Psychological treatment for anorexia nervosa

Use psychological treatment in combination with nutritional replenishment in the management of all patients with anorexia nervosa. Specific training and protocols are required for psychological therapies for eating disorders; only a healthcare professional with appropriate expertise in the management of eating disorders (usually a psychologist, social worker, psychiatrist or occupational therapist) can deliver psychological treatment.

If a comorbid psychiatric disorder is present, see Managing psychological comorbidities of anorexia nervosa.

For children and adolescents with anorexia nervosa, use:

• family-based treatment (FBT)—recommended initially
• separated family therapy—where the parents or carers are seen separate to the child
• adolescent-focused therapy
• cognitive behavioural therapy, in adolescents.

Of these, the most effective is manualised FBT where all family members are seen together—this has demonstrated improved physical and psychological outcomes. FBT involves family members to assist with the patient’s recovery, particularly to support interventions to restore weight (eg eating meals together).

For adults with anorexia nervosa, use individual psychological therapy see Psychological therapies for adults with anorexia nervosa.