Exposure therapy for anorexia

If you've tried to eat with an anorexic you know that phobia is a mild word for what a plate of food engenders in your loved one. A donut is like a pit viper. The thousands of daily calories needed to recover is more like a pit of vipers.

"Exposure" and "fear extinction" are concepts used more often in treatment for anxiety disorders, OCD, and PTSD. The idea is to expose the client to measured amounts of the thing they fear, to desensitize them to it, and normalize behaviors around it.

With an eating disorder, the feared thing is food. Eating normally is the challenge.

It takes enormous bravery on the part of the patient and loving firmness on the part of caregivers to have normal meals, to face the fears, to provide security and structure while the ability to eat normally is re-learned. Meal after meal aftermealaftermeal for a long, long time.

Is there a drug that could help with this process? D-Cycloserine is an interesting creature: an antibiotic drug that used to be used for tuberculosis and more recently has been helping people with phobias to unlearn fear they've associated with benign things.

A small preliminary study, The Application of Exposure Therapy and D-Cycloserine to the Treatment of Anorexia Nervosa: A Preliminary Trial, applied the drug to anorexic patients being exposed to a test meal. And the results were encouraging.

Imagine, parents: an easier time at dinner during early recovery. Less fear and resistance. Faster, safer recovery. Imagine if a donut was just a donut.


  1. That's interesting- I knew the drug had psychotropic properties when I worked in tuberculosis and couldn't advice prescribing it in patients with known mental disorders (psychosis, I think, maybe one or two others...it's been a while).

    How ironic that it's being investigated in AN.

    But I think the most important part of exposure therapy is not one exposure. It's the repeated exposure, constantly, over time.

    A donunt is not just a donut...it's a yummy item that can and should be consumed 24/7. :)

    Take that Ed.


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