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Home  Disorders
How to Get Rid of Anorexia Nervosa Disorder
Anorexia nervosa Treatment, Picture, Symptoms, Cause of Anorexia nervosaThese are dangerously thin people, only they fail to recognize as such. Avoiding food is an obsession with them. They would rathger stick to certain low calorie food or would carefully weight and portion food. People with anorexia may repeatedly check their body weight, and many engage in other techniques to control their weight such as intense and compulsive exercise or vomiting. Girls with Anorexia often experience a delayed onset of their first menstrual period. If things get worse, it can even cause death. Anorexia Nervosa DiagnosisThe main clinical criteria for diagnosis are:
Clinical features include:
The physical consequences of anorexia include sensitivity to cold, constipation, hypotension and bradycardia. In most cases, amenorrhoea is secondary to the weight loss. Vomiting and abuse of purgatives may lead to hypokalaemia and alkalosis. Prevalence Case register data suggest a rate of 1-10 per 100 000 females aged between 15 and 34 years. Surveys have suggested a prevalence rate of 1-2% among schoolgirls and university students. However, many more young women have amenorrhoea accompanied by less weight loss than the 15% required for the diagnosis. The condition is much less common among men (ratio of 1 : 10). The onset in women is usually at between 16 and 17 years of age and it seldom occurs after the age of 30 years. Anorexia occurs in 1 % to 2% of the female population and in 0.1 % to 0.2% of the male population. This disorder occurs primarily in adolescents and young adults but may also affect older women. The occurrence among males is rising, but this disorder mains more prevalent in females. The prognosis varies but improves if the patient is diagnosed early, or if she wants to overcome the disorder and voluntarily seeks help. Mortality ranges from 5% to 15%- one-third of these deaths can be attributed to suicide. Anorexia nervosa and Bulimia nervosa Cause of Anorexia nervosaBiological factors Genetic. Six to ten per cent of siblings of affected women suffer from anorexia nervosa. There is an increased concordance amongst monozygotic twins, suggesting a genetic predisposition. Psychological factors Individual. Anorexia nervosa has often been seen as an escape from the emotional problems of adolescence and a regression into childhood. Patients will often have had dietary problems in early life. Perfectionism and low self-esteem are common antecedents. Recent studies suggest that survivors of childhood sexual abuse are at risk of developing an eating disorder, usually anorexia nervosa, in adolescence. Family. Families of such patients are allegedly characterized by overprotection, inflexibility and lack of conflict resolution. Anorexia is alleged to prevent dissension in families. However, a recent case control study suggested that there is no more evidence of these factors in families of anorexia nervosa than in control families with a child with an established physical disease. Prognosis of Anorexia nervosaThe condition runs a fluctuating course, with exacerbations and partial remissions. Long-term follow-up suggests that about two-thirds of patients maintain normal weight and that the remaining one-third are split between those who are moderately underweight and those who are seriously underweight. Indicators of a poor outcome include:
Suicide has been reported in 2-5% of patients with chronic anorexia nervosa. The mortality rate per year is 0.5% from all causes. More than one-third have recurrent affective illness, and various family, genetic and endocrine studies have found associations between eating disorders and depression. Fifty per cent of patients make a full recovery, 30% a partial recovery and 20% none. Treatment of Anorexia nervosaTreatment can be conducted on an outpatient basis unless the weight loss is severe and accompanied by marked physical symptoms, dizziness and weakness and/or electrolyte and vitamin disturbances. Hospital admission may then be unavoidable and may need to be on a medical ward initially. Rarely the patient's weight loss may be so severe as to be life-threatening. A team approach to care - combining aggressive medical management. nutritional counseling, and individual, group. or family psychotherapy or behavior modification therapy - is the most effective treatment for anorexia nervosa. Even so, treatment results may be discouraging. Many clinical centers are developing inpatient and outpatient programs specifically aimed at managing eating disorders. If the patient cannot be persuaded to enter hospital, compulsory admission may have to be used. Inpatient treatment goals include:
Outpatient treatment can be conducted on cognitive behavioural or dynamic psychotherapeutic lines or on a combination of both. Setting up a therapeutic alliance is vital. Individual psychotherapy is better than family therapy if the patient has left home, and vice versa. Motivational enhancement techniques are being used with some success. All forms of psychotherapy, from psychoanalysis to hypnotherapy, have been used in treating anorexia nervosa, with varying success. To be successful, psychotherapy should address the underlying problems of low self esteem, guilt. anxiety, feelings of hopelessness and helplessness, and depression. Treatment may include behavior modification (privileges depend on weight gain); curtailed activity for physical reasons (such as arrhythmias); vitamin and mineral supplements; a reasonable diet with or without liquid supplements; subclavian, peripheral, or enteral hyperalimentation (enteral and peripheral routes carry less risk of infection); and group, family, or individual psychotherapy. Drug treatment has met with limited success, except to symptomatically treat insomnia and depressive illness.
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