What is most important when first treating a patient for anorexia nervosa?
What is anorexia nervosa?Anorexia nervosa (AN) is an eating disorder that can lead to devastating physical, psychological, and social consequences if left unaddressed. Show
Anorexia nervosa is characterized by an intrusive preoccupation about body size and shape, leading to the patient not adequately nourishing themselves. It is essential to understand that anorexia nervosa can happen at any body size due to anorexia nervosa being centered around self-starvation, regardless of body weight. Diagnosing anorexia nervosaEarly diagnosis and treatment of anorexia nervosa is essential to preventing permanent health damage and accelerating the recovery process. In fact, with proper treatment many can make a full recovery from AN. Before settling on a treatment option, a medical provider with specialized training in eating disorders, and AN, will complete a thorough examination of the patient. After establishing a diagnosis, the provider will then suggest appropriate treatments based on the patient’s needs. Medical professionals use the following indicators to make a diagnostic determination: Preoccupation with body sizeWhile not every patient with anorexia nervosa is underweight at the time of diagnosis, most present with low body weight and are undernourished. Regardless of weight, however, the common thread is an altered perception of body weight. (3) BehaviorBehavioral patterns, such as eating habits, exercise frequency, and intensity, and the use of laxatives and diuretics indicate disordered eating. Physical assessmentA thorough medical history and physical examination of patients with suspected eating disorders can reveal malnutrition and other related health conditions. In addition to a visual inspection of hair, skin, nails, knuckles, and teeth, providers also assess vital signs like blood pressure, pulse, temperature, and respiration rate. People with anorexia nervosa often have a low heart rate and low blood pressure, in addition to muscle loss. Laboratory valuesBlood tests provide other valuable insights about the health status of patients who engage in restrictive eating behaviors. Low blood counts often indicate inadequate nutrition, compromised immune function, and impaired metabolism. They can also detect related medical conditions, such as dehydration and vitamin deficiencies. In people with anorexia nervosa, low sodium, potassium, creatinine, and urea are common. Library sections you should visit
Signs & symptoms of anorexia nervosaEating disorders can be elusive, and the subtle nuances between the different types of eating disorders can also make them difficult to diagnose. Identifying the signs and symptoms of anorexia nervosa is therefore a critical part of getting a proper diagnosis. Prompt treatment can prevent permanent organ damage and help people with anorexia nervosa recover fully. Here are a few warnings signs that could reveal anorexia nervosa:
Effects of anorexia nervosaShort-term effectsIn the short term, the effects of anorexia nervosa are more subtle. Anorexia nervosa causes electrolyte imbalances and blood pressure changes that lead to fatigue and interfere with day-to-day activities. Many people who engage in disordered eating also experience gastrointestinal distress, including bloating, abdominal pain, and constipation. Long-term effectsThe long-term effects of anorexia nervosa are more devastating. The restriction of calories and lack of nourishment impacts every organ system. Irreversible effects can include osteoporosis and infertility. Out of all the eating disorders, people with anorexia nervosa are most likely to die by suicide, with studies showing 20-40% of AN patients take their own lives. (15) Over time, anorexia nervosa interferes with the body’s ability to function correctly, leaving the immune system vulnerable. (1) Here are some other negative long-term health consequences associated with anorexia nervosa:
The effects of disordered eating also take a toll on a person’s emotional well-being, which can lead to strained relationships and poor social support. Related disordersIn most cases, anorexia nervosa does not occur independently. Over half of those diagnosed with AN also have at least one other co-occurring DSM-IV disorder. (10) Other related disorders that commonly occur alongside AN include:
Treatment of anorexia nervosaAnorexia nervosa is a life-threatening disorder, yet only one-third of those who suffer from the condition seek treatment. (10) These are some common reasons patients resist treatment:
Overcoming resistance to anorexia nervosa treatment is vital, since early intervention reduces both the condition’s short- and long-term effects. Treatment of anorexia nervosa may include the following:
Additional psychological therapies for anorexia nervosa include:
Within Health's treatment options for those struggling with anorexia nervosa depend on the severity of the condition and the overall health of the individual seeking treatment. Still, the most important thing to understand is that eating disorders are treatable. Therapies for anorexia nervosaThe most effective treatments for disordered eating are individualized, considering the patient’s unique medical needs, behaviors, barriers, and challenges. Interdisciplinary teams consist of healthcare professionals with specialized knowledge in the treatment of eating disorders. A comprehensive clinical care team should include (at minimum):
In addition to the core medical team, family and friends also play a vital role in the recovery process. By offering additional support and encouragement throughout the treatment process, patients achieve better outcomes. Medications for anorexia nervosaCurrently, there is no FDA-approved medication specifically targeted to treat anorexia. (11) However, some medications may be prescribed to treat related psychological conditions. Understanding anorexia nervosaWithout a clear understanding of eating disorders such as anorexia nervosa, people often make over-generalizations that lead to inaccurate assumptions and judgments. For example, anorexia nervosa is not a lifestyle choice – it is a complex medical psychological condition that requires professional treatment. There is a common misconception that anorexia nervosa only affects women when it actually affects people across all genders. Anorexia nervosa does not discriminate and affects all gender identities, sexualities, races, ages, and ethnicities. One in three people diagnosed with an eating disorder identifies as male. (4) Likewise, anorexia nervosa also occurs in sexual and gender minority populations. (13) Living with anorexia nervosaFor those who live with the condition, anorexia nervosa influences every aspect of their life. From food choices to social interactions, every decision is based on how it will affect a person’s weight and body image. The preoccupation with food and weight can lead to feelings of isolation, which take a toll on mental health. With treatment, however, people with anorexia nervosa can make a full recovery. People who are navigating the challenging landscape of anorexia need a great deal of support, medical care and psychological care. Coping with anorexia nervosa requires a team of medical professionals like those at Within Health. Our team has specialized knowledge in the physical, emotional, and social aspects of the condition. Equipped with effective coping strategies and treatment, a full recovery from anorexia nervosa is possible. History of anorexia nervosa
Anorexia nervosa in pop cultureOver the past 50 years, there has been a spike in cases of eating disorders in younger populations.8 Some health experts believe this is due to the constant societal messaging that thinness is something to be celebrated. In recent years eating disorders have increased substantially in adolescents during the pandemic. The National Eating Disorder Association (NEDA) has experienced a 40% increase in helpline calls, while hospitals estimate intake for patients with eating disorders is also up 25%. (13) In some industries, such as fashion and entertainment, expectations around weight are unrealistic. As many as 62% of fashion models have been encouraged to lose weight at some point in their careers. (9) You might also be interested in
How to help someone with anorexia nervosaEarly treatment is critical if you or someone you know is experiencing signs of anorexia nervosa. The first step in the recovery process is to find a trusted health care provider who can guide you through the treatment process. Within Health offers compassionate, highly-personalized treatment programs for people with eating disorders. Call our admissions team today to learn how we heal anorexia nervosa. Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset. When dealing with anorexia What should the patient know?Nutrition education
Understand how nutrition affects your body, including recognizing how your eating disorder causes nutrition issues and physical problems. Practice meal planning. Establish regular eating patterns — generally, three meals a day with regular snacks. Take steps to avoid dieting or bingeing.
Which is the most common technique to treat anorexia nervosa?However, many people with anorexia do see an improvement with therapy. CBT and IPT are the most established treatments for binge eating disorder and bulimia nervosa. FBT is the most established type of therapy for children and adolescents with anorexia nervosa, and may also be beneficial for those with bulimia nervosa.
What is the first goal of nutrition therapy for patients with anorexia nervosa?Key goals in nutritional therapy for anorexia nervosa include: Weight restoration and body-weight maintenance. A development of neutrality toward food through re-developing intuitive understandings of hunger, fullness, and satiety.
What is considered to be the most important cause of anorexia nervosa?Dieting and starvation.
Dieting is a risk factor for developing an eating disorder. There is strong evidence that many of the symptoms of anorexia are actually symptoms of starvation. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction in appetite.
|
