Compulsive Disorder (OCD). There is evidence that some people who suffer from anorexia have traits of obsessive-compulsive disorder (OCD). Having OCD helps individuals suffering from Anorexia to adhere to restrictive diets or refuse to eat despite being hungry.

Symptoms of Anorexia

Symptoms of anorexia nervosa can include:

  • Extremely thin appearance or weight loss
  • Exact measuring of food and/or counting calories
  • Soft hair covering the entire body
  • Hair loss
  • Low tolerance to cold
  • Fatigue
  • Bluish discoloration of the fingers
  • Excessive moving/difficulty resting and sitting still
  • Lying, excuses and secrecy around eating
  • Cooking for others but not eating what is cooked
  • Wearing layers of clothing
  • Memory loss, poor concentration
  • Isolation and withdrawal
  • Controlling and/or people pleasing behaviors
  • Difficulty receiving criticism
  • Food rituals (cutting food into very small pieces, moving food around plate, eating extremely slow…)
  • Comparisons
  • Irritable, depressed, anxious
  • Self Harm and suicidal ideation may be present

Risk Factors of Anorexia

There are many health risk factors associated with Anorexia. These can include:

  • Osteoporosis
  • Kidney and liver problems
  • Abdominal and bowel issues like constipation
  • Slow heart rate or irregular heart rhythm
  • Dizziness, fainting
  • Dry skin, Brittle hair and nails
  • Bruising Easily
  • Broken bones, stress fractures or muscular injuries
  • Headaches
  • Muscle loss
  • Brain shrinkage
  • Death

Additional Eating Disorders We Treat:

For more information on these eating conditions, click below.
Binge Eating Disorder
Bulimia Nervosa

Additional Conditions We Treat:

For more information on these eating conditions, click below.
Generalized Anxiety Disorder
Social Anxiety Disorder
Post-Traumatic Disorder
Body Dysmorphic Disorder

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