Anorexia Nervosa

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Anorexia Nervosa

Sometimes our relationship with food can be damaging due to it feeling like the only part of life we can control. Food begins to represent everything negative so eating habits develop into extreme patterns such as excessive lowering of food intake, missing meals and altering what you eat. The loosing of weight makes you feel safe and is your response to low self-worth, extreme fear of rejection and distorted self-image. This is known as anorexia nervosa.

You can recover from anorexia nervosa and improve the quality of your life. Nightingale Hospital can help you take that vital step to regain a healthy and happy life. Please call us about eating disorder treatment.

Our treatment approach for anorexia nervosa

Based on current clinical evidence and put into practice by an experienced, multidisciplinary team of consultant psychiatrists, unit doctors, nurses, a dietician and specialist therapists, our approach to eating disorder treatment is tailored to the individual.

Through intensive psychological and emotional support in group therapy sessions and individual counselling and psychotherapy you can understand underlying factors that have contributed to your anorexia and find strategies to overcome the eating disorder. Cognitive Behavioral Therapy can help you identify your negative thoughts and learn more positive emotional and behavioural responses to your beliefs about yourself and your eating. Family therapy can improve the way family members relate to each other and communicate and Occupational Therapy can support you practically in returning to a normal life away from anorexia nervosa.

Anorexia treatment tailored to you

We have the expertise in eating disorders to approach the support and treatment we offer adults and adolescents in a personal and flexible way to benefit you the most in your recovery. Treatments for anorexia here at Nightingale Hospital London can be accessed as an outpatient, day patient or inpatient.

Through therapy, education and alternative supportive approaches such as art and drama therapy, meditation and relaxation, life skills, sleep therapy and support groups for you and your family we aim to give you knowledge and coping skills to recover from your anorexia.

Young people with an eating disorder also benefit from a teacher to enable your education to continue.

Anorexia Nervosa Specialists

Nightingale Hospital London has a number of Consultant Psychiatrists and Therapists that can help you through your anorexia. It is vital you find an eating disorder specialist that you can trust and work with on your recovery. If you cannot find the information you need on anorexia specialists and anorexia treatment programmes we would welcome your call so you feel secure in the decisions you make.

Please contact us confidentially on 020 7535 7700 24 hours a day.

Severe and Enduring Anorexia Nervosa Programme

Following the results of the “Treating severe and enduring anorexia nervosa: a randomized clinical trial” this new dedicated service has been introduced to Nightingale Hospital London.

Many NHS services find it difficult to treat severe and enduring anorexia, resulting in patients often being treated by GPs or other generic services. The Severe and Enduring Anorexia Nervosa trial conclusively shows that patients can benefit from outpatient treatment, improving self-esteem and self-worth whilst addressing low mood and improving quality of life.

The programme focuses on quality of life, rather than weight, though all patients who have received the treatment gained some weight. 85% of study participants completed their eating disorder treatment – almost three times the usual retention rate and all described improved quality of life, pursuing more meaningful lives after treatment.

This is the first treatment that has been shown to be effective in enduring anorexia and is only available at Nightingale Hospital London.

Who is the anorexia service for?

The programme has been developed for people who have suffered from severe anorexia for at least seven years. It is likely that they will be:

  • Ambivalence about change and be phobic of normal body weight
  • Ego-synchronically attached to low weight
  • Had repeat hospital admissions or treatments
  • Have little or no or fluctuating motivation to change

What does the anorexia service consist of?

The patient receives a Specialist Supportive Clinical Management (SSCM), which is adapted completely to the individual needs of the patient. Experienced therapists trained to competence by Professor Lacey and supervised by him provide the weekly sessions. The programme consists of 25 fifty-minute sessions spread over six to eight months. It is preceded by an eating disorder assessment by Professor Lacey and one or two check-ups.

The primary aim is an improvement in quality of life as defined by the patient and improvement in general mental health particularly mood and social adjustment. Secondary aims include weight gain and a motivation to change habits away from the anorexia fixations. Eating disorder participants in the study showed significant improvement in all aims.

If you cannot find the information you need on the Severe and Enduring Anorexia Nervosa Programme we would welcome your call so you feel secure in the decisions you make.

Signs and symptoms of anorexia

You may find that you:

  • Worry more and more about your weight
  • Eat less and less
  • Exercise more and more, to burn off calories
  • Can’t stop losing weight, even when you are well below a safe weight for your age and height
  • Smoke more or chew gum to keep your weight down
  • Lose interest in sex
  • In girls or women – monthly menstrual periods become irregular or stop
  • In men or boys – erections and wet dreams stop, testicles shrink

When does it start?

Usually in the teenage years and affects around:

  • 1 fifteen-year-old girl in every 150
  • 1 fifteen-year-old boy in every 1000
  • It can also start in childhood or in later life

What happens?

  • You take in very few calories every day. You eat ‘healthily’ – fruit, vegetables and salads – but they don’t give your body enough energy.
  • You may also exercise, use slimming pills, or smoke more to keep your weight down.
  • You don’t want to eat yourself, but you buy food and cook for other people.
  • You still get as hungry as ever, in fact you can’t stop thinking about food.
  • You become more afraid of putting on weight, and more determined to keep your weight well below normal.
  • Your family may be the first to notice your thinness and weight loss.
  • You may find yourself lying to other people about the amount you are eating and how much weight you are losing.
  • You may also develop some of the symptoms of bulimia. Unlike someone with Bulimia Nervosa, your weight may continue to be very low.

How can anorexia affect you?

If you aren’t getting enough calories, you may:

Psychological symptoms

  • Sleep badly
  • Find it difficult to concentrate or think clearly about anything other than food or calories
  • Feel depressed
  • Lose interest in other people
  • Become obsessive about food and eating (and sometimes other things such as washing, cleaning or tidiness)

Physical symptoms

  • Find it harder to eat because your stomach has shrunk
  • Feel tired, weak and cold as your body’s metabolism slows down
  • Become constipated
  • Not grow to your full height
  • Get brittle bones which break easily
  • Be unable to get pregnant
  • Damage your liver, particularly if you drink alcohol
  • In extreme cases, you may die. Anorexia Nervosa has the highest death rate of any psychological disorder

If you vomit, you may:

  • Lose the enamel on your teeth (it is dissolved by the stomach acid in your vomit)
  • Get a puffy face (the salivary glands in your cheeks swell up)
  • Notice your heart beating irregularly – palpitations (vomiting disturbs the balance of salts in your blood)
  • Feel weak
  • Feel tired all the time
  • Damage your kidneys
  • Have epileptic fits
  • Be unable to get pregnant

If you use laxatives regularly, you may:

  • Have persistent stomach pain
  • Get swollen fingers
  • Find that you can’t go to the toilet any more without using laxatives (using laxatives can damage the muscles in your bowel)
  • Have huge weight swings. You lose lots of fluid when you purge, but take it all in again when you drink water afterwards (no calories are lost using laxatives)

How you can help yourself with your anorexia

Helping yourself

  • Anorexia usually needs more organised help from a clinic or therapist. It is still worth getting as much information as you can about the options, so that you can make the best choices for yourself


  • Stick to regular mealtimes – breakfast, lunch and dinner. If your weight is very low, have morning, afternoon and night time snacks.
  • Try to think of one small step you could take towards a healthier way of eating. If you can’t face eating breakfast, try sitting at the table for a few minutes at breakfast time and just drinking a glass of water. When you have got used to doing this, have just a little to eat, even half a slice of toast – but do it every day.
  • Keep a diary of what you eat, when you eat it and what your thoughts and feelings have been every day. You can use this to see if there are connections between how you feel, what you are thinking about, and how you eat.
  • Try to be honest about what you are or are not eating, both with yourself and with other people.
  • Remind yourself that you don’t always have to be achieving things – let yourself off the hook sometimes.
  • Remind yourself that, if you lose more weight, you will feel more anxious and depressed.
  • Make two lists – one of what your eating disorder has given you, one of what you have lost through it. A self-help book can help you with this.
  • Try to be kind to your body, don’t punish it.
  • Make sure you know what a reasonable weight is for you, and that you understand why.
  • Read stories of other people’s experiences of recovery. You can find these in self-help books or on the internet.
  • Think about joining a self-help group. Your GP may be able to recommend one, or you can contact Beat.


  • Don’t weigh yourself more than once a week.
  • Don’t spend time checking your body and looking at yourself in the mirror. Nobody is perfect. The longer you look at yourself, the more likely you are to find something you don’t like. Constant checking can make the most attractive person unhappy with the way they look.
  • Don’t cut yourself off from family and friends. You may want to because they think you are too thin, but they can be a lifeline.
  • Avoid websites that encourage you to lose weight and stay at a very low body weight. They encourage you to damage your health, but won’t do anything to help when you fall ill.

Please call us on 020 7535 7700 to find out how we can help you.

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“When you have a problem and you drink, take drugs or gamble, the problem won’t go away. Stay and tackle the problem”