Recently, in a randomised controlled trial, specialist supportive clinical management (SSCM) has proven to be more effective than the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA), a treatment specially designed to address the disorder according to a rather complex rationale in comparison with SSCM. ^{Reference Schmidt, Oldershaw, Jichi, Sternheim, Startup and McIntosh1} Specialist supportive clinical management, originally ‘non-specific supportive clinical management’ administered to a control group in a previous randomised controlled trial, ^{Reference McIntosh, Jordan, Carter, Luty, McKenzie and Bulik2} was found to be more effective than two specialised treatments - cognitive-behavioural therapy and interpersonal therapy - and was as effective as these treatments at 5-year follow-up. ^{Reference Carter, Jordan, McIntosh, Luty, McKenzie and Frampton3}

Specialist supportive clinical management was originally defined as clinical management and supportive psychotherapy, as revealed by its original definition:

In contrast, MANTRA claims to be novel in several respects: (a) it is biologically informed and trait-focused, drawing on neuropsychological, social cognitive and personality trait research; (b) it includes both intra- and interpersonal maintaining factors and strategies to address these; and (c) it is modularised with a hierarchy of procedures tailored to the individuals (as described in the authors' online Table DS1). ^{Reference Schmidt, Oldershaw, Jichi, Sternheim, Startup and McIntosh1}

Current treatment of anorexia nervosa is disheartening. Following successful weight restoration, almost 50% of patients relapse after 1-year follow-up, and pharmacological or psychological treatment persistently fails to neutralise the purported mechanisms underlying anorexia psychopathology. ^{Reference Attia and Walsh4} Against this backdrop, according to the American Psychological Association Task Force criteria for the Promotion and Dissemination of Psychological Procedures, SSCM could be the first treatment for adult anorexia to attain the consideration of a well-established psychosocial intervention. However, the acronym SSCM disguises the fact that it has entered the stage through the back door of non-specific supportive treatments originally assigned to control groups, and SSMC efficacy over advanced treatments that have a sound theoretical basis raises perplexing questions. Maybe we are on the wrong track by persistently failing to understand either the fundamental features articulating the current concept of the disorder in terms of symptoms, personality traits, psychopathology and neuropsychological profile, or that these features are an epiphenomenon of malnutrition and are thus irrelevant as targets for treatment. Rather than delving into the self, perhaps the focus should be on the starvation side of self-starvation. ^{Reference Gutierrez5}