Researching and Treating Anorexia Nervosa
Specialists at Mount Sinai’s Eating and Weight Disorders Program are developing new methods to treat children and adolescents with eating disorders
The highest mortality rate of all mental illness is among males and females with anorexia nervosa — a disease that can develop when dieting becomes compulsive and leads to a state of chronic starvation. At Mount Sinai’s Eating and Weight Disorders Program, Tom Hildebrandt, PhD, Assistant Professor of Psychiatry, and his colleagues, are developing new behavioral approaches to treat eating disorders such as anorexia nervosa, bulimia nervosa and binge eating. They are also performing cutting-edge research, exploring the roles of hormones during puberty in the development and maintenance of anorexia nervosa.
The program provides parents and their children with the tools they need to prevent the chronic course of this disease. As a leader in the Maudsley Family Therapy approach, therapists in the program work to enhance existing family therapy models by training parents to help their children tolerate disgust over body fat and eat enough food to be healthy. This includes finding ways for parents and children to cope with the feelings of disgust that they will develop body fat, which causes them to limit food intake. For example, having parents limit food avoidance and enlisting siblings to help engage their brother or sister in a non-food related activity after eating a particularly difficult meal.
“Maudsley Family Therapy is one of the most potent treatments for anorexia nervosa in adolescents,” says Dr. Hildebrandt. “As clinicians and researchers, we are constantly looking for new ways to make this family therapy model more effective for our patients and their loved ones.”
Similar approaches are used to help parents and their children deal with body image issues, which are also characteristics of anorexia nervosa. For example, interventions include learning how to use the mirror to disconnect negative evaluations and emotions when viewing one’s own body. This can be done by repetitively using nonjudgemental language to describe one’s own appearance in front of the mirror.
Dr. Hildebrandt and his team are also conducting research examining whether hormones may make it easier to become disgusted by food and consequently maintain a chronic state of starvation. Anorexia nervosa typically begins during adolescence when pubertal hormones are starting to flood the body and brain. Recently, they have started to examine whether the absence of these hormones among adolescents with anorexia nervosa leaves these individuals susceptible to feeling disgusted by food and their shape or weight.
“Since severe dieting associated with anorexia nervosa often leads to dysregulation in these hormones, it may be a key catalyst in the disease,” explains Dr. Hildebrandt, “especially if these hormones remain dysregulated throughout adolescence when important aspects of brain development occur.”