Anorexia Nervosa: Diagnosis, Treatment And Recovery

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

About 1–2% of young women have anorexia nervosa, a serious but treatable mental illness that is three times more common in women than in men. What are the main symptoms, causes and treatments for this complex but treatable mental disorder?

Alison was a 17-year-old schoolgirl. She was always shy and restless, but excelled in her studies. Within three months, her parents noticed that she rarely ate at home and was constantly losing weight. They asked her about it, but she said she ate at school or on the way home with her friends. A few weeks later, Alison's mother unexpectedly found her daughter in the bathroom while she was trying to induce herself to vomit.

Alison burst into tears and admitted that she was deliberately starving because she was afraid to become fat and believed that she currently looks fat. She also said that some of her friends did the same and offered her pills that they said would make her thin. The girl was too scared to accept them since she had already passed out twice at school last week. However, she continued to induce vomiting up to four times a day.

Alison agreed to see her family doctor, who found that her period had recently stopped due to rapid weight loss, and that Alison probably had anorexia nervosa.

About 1–2% of young women have anorexia nervosa, a serious but treatable mental illness that is three times more common in women than in men.

Anorexia is characterized by deliberate weight loss when body weight is 15% or more less than normal, or body mass index (BMI) is 17.5 or less (for people aged 16 and over). A person's BMI is calculated using a person's weight (in kilograms) and height (in meters). BMI is weight divided by height squared (i.e. kg / m2). A person weighing 70 kg and a height of 1.8 m has a BMI of 21.6.

A BMI between 18.5 and 24.9 is normal, with lower values indicating underweight and higher values indicating overweight or obesity (30 or more). These guidelines are not set in stone and many factors need to be taken into account when interpreting them, but a BMI of 17.5 or below is usually one of the key signs of anorexia.

In addition, weight loss in anorexia nervosa is usually self-induced, mainly to avoid weight gain. Vomiting or so-called vomiting may also be involved. body cleansing, excessive exercise, medications to suppress appetite and reduce weight. Psychologically, there is a distortion of the visible body image and fear of obesity.

Physically anorexia causes widespread hormonal imbalance, which leads to abnormal absence of menstruation in women (amenorrhea) and loss of sexual interest and potency in men. In young people, puberty may be delayed. Other features include dry skin, thin hair, weak pulse, cold intolerance, and the physical effects of repeated vomiting (such as damaged teeth).

Causes of anorexia not fully established, but the family can play a large role in this. People with anorexia tend to have low self-esteem, anxious personality types, signs of OCD, and sometimes have experienced childhood abuse. Media pressure also creates unrealistic expectations for appearance, contributing significantly to the problem.

Anorexia is treatable … First of all, it is important that a person's physical health needs are identified and reviewed by a family doctor. The Royal College of Psychiatrists in the UK has compiled a useful Do and Dont list for anorexia from a psychological perspective.

The "Needed" list includes:

• Adhere to a regular meal schedule.
• Take small steps towards healthy eating (for example, if you can't eat breakfast, just sit at the table for a few minutes during breakfast, drink a glass of water and try to make at least small improvements day after day or week after week).
• Keep a diary of food, your thoughts and feelings.
• Be honest about what you eat or don't eat.
• Be kind to yourself.
• Figure out which weight is reasonable for you.
• Reading other people's stories.
• Joining self-help groups.
• Avoid websites and social media. networks that promote very low body weight.

The "Not allowed" list includes:

• Weigh yourself more often than once a week.
• Spend time looking at your body in the mirror.
• Isolate your family and friends.

Psychiatric treatmentwhen needed, it usually focuses on psychological therapy, in some cases in combination with medication and with support from family, loved ones and society.

Cognitive Behavioral Therapy (CBT)is the psychological therapy most commonly used for eating disorders. It includes gaining knowledge of the disorder itself; understanding how to predict symptoms and when they get worse; keeping a diary of meals, overeating, cleansing, vomiting, and any other triggers; developing healthy eating habits; changing attitudes towards your behavior, feelings and symptoms; and solving everyday problems and tasks is more positive.

Other forms of therapy, such as family involvement, can also help. Most people with anorexia are treated on an outpatient basis, but hospitalization may be required if outpatient treatment is not effective; mental or physical health deteriorates sharply; BMI falls below 13.5; or there is a significant risk of self-harm. If there are signs of depression or oCD, antidepressants may be used.

As a result of psychotherapy, 40-50% of people with anorexia nervosa recover completely; up to 35% show significant improvement; and about 20% develop chronic, variable disease. Five percent die from the complications of anorexia.

Treatment of anorexia nervosa can be difficult due to late diagnosis, patient ambivalence about change, and problems accessing specialized services. Early diagnosis and timely intervention, on the other hand, can go a long way in treating this complex but treatable disorder.

PhD in Psychology, cognitive-behavioral psychotherapist L. P. Ponomarenko - translation of the article: