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Anorexia Nervosa — MRCPsych Paper B MCQ

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HardEating DisordersAnorexia NervosaMRCPsych Paper B

A 25-year-old woman with anorexia nervosa and a BMI of 13.0 has completed acute medical stabilisation. Multidisciplinary assessment concludes that she can engage in specialist psychological treatment alongside nutritional rehabilitation and ongoing physical monitoring. She has not previously received an evidence-based psychotherapy for anorexia nervosa. According to NICE NG69, which is the most appropriate initial psychological-treatment plan?

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Correct answer: D — Collaboratively select individual eating-disorder-focused CBT, MANTRA or SSCM

NICE recommends considering one of three initial psychological treatments for adults with anorexia nervosa: individual eating-disorder-focused CBT (CBT-ED), Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), or specialist supportive clinical management (SSCM). The treatments should be explained so that the patient can participate in choosing between them. A very low BMI requires continuing multidisciplinary risk management, nutritional rehabilitation and physical monitoring, but does not make family therapy the sole psychological option. Anorexia-nervosa-focused family therapy is principally recommended for children and young people. Eating-disorder-focused focal psychodynamic therapy is an alternative when CBT-ED, MANTRA and SSCM are unacceptable, contraindicated or ineffective, rather than routine first-line treatment. Interpersonal therapy and guided self-help are not NICE-recommended initial treatments for adult anorexia nervosa.

Reference: NICE. Eating disorders: recognition and treatment (NG69), sections 1.3.4 and 1.3.8. Published 2017; current recommendations checked through December 2025. https://www.nice.org.uk/guidance/ng69/chapter/recommendations