Reviewing Treatment Types of Anorexia Nervosa
In 2026, Elsevier published a review on the treatment types for eating disorders: Anorexia nervosa(AN), bulimia nervosa(BN), binge-eating disorder (BED), and avoidant/restrictive food intake disorder (ARFID). The findings mentioned in the review were based on evidence based research.
This article is tailored for general audiences to explain the effectiveness of different types of medications and psychotherapy approaches used for anorexia nervosa discussed in the review.
What is Psychotherapy?
Psychotherapy is treatment where you talk to a mental health professional to work on thoughts, behaviors, and actions and how to cope with stress in a healthy way. There are different types of psychotherapy approaches. The paper discusses cognitive behavioral therapy, family based therapy, parent focused treatment, separated family therapy, and multi-based family treatment. The summaries for each treatment are outlined below.
Therapy Type | Goal | People Involved |
Cognitive Behavioral Therapy | Identify and change negative thoughts and behaviors to build coping skills. | Patient |
Family-Based Therapy | Family therapy to empower and support patient | Patient and their family |
Parent-Focused Treatment | Equipping parents with skills to cope with patient | Parent |
Separated Family Therapy | Help co-parents in different households to support patient | Separated/divorced parents and patient |
Multibased Family Treatment | Using family, school, and community to support patient | Patient, family, and other systems/organizations involved with patient |
Anorexia Nervosa
There are two types of anorexia nervosa: restricting type and binge-eating/purging type. Both are recognized as brain disorders. Treatment has been challenging with people suffering from the disorder. In random clinical trials, people taking olanzapine had some weight gain. Behavioral treatments for AN restored weight in the short term, but adults were likely to relapse.
Olanzapine is the Most Effective
Currently, there are no guideline-recommendations for medications for treating AN. Psilocybin was used in a study, but not shown to be effective. Dronabinol has also been used since it targets pathways involved in appetite. However, the medication does not address attitude or behaviors associated with AN. To date, olanzapine is the only medication to be modestly effective.
Looking at Root Causes Rather than Treating Symptoms
To help address this, researchers and health professionals are looking at treatments that target the root cause of the disorder rather than treating symptoms. For example, behavioral treatments that target habit-learning and treatments that target brain pathways believed to be active during food choices in anorexia nervosa are recommended.
Repetitive transcranial magnetic stimulation (rTMS) is used to target these pathways. According to StatPearls, rTMS is a brain-stimulation technique where a patient is seated with a large wire coil near the scalp. The device generates magnetic pulses that treat underlying brain regions. Although it is non-invasive, side effects are rare and may trigger seizures and are not recommended for patients with epilepsy.
Similar treatments include transcranial direct current stimulation (tDCS) and deep brain stimulation (DBS). Although all of these methods are considered safe, they remain controversial.
Family Based Therapy and Enhanced Cognitive Behavioral Therapy
Of all the psychotherapies mentioned in this paper, family based therapy has shown to be the most effective for adolescents suffering from AN. Despite this being the case, only 33-42% of adolescents who receive this therapy remain fully recovered after 3-4 years of treatment. Another challenge is that many patients do not have access to FBT providers or the family support to benefit from this therapy.
However, for adults family based therapy did not have the same benefits. Instead, researchers examined enhanced cognitive behavioral therapy (CBT-E), a version of cognitive behavioral therapy tailored for people with eating disorders. In one study, 59% of people under this treatment achieved a healthy BMI after a year's follow up. However, there was no mention of behavioral changes.
New Psychotherapies on the Horizon: Is REaCH the Answer?
As previously mentioned, researchers are looking at treatments and models that look at brain pathways that lead to behaviors seen in AN. AN is believed to be caused by changes in dorsal striatal brain regions and dorsolateral prefrontal cortex regions.
Regulating Emotions and Changing Habits (REaCH) is a treatment based on habit reversal therapy. The goal of this treatment is to identify the cues that trigger AN and interrupting the behavior.
REaCH is currently has only been tested in studies and is not widely used as CBT and other therapies. It has been documented with lower self-report habit scores and lower eating disorder symptoms. However, more research is needed to establish its effectiveness.
Accessibility is Still Important
It is important to note that the review briefly mentions that although psychotherapy treatments are available, they may not necessarily be accessible to the patient. Medication may be recommended in place of such cases. Although this may be the case, there needs to be a removal of barriers to access care.
One such alternative could be finding places that offer sliding scale and telehealth options for patients for adults and parents affording care for their children. Adolescents could be better supported by training teachers to identify early behaviors and better integration of mental health support in schools.
References
Primary Source Article
Allam, A. R., & Attia, E. (2026). Recent developments in treatments for eating disorders. Neurotherapeutics, 23(1), Article e00773. https://doi.org/10.1016/j.neurot.2025.e00773
Secondary Sources
Thair, H., Holloway, A. L., Newport, R., & Smith, A. D. (2017). Transcranial Direct Current Stimulation (tDCS): A Beginner's Guide for Design and Implementation. Frontiers in neuroscience, 11, 641. https://doi.org/10.3389/fnins.2017.00641
Comments