Habit-Centered Treatment for Anorexia Nervosa

Abstract Anorexia nervosa presents a clinical challenge due to the persistence of maladaptive restrictive eating behaviors, even among individuals undergoing treatment. The habit-centered hypothesis of anorexia nervosa proposes that these behaviors become entrenched due to their acquisition of habitual characteristics, rendering them cue-dependent and outcome-insensitive. This chapter explores the biological framework underlying habit formation, focusing on the transition from goal-directed to habitual behavior mediated by ventral and dorsal striatal function. The chapter introduces Relapse Prevention and Changing Habits, a habit-focused intervention for outpatients following acute treatment. Relapse Prevention and Changing Habits emphasizes cue awareness, behavioral experiments, and reward-based reinforcement to interrupt maladaptive habits and promote adaptive behavior. Alternative perspectives and criticisms are discussed, including the integration of habit-focused interventions with existing approaches. Overall, the habit-centered hypothesis provides a novel framework for understanding and targeting the persistent behaviors characteristic of anorexia nervosa, offering promise for improving long-term treatment outcomes.