Understanding
Anorexia Nervosa
If you’re here, something may already feel off. Eating has become more complicated, more stressful, or more consuming than it used to be.
Anorexia is not just about being underweight. It is a pattern of restrictive eating, an intense fear of gaining weight, and a growing sense that food, body, and control are taking up too much space in your life.
Many people assume anorexia always looks extreme. In reality, people can be at a “normal” weight or even in a higher weight and still be struggling significantly. What matters is the pattern. Ongoing restriction, fear, and preoccupation with food or weight are what define the illness, not how someone looks from the outside.
Anorexia is not about willpower or appearance alone. It is driven by a combination of biological vulnerability, psychological patterns, and environmental factors. And without treatment, it tends to deepen and become more rigid over time.
If any part of this feels familiar, it’s worth paying attention. Early support can make a meaningful difference.
When Food and Weight Take Over: Signs of Anorexia
It can be hard to tell when eating “healthy” or “losing just a little bit of weight” has crossed into something more serious. Often, the shift is gradual. What starts as a goal or intention can slowly become something that feels harder to control.
Some signs we look for:
➤ Frequent thoughts about food, weight, or body shape
➤ Meals becoming stressful or something to avoid
➤ A strong pull toward rigid rules around eating
➤ Discomfort eating in front of others
➤ Increasing restriction, whether through fewer foods or smaller portions
➤ Guilt after eating or a sense of needing to compensate
➤ Secrecy around eating habits
➤ Food rituals that feel necessary rather than optional
➤ Changes in mood, energy, or concentration
➤ Concern expressed by family or friends
In younger people, this may present as increased rigidity, irritability, or growing tension around meals. Parents often describe feeling like they are walking on eggshells.
These patterns do not have to be extreme to matter. When eating begins to feel controlling, secretive, or distressing, it is a sign that support could help.
Columbus Park’s Approach to Treatment for Anorexia
Treating anorexia requires a careful match between the individual, their stage of life, and the patterns maintaining the disorder.
We look closely at how the illness is showing up, including duration, severity, prior treatment, and the behaviors and thinking patterns that keep it going, so that treatment is targeted and effective.
Because anorexia unfolds differently across development, we tailor our approach for adolescents and adults using evidence based treatments that are most effective for each group.
Anorexia Treatment for Adults
For adults, treatment is grounded in Enhanced Cognitive Behavioral Therapy (“CBT-E”), a structured, evidence based approach designed specifically for eating disorders.
CBT-E addresses the core features of anorexia, including persistent preoccupation with food, weight, and shape, rigid eating patterns, and the ways the disorder narrows a person’s life and consumes mental space, while supporting nutritional and physical stabilization.
Because anorexia in adults can present in different ways, we use careful assessment to determine whether CBT-E is the right fit or whether a different approach may be more effective, and we build the treatment plan accordingly.
Learn about the gold-standard treatment for adults with anorexia
About CBT-E»
Alternatives
to CBT-E for anorexia in adults
Learn »
Anorexia Treatment for Adolescents
For children and teens, we primarily use Family Based Treatment (“FBT”), the leading evidence-based approach for adolescent anorexia.
In FBT, parents take an active and essential role in restoring their child’s eating and weight, with close guidance and support from the treatment team. This approach recognizes that anorexia interferes with a young person’s ability to manage nutrition independently, so parents provide the structure and consistency needed for recovery.
As health improves, control is gradually returned to the adolescent in a developmentally appropriate way, while co occurring concerns such as anxiety, OCD, or depression are addressed as needed.
Read about FBT, the leading treatment for teens with anorexia
About FBT »
Treatment alternatives for teens with anorexia
Learn »
Many people struggling with anorexia are also dealing with anxiety, OCD, depression, or trauma. We take these into account while maintaining a clear initial focus on restoring nourishment and stability. As treatment progresses, these areas are addressed in a way that is thoughtful and manageable.
Some individuals present with added complexity, such as significant emotion dysregulation or challenging family dynamics. In these cases, we use careful assessment to guide a more tailored treatment plan, drawing from evidence based approaches while maintaining a clear and consistent focus on recovery.
The cascading effects of starvation are more powerful than most people realize.
LEARN MORE →
Curated Articles About Anorexia
And Explore Our Blog for More Insight Into Anorexia and Other Forms of Disordered Eating
Understanding Anorexia Nervosa: Causes, Impact, and Evidence-Based Treatment
Read more →
When Eating Disorders and OCD Collide: How to Tell What's What
Read more →
