One problem with focusing on increasing self-esteem without directly addressing the client's weight loss and inadequate nutrition is that anorexia nervosa can prove fatal. With anorexics who are not at risk medically, one may be able to work on other issues while monitoring the client's weight loss but with anorexics who are medically at risk because of their weight loss it can be important to work directly to maintain adequate nutrition. Unfortunately, this is often easier said than done. Certainly, working to enhance self-esteem can be useful. Reportedly, anorexics often base their self-esteem on their thinness and their self-denial. Helping them develop self-esteem that does not depend on thinness and self-denial should be useful but I haven't seen any reports that suggest that working on self-esteem is sufficient in treating anorexics.
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