TMS treatment for Anorexia

Anorexia nervosa is a serious eating disorder and mental health condition characterised by persistent restriction of food intake, intense fear of gaining weight, and a distorted perception of body image. It can affect individuals of all ages and genders and is associated with significant physical and psychological health risks.

Anorexia has one of the highest mortality rates of any mental health condition. The disorder affects not only eating behaviour but also brain function, emotional regulation, cognitive flexibility, and reward processing. Effective treatment therefore requires a coordinated, multidisciplinary approach.

There is no single cause of anorexia nervosa. It develops due to a complex interaction of biological, psychological, and environmental factors, including:

• Genetic vulnerability and family history of eating disorders

• Neurobiological differences in brain circuits related to reward, anxiety, and cognitive control

• Psychological factors such as perfectionism, low self-esteem, and high anxiety

• Trauma, stress, or significant life changes

• Sociocultural pressures related to weight, shape, and control

Because of this complexity, anorexia is understood as a brain-based and psychological illness, not a lifestyle choice.

Evidence-based treatment for anorexia nervosa typically includes:

Medical management
Ongoing monitoring of physical health, weight, cardiovascular status, and metabolic stability is essential, particularly in moderate to severe cases.

Nutritional rehabilitation
Structured nutritional support aims to restore weight safely and address disordered eating patterns under professional supervision.

Psychological therapies
Therapies such as cognitive behavioural therapy for eating disorders (CBT-E), family-based therapy (FBT), and other specialist psychological interventions are central to treatment.

Medication
There is no single medication that treats anorexia directly, but medication may be used to manage co‑occurring conditions such as anxiety, depression, or obsessive-compulsive symptoms.

In more severe cases, inpatient or day‑patient treatment may be required.

TMS is a non-invasive brain stimulation treatment that uses magnetic pulses to modulate activity in specific brain regions. In anorexia nervosa, research has focused on TMS effects on neural circuits involved in:

• Cognitive control and rigidity

• Anxiety and emotional regulation

• Reward processing and decision-making

• Compulsive and restrictive behaviours

Most studies have targeted the prefrontal cortex, a brain area involved in executive function, self-regulation, and flexible thinking. Modulating activity in these circuits may help reduce rigid thought patterns, support emotional regulation, and enhance engagement with nutritional and psychological treatment.

TMS for anorexia is not a standalone or first-line treatment. It is offered as a supportive therapeutic intervention within a broader, specialist treatment plan and is most appropriate when delivered alongside ongoing medical and psychological care.

TMS for BPD, PTSD, ADHD + other 

Dr Neal and his team understand the need to help our patients stay well beyond the end of their TMS treatment. Using research and our own experience, we have designed aftercare packages to provide ongoing care with a planned programme of regular top-up treatments.

Have you had TMS treatment for depression at another clinic? Smart TMS can offer you maintenance therapy, too.