What Keeps Anorexia Going?

The What Keeps Anorexia Going? handout presents key factors that maintain anorexia nervosa (AN).

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.

Overview

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, they provide an easy way for clients to understand at a glance why their difficuties persist, and how they might be interrupted.

What Keeps Anorexia Going? is designed to help clients experiencing anorexia nervosa understand more about their condition.

Why Use This Resource?

Understanding what keeps anorexia nervosa going is crucial for effective intervention. By identifying these factors, therapists can develop idiosyncratic models of clients' experiences and focus their interventions.

  • Highlights and explains key factors that maintain anorexia nervosa.
  • Provides a visual model that to facilitate discussion and inform case conceptualization.
  • Helps clients better understand the difficulties they are experiencing.

Key Benefits

Insight

Provides insights into what perpetuates anorexia nervosa.

Guidance

Serves as a roadmap for therapeutic discussions and formulations.

Understanding

Helps clients comprehend their difficulties and the ways to address them.

Engaging

Simplifies complex ideas and explanations, enhancing understanding and communication.

Who is this for?

Anorexia Nervosa (AN)

Designed to help clients affected by anorexia nervosa.

Integrating it into your practice

01

Introduce

Explain to the client that certain difficulties persist due to cycles that maintain them.

02

Discuss

Use the handout to discuss what might be keeping the client's difficulties going.

03

Identify

Pinpoint and personalize maintaining factors that are relevant to the client.

04

Strategize

Explore how these maintaining cycles can be interrupted.

Theoretical Background & Therapist Guidance

It is common for people to feel conscious of their eating, but extreme dieting and weight loss can lead to an eating disorder called anorexia (or anorexia nervosa), which may impact their physical and mental health. Symptoms of anorexia include restricted eating, weight loss, and preoccupation with weight, body shape, and eating.

Research has demonstrated that cognitive behavioral therapy (CBT) is a helpful psychological therapy for anorexia. CBT therapists work a bit like firefighters: while the fire is burning they’re not so interested in what caused it, but are more focused on what is keeping it going, and what they can do to put it out. This is because if they can work out what keeps a problem going, they can treat the problem by ‘removing the fuel’ and interrupting this maintaining cycle.

The What Keeps Anorexia Going? information handout describes some of the key factors which act to maintain anorexia, and it illustrates them in a vicious cycle or 'flower' format in which each ‘petal’ represents a separate maintenance cycle. Helping clients to understand more about these processes is an essential part of cognitive therapy for anorexia. Therapists can use this handout as a focus for discussion, or as a template from which to formulate an idiosyncratic model of a client’s experiences.

What's inside

  • Introduction and overview of anorexia nervosa.
  • Guidance for introducing the resource to clients.
  • Template for developing personalized maintenance cycles.
  • Key references for learning more about anorexia nervosa.
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FAQs

It can serve as a discussion point and a template for creating personalized formulations, helping clients understand what maintains their difficulties.
Introduce it as a framework for gaining a deeper understanding of their difficulties and the reasons why they persist.
Use it as a starting point to explore unique factors that are specific to the client's experience, and tailor the diagram accordingly.

How This Resource Improves Clinical Outcomes

This resource aims to:

  • Increase insight into the processes maintaining clients' difficulties.
  • Support collaborative formulation and treatment planning.
  • Present key information in a structured, understandable format.

Therapists benefit from:

  • A clear framework that helps explain why problems persist.
  • A visual tool to enhance communication and understanding.
  • An adaptable resource that can be tailored to clients' unique experiences.

References And Further Reading

  • Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.
  • Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509-528.
  • Galsworthy-Francis, L., & Allan, S. (2014). Cognitive behavioural therapy for anorexia nervosa: A systematic review. Clinical Psychology Review, 34, 54-72.
  • Keski-Rahkonen, A., & Mustelin, L. (2016). Epidemiology of eating disorders in Europe: prevalence, incidence, comorbidity, course, consequences, and risk factors. Current Opinion in Psychiatry, 29, 340-345.
  • National Institute for Health and Care Excellence (NICE: 2017). Eating disorders: Recognitions and treatment. Retrieved from: https://www.nice.org.uk/guidance/ng69
  • Waller, G., Cordery, H., Corstorphine, E., Hinrichsen, H., Lawson, R., Mountford, V., & Russell, K. (2007). Cognitive behavioral therapy for eating disorders: A comprehensive treatment guide. Cambridge University Press.