Triggers, Myths & Lies | Anorexia Nervosa

This is the complete programme in original 4×3 format, digitally restored in 2025.

Clinical illustrations are always valuable and this programme consists of edited interviews with three patients, including one successfully treated over fifteen years ago. The programme also includes an interview with a dietician and a short section on the theory.

It has been constructed in such a way that it can be used as a lecture aid, stopping as required to allow for small group discussion.

Patient One

A form of protest? Well, see what you think of her answer to the question. She explains why she developed the condition, elegantly and clearly illustrating the hypothesis presented in the lecture programme.

The Boyfriend? Not everybody who splits up with their boyfriend or girlfriend develops Anorexia Nervosa. This patient explains how it was the final straw and that she always had difficulty expressing anger. Can you see how important it is to consider life events in a personal context? How else might she have coped with such an upset?

The Family? First she describes her own family and their attitudes and how they have helped her when she has been ill. It is worth emphasising that it is not a matter of apportioning blame, but rather to do with understanding the situation and helping the family cope and change in the most appropriate ways.  All families with an anorectic member will be struggling and displaying conflict.

Growing Pains? Our childhood experiences are fundamental to the way we are as adults and the patient gives a typical illustration: the realisation at an early age that things could be different.

Self Esteem? This everyday term is used to describe the complex way we think and feel about ourselves. This patient thought that she was unattractive – true or not?

She recognised that it was not just a case of  one of these factors causing the illness. There were wider problems to do with the way she related to people in general and the difficulty she had in expressing anger and hostility.

Treatment. She considered that she used Anorexia Nervosa to avoid dealing with these problems and admission to hospital protected her from the outside world. Any treatment setting must provide the patient with the assurance that she will have the opportunity of effectively dealing with the underlying problems. If this trust does not exist then she will not give up her illness.

Treatment consists of individual, family and group psychotherapy. Additionally there is a very important behavioural component. Patients are helped to confront their avoidance of normal body weight and all it represents. She highlights the importance of this aspect and knowing that eating was part of the treatment.

Patient Two

Recognising that you have Anorexia Nervosa. This patient describes the various levels of diagnosis and its relationship to slimming. Do not expect patients to be as forthcoming or as open about their symptoms.

Sometimes the upset is all too understandable. Although she had been well for a while the singularly adverse and upsetting life event resulted in a relapse. Does this surprise you?

View of treatment. She emphasises the importance of counselling skills and help after leaving hospital and describes her lengthy inpatient stay.

The family. Do you notice any similarities with patient one?

Dietary Advice.

In this section a dietician discusses the essentials of the behavioural aspects of treatment. All patients are bound to test the limits. Staff need to have a clear understanding of this and agree with the treatment regimen, so that they can anticipate and minimise manipulative behaviour by the patient.

The Theory

The condition can usefully be understood as a phobic avoidance of normal body weight and what that represents for the individual. A theory represents our best understanding of the subject at any one time, based on the available scientific evidence. The hypothesis presented in this section is well established and accepted but other models do exist. 

Patient Three

Anorexia Nervosa behind you? If patients remain preoccupied with food then they have not shaken off the condition, even if they are at a normal body weight. At another level it is useful to consider the emotional aspect of life: remember how the first patient thought it was a wider problem to do with relationships? Patient three has been able to marry and have children. In the interview she is able to talk freely about family relationships and most people would consider her attitude to food normal. 

But can your remember the statistics for outcome (morbidly and mortality)?