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Anorexia nervosa

What Is Anorexia nervosa?

  • Anorexia nervosa, commonly referred to in the general public as “anorexia” (literally meaning ‘lack of appetite’), is an eating disorder that affects both males and female. The commonest age group is between 14 and 25 years.
  • The majority of patients diagnosed are females, and an estimated percentage of between 0.3 and 1% of females are affected.
  • It is a common misperception that men are not affected by eating disorders. Approximately 25% of individuals with anorexia nervosa are males. They often have the worst outcomes, due to late diagnosis, specifically related to this misperception, even by doctors and psychologists.    

What Is Anorexia nervosa?

  • Anorexia nervosa, commonly referred to in the general public as “anorexia” (literally meaning ‘lack of appetite’), is an eating disorder that affects both males and female. The commonest age group is between 14 and 25 years.
  • The majority of patients diagnosed are females, and an estimated percentage of between 0.3 and 1% of females are affected.
  • It is a common misperception that men are not affected by eating disorders. Approximately 25% of individuals with anorexia nervosa are males. They often have the worst outcomes, due to late diagnosis, specifically related to this misperception, even by doctors and psychologists.    

What Are The Symptoms Of Anorexia nervosa?

  • Anorexia nervosa is diagnosed using the DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) classification of mental illnesses. The symptoms needed for diagnosis are the following:
  • Restricting the required energy intake that is required for the person's specific gender, age, stage of development and health, leading to a significantly low body weight that is less than the minimum norm expected for the person.
  • Patients with anorexia are usually extremely fearful of gaining weight and may behave in certain ways to ensure not gaining weight. These behaviors include restriction of food, excessive exercise, purging and unindicated use of laxatives.
  • Persons who suffer from anorexia usually have a distorted body image. They persistently believe and see themselves as overweight and often cannot recognize their extremely low body weights.
  • The severity of anorexia is based on the person’s body mass index (BMI)- calculated according to their weight and height. Each age group has a particular set of normal BMI parameters.
  • The mortality rate of anorexia nervosa is the highest of all eating disorders and may be as much as 4%. The mortality is related to complications that develop over time because of the severe restriction of necessary nutrients
  • These complications include muscle wasting or weakness (muscular atrophy), thinning of bones (osteoporosis), a fine growth of hair over the body (to assist in maintaining body heat in the absence of healthy subcutaneous fat), infertility, amenorrhoea, and constipation. Anorexia may also lead to different as well as multiple organ failures such as the heart and kidneys.    

What Are The Causes Of Anorexia nervosa?

  • Psychosocial causes are the main aetiologies.
  • Psychological factors involved are low self-esteem, perfectionistic or “A”-type personalities.
  • Social factors include lack of close or intimate friendships. They may also often grow up in environments where performance and perfectionism are encouraged, and patients may strive to achieve this in attempts to find approval from their parents or guardians. It may also be that the social environment at home is unstable, and often patients find controlling what they eat as a way to feel in control, even when outside circumstances are uncontrollable.
  • There are some studies done that may suggest abnormalities in underlying neurotransmitters, although it is hard to estimate, as anorexia is a state of starvation, and that in itself may alter the neurotransmitters. Other studies suggest underlying abnormalities in neuro circuit connections in the limbic system and prefrontal gyrus of the brain.    

What Are The Things One Should Do To Manage Anorexia nervosa?

  • Acknowledge that you need help, and seek medical and psychological assistance. It is possible to recover from anorexia, despite how difficult it may appear when you are suffering from it
  • Seek a social support system during your recovery process. Family members, friends or specific anorexia support forums may be of assistance
  • Take time to heal. Recovery from eating disorders take time, as the causes are multifactorial, and often psychological and social issues or stressors that underlie your condition will only improve with time    

What Are The Things One Should Avoid To Manage Anorexia nervosa?

  • Delay seeking help if you know someone who is suffering from anorexia. Complications may be life-threatening.
  • Don’t stigmatize people who suffer from anorexia. There are very real and underlying factors for their disease.
  • If you suffer from anorexia, don’t allow yourself to feel like a failure because you are seeking help. Sufferers from anorexia are often very perfectionistic and extremely hard on themselves.    

What Are The Best Foods For Anorexia nervosa?

  • Dietary management is foundational during the recovery process and needs to be properly assessed and monitored as there may be associated risks involved. Anorexia patients are often in a state of chronic starvation, and refeeding should be done properly and tailored to the individual patient's needs
  • An assessment of underlying micronutrient deficiencies, kidney and liver function, and protein levels in the blood are all important determinants in the correct dietary approach.
  • Refeeding syndrome may occur if patients have been in a state of starvation for too long. This syndrome occurs specifically when carbohydrates are consumed in large quantities following periods of malnutrition or starvation. This can lead to a shift in electrolytes and low levels of phosphate, magnesium, and potassium. Eventual heart failure may occur if severe.

What Are The Worst Foods For Anorexia nervosa?

What Are The Medicines For Anorexia nervosa?

  • Psychological treatment is the foundation on which management of any eating disorder should be built, including anorexia.
  • Psychotherapy is used to address underlying factors such as low self-esteem and body image.
  • Social workers may also be involved if there are difficult home circumstances, especially in adolescents still staying at home. Setting up of a support structure is important during the recovery phase.
  • Medical treatment may include hospitalization if the patient's condition is very severe.
  • This will include treatment of other complications such as organ failure, heart failure, anemia, low blood pressure.
  • Patients with eating disorders often have underlying micronutrient deficiencies and electrolyte abnormalities that need to be corrected with medications or supplements during an admission.
  • Patients may need parenteral feeding (feeding through a drip) or feeding through a nasogastric tube if they refuse to ingest food.
  • Psychotropic medications that a psychiatrist may prescribe include anti-depressants (usually Selective Serotonin Reuptake Inhibitors), low dose antipsychotics such as Risperidone or mood stabilizers. 

What Are The Tips To Manage Anorexia nervosa?

What Are The Symptoms Of Anorexia nervosa?

  • Anorexia nervosa is diagnosed using the DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) classification of mental illnesses. The symptoms needed for diagnosis are the following:
  • Restricting the required energy intake that is required for the person's specific gender, age, stage of development and health, leading to a significantly low body weight that is less than the minimum norm expected for the person.
  • Patients with anorexia are usually extremely fearful of gaining weight and may behave in certain ways to ensure not gaining weight. These behaviors include restriction of food, excessive exercise, purging and unindicated use of laxatives.
  • Persons who suffer from anorexia usually have a distorted body image. They persistently believe and see themselves as overweight and often cannot recognize their extremely low body weights.
  • The severity of anorexia is based on the person’s body mass index (BMI)- calculated according to their weight and height. Each age group has a particular set of normal BMI parameters.
  • The mortality rate of anorexia nervosa is the highest of all eating disorders and may be as much as 4%. The mortality is related to complications that develop over time because of the severe restriction of necessary nutrients
  • These complications include muscle wasting or weakness (muscular atrophy), thinning of bones (osteoporosis), a fine growth of hair over the body (to assist in maintaining body heat in the absence of healthy subcutaneous fat), infertility, amenorrhoea, and constipation. Anorexia may also lead to different as well as multiple organ failures such as the heart and kidneys.    

What Are The Causes Of Anorexia nervosa?

  • Psychosocial causes are the main aetiologies.
  • Psychological factors involved are low self-esteem, perfectionistic or “A”-type personalities.
  • Social factors include lack of close or intimate friendships. They may also often grow up in environments where performance and perfectionism are encouraged, and patients may strive to achieve this in attempts to find approval from their parents or guardians. It may also be that the social environment at home is unstable, and often patients find controlling what they eat as a way to feel in control, even when outside circumstances are uncontrollable.
  • There are some studies done that may suggest abnormalities in underlying neurotransmitters, although it is hard to estimate, as anorexia is a state of starvation, and that in itself may alter the neurotransmitters. Other studies suggest underlying abnormalities in neuro circuit connections in the limbic system and prefrontal gyrus of the brain.    

What Are The Things One Should Do To Manage Anorexia nervosa?

  • Acknowledge that you need help, and seek medical and psychological assistance. It is possible to recover from anorexia, despite how difficult it may appear when you are suffering from it
  • Seek a social support system during your recovery process. Family members, friends or specific anorexia support forums may be of assistance
  • Take time to heal. Recovery from eating disorders take time, as the causes are multifactorial, and often psychological and social issues or stressors that underlie your condition will only improve with time    

What Are The Things One Should Avoid To Manage Anorexia nervosa?

  • Delay seeking help if you know someone who is suffering from anorexia. Complications may be life-threatening.
  • Don’t stigmatize people who suffer from anorexia. There are very real and underlying factors for their disease.
  • If you suffer from anorexia, don’t allow yourself to feel like a failure because you are seeking help. Sufferers from anorexia are often very perfectionistic and extremely hard on themselves.    

What Are The Best Foods For Anorexia nervosa?

  • Dietary management is foundational during the recovery process and needs to be properly assessed and monitored as there may be associated risks involved. Anorexia patients are often in a state of chronic starvation, and refeeding should be done properly and tailored to the individual patient's needs
  • An assessment of underlying micronutrient deficiencies, kidney and liver function, and protein levels in the blood are all important determinants in the correct dietary approach.
  • Refeeding syndrome may occur if patients have been in a state of starvation for too long. This syndrome occurs specifically when carbohydrates are consumed in large quantities following periods of malnutrition or starvation. This can lead to a shift in electrolytes and low levels of phosphate, magnesium, and potassium. Eventual heart failure may occur if severe.

What Are The Worst Foods For Anorexia nervosa?

What Are The Medicines For Anorexia nervosa?

  • Psychological treatment is the foundation on which management of any eating disorder should be built, including anorexia.
  • Psychotherapy is used to address underlying factors such as low self-esteem and body image.
  • Social workers may also be involved if there are difficult home circumstances, especially in adolescents still staying at home. Setting up of a support structure is important during the recovery phase.
  • Medical treatment may include hospitalization if the patient's condition is very severe.
  • This will include treatment of other complications such as organ failure, heart failure, anemia, low blood pressure.
  • Patients with eating disorders often have underlying micronutrient deficiencies and electrolyte abnormalities that need to be corrected with medications or supplements during an admission.
  • Patients may need parenteral feeding (feeding through a drip) or feeding through a nasogastric tube if they refuse to ingest food.
  • Psychotropic medications that a psychiatrist may prescribe include anti-depressants (usually Selective Serotonin Reuptake Inhibitors), low dose antipsychotics such as Risperidone or mood stabilizers. 

What Are The Tips To Manage Anorexia nervosa?