Eating disorders: recognition and treatment

What does cognitive behavioural therapy involve?

If you have CBT you should be offered weekly therapy sessions for up to 40 weeks (9 to 10 months). For the first 2 or 3 weeks you should be offered 2 sessions a week. You will work with a practitioner (for example a therapist) to make a personal treatment plan and start making changes in your behaviour. This should involve:

You should be given simple 'homework' to help you put into practice what you have learned. You should also be taught how to monitor your own progress, and how to cope with times when you find it hard to stick to your new eating habits (this is called relapse prevention).

What does the Maudsley Anorexia Nervosa Treatment for Adults involve?

You should be offered 20 sessions with a practitioner. The first 10 should run weekly, and the next 10 can be on a flexible schedule based on what works best for you. Some people will have extra sessions, depending on how severe their problems are.

MANTRA helps people to understand what causes their anorexia. It focuses on what is important to you personally, and on encouraging you to change your behaviour when you are ready. Your family and carers can be involved in the therapy too if you think it could help.

What does specialist supportive clinical management involve?

You should be offered 20 or more weekly sessions. At these sessions your practitioner will help you to explore the main problems that cause your anorexia. You will learn about nutrition and how your eating habits cause your symptoms. Your practitioner will help you set a target weight and encourage you to reach it.

You can also include other things as part of the therapy if you want to (such as improving relationships with other people, or getting back into work or education).

Changing to a different therapy

If you are offered a therapy and you don't think it is right for you, or you try one and it doesn't help, you should be able to have a different therapy. Talk to your practitioner if you think you would like to try something different. It could be another of the therapies above, or a treatment called focal psychodynamic therapy.

Diet advice

During your treatment you may be given some advice about healthy eating by a dietitian. Although a healthy diet is important and will help you get to a healthy weight, dietary advice on its own does not work as a treatment for anorexia so you should be offered other therapies too.

While you are recovering you should take a multivitamin and mineral supplement, to make sure you get the vitamins and minerals you need.

Bone health

If you have anorexia your bones can become weaker, especially if your weight has been very low for a long time. Losing bone strength makes you more likely to develop osteoporosis, a condition where your bones become fragile and break (fracture) easily, even from a minor knock or fall.

If you have osteoporosis or another bone disorder you will need to be careful about what types of exercise you do. To avoid broken bones you should avoid high-impact physical activities like running, and other activities that might increase your chance of falling. The best way to protect your bones is to work towards reaching a healthy weight or BMI.