Magnetic Resonance-Guided Focused Ultrasound Bilateral Capsulotomy for Refractory Anorexia Nervosa With Comorbid Obsessive Compulsive Disorder or Major Depressive Disorder

This study is testing a non-invasive brain procedure called MR-guided focused ultrasound bilateral capsulotomy — which uses focused sound waves guided by MRI to modify specific brain circuits — as a treatment for severe, long-standing anorexia nervosa that has not responded to any other treatment. This is a last-resort option for people who have been very ill for many years. **You may be eligible if...** - You are between 18 and 65 years old - You have anorexia nervosa along with OCD and/or major depressive disorder (diagnosed by DSM-5) - Your illness has been treatment-resistant, meaning: it has lasted more than 10 years with less than 3 months of remission, OR you have had at least three unsuccessful hospital-based treatment attempts, OR you have needed at least two emergency or involuntary re-feeding episodes over at least two years - You are able to give informed consent and make medical decisions **You may NOT be eligible if...** - You have unstable heart disease (such as recent heart attack, uncontrolled heart failure, or arrhythmia) - Your body weight is too low to safely undergo the procedure - You have metal implants or other conditions incompatible with MRI - You have active suicidal intent - You have severe cognitive impairment preventing informed consent Talk to your doctor to see if this trial is right for you.