“I am treating a young person who denies she is unwell.  Her parents are struggling to feed her therefore moving forward has become a major challenge. Can you offer any suggestions please”?

Empowering Adolescents to Overcome Anorexia: A Three-Stage Approach

Your young person appears to be totally enmeshed with her anorexia and it has become her identity. Recovery from anorexia requires a comprehensive approach that addresses both the physical and psychological aspects of the condition. A crucial component of any treatment is a) helping adolescents separate themselves from their eating disorder; b) learning to let go of it; and c) refocus on positive aspects of life. This three-stage process empowers clinicians to guide young individuals towards recovery.

Stage 1: Separating Anorexia from the Self – One of the initial steps in helping an adolescent with anorexia is to assist them in recognizing that their eating disorder is not synonymous with their identity. Anorexia is an external force that has taken hold of their thoughts and behaviors. There are many strategies clinicians can use such as a cost/benefit analysis; Take an Internal family systems approach ie “there is a part of you that doesn’t want to eat etc etc. 

 A good analogy to commence sowing the externalisation seed is as follows. “When you catch a cold, a virus has entered you body.  It creates a lot of symptoms such as a runny nose, headache, cough, sore throat etc.  Your body has changed, and the cold makes it respond differently, but it is still you.  It is the same when you have anorexia.  It is still you, but you are functioning differently.  Your thoughts are distorted, and you are starving yourself. An illness has entered your body.  You are not the same, certain aspects of you have changed, just as you are not the same when you have a cold.”

Stage 2: Letting Go of Anorexia – Once the adolescent develops an awareness of being separate from anorexia, however minimal, the next step is to help them let go of the disorder’s grip on their life. This involves developing strategies to challenge and resist anorexic behaviors as well as addressing the core anorexic fears and managing the strong anorexic voice which research shows impedes treatment.

Stage 3: Replacing Anorexia with Positive Aspects of Life – Recovery involves more than just letting go of anorexia; it also entails finding joy, purpose, and fulfillment outside of the disorder. Clinicians can help adolescents refocus their energies and set positive goals:

1. Identifying Interests and Passions: Explore the adolescent’s interests, hobbies, and passions. Encourage them to rediscover or discover new activities that bring joy and fulfillment.
2. Setting Realistic Goals: Collaborate with the adolescent to set achievable short-term and long-term goals. This process helps shift their focus from anorexia to personal growth and aspirations.
3. Building a Supportive Environment: Assist the adolescent in creating an environment that fosters their well-being. This may involve restructuring daily routines, eliminating triggers, and nurturing positive relationships.

Conclusion: Helping adolescents overcome anorexia requires a three-stage approach that empowers them to separate from their eating disorder, let go of its destructive influence, and refocus on a fulfilling life. Clinicians play a pivotal role in guiding young individuals through this journey, providing the support and tools necessary for a successful recovery. By following this comprehensive approach, adolescents can regain control of their lives and work towards a healthier, happier future.