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Recent follow-up studies failed to provide evidence that treatments can influence long-term results  with relevant consequences on public health-related costs [7–9].
Motivation, insight and subjective meaning of the illness can be useful tools to manage the resistance phenomenon when coupled with a wider approach.
The latter enables the therapists to be aware of their role in the therapeutic alliance through countertransference aspects and to consider the EDs as disorders of the development of both personality and self, entailing severe impairments as regards identity and relationships.
And while eating disorders have the highest mortality rate of any mental illness, it’s important to remember that recovery is possible.
The National Eating Disorders Association (NEDA) notes that eating disorder treatment usually includes a mix of both psychological and nutritional counseling, while also monitoring the person’s physical and mental health.
“Treatment must address the eating disorder symptoms and medical consequences, as well as psychological, biological, interpersonal, and cultural forces that contribute to or maintain the eating disorder,” NEDA writes on their website.
It’s clear from Jennette’s essay that the actor hopes her story will help others get the treatment they need.A literature search was conducted on Pub Med and Psych INFO; English-language articles published between 19 investigating the phenomenon of resistance to treatment in AN have been considered.The selected papers have been then grouped into four main thematic areas: denial of illness; motivation to change; maintaining factors and treatment outcome; and therapeutic relationship.In fact, many individuals do not respond to the available treatments and develop an enduring and disabling illness.With this overview we aimed to highlight and discuss treatment resistance in AN – with an in-depth investigation of resistance-related psychological factors.In fact, one-third of adult AN patients show poor outcome also because of an enduring and refractory illness [5, 11] whilst many maintaining factors of the AN symptomatology are less entrenched in younger patients . CO;2-4." href="/articles/10.1186/1471-244X-13-294#ref-CR12" id="ref-link-section-d62468e549"12] and dropouts - ranging between 20 and 51% in the inpatient population and from 23 to 73% in outpatient samples – are related to the great difficulty existing in engaging and maintaining their treatment adherence [13, 14].In AN, willingness to improve represents only one of several factors required to achieve recovery.Resistance to treatment has been variously interpreted across psychiatric disorders with this concept being often used as a synonym of difficult-to-treat disorders.In literature, there is a general consensus that the available treatments for major psychiatric disorders frequently result in either a lack of effect or a moderate response.“I made justifications for my mom’s support of my disordered eating and I made justifications for my continuing down the road I was traveling,” she writes, recalling an instance where her mother instructed her to tell others she was “eating normally” if Jennette were approached with concerns.Over the next few years, Jennette dealt with both anorexia and bulimia, noting that she was never confronted by anyone in the entertainment industry about her disordered eating.