Anorexia nervosa (AN) is often highly valued by the individual. This can result in the individual having ambiguous and ambivalent feelings towards change. This ambiguity and ambivalence poses a major hurdle within the treatment process. The use of motivational interviewing (MI) during the initial phase of treatment to subtly guide the individual towards committing to change is increasing. Working within the particular constraints that govern the treatment of AN, such as impaired cognitive function, age of the patient, and the natural (biological) and social (Mental Health Act) laws that govern the need to eat, it is possible to adjust particular assumptions of the MI model (e.g. patients autonomy) to enable treatment and care to be provided in the MI spirit (e.g. supportive, affirming and empathic).