Anorexia Nervosa

Anorexia nervosa is a type of eating disorders. It is more common in adolescent girls. People who have anorexia nervosa concern with their body shape and weight. They restrict food intake. Food restriction causes a significant weight loss and effects health in a negative way.

 Dsm 5 Diagnostic Criterions For Anorexia Nervosa

A. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.

B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.

C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight (American Psychiatric Association, 2013).

Anorexia nervosa consist of two subtypes. One of them is restricting type and other one is binge eating/purging type. People who have restricting subtype generally loss weight through fasting, excessive exercise and dieting. People who have binge eating/purging subtypes generally loss weight through self induced vomiting, misuse of laxatives, diuretics or enemas (American Psychiatric Association, 2013).

Sometimes anorexia nervosa can be confused with other disorders. Women with anorexia nervosa are frequently diagnosed with deppression, obsessive compulsive disorder, phobias, panic disorder, substance use disorders, and various personality disorders. Men with anorexia nervosa are also likely to have a diagnosis of a mood disorder, schizophrenia, or substance use disorder. Suicide rates are quite high for people with anorexia, with as many as 5 percent completing suicide and 20 percent attempting suicide (Davison & Neale, 2012). In addition that anorexia nervosa patients have increased rates of other psychological disorders such as deppression and anxiety (Locke & Arnocky,2020).

How Does Anorexia Nervosa Effect Physical Health?

Eating disorders can be detrimental to one’s overall health and, in some cases, they can be life-threatening conditions. There are a lot of physical consequences of anorexia nervosa. Blood pressure often falls, heart rate slows, kidney and gastrointestinal problems develop, bone mass declines, the skin dries out, nails become brittle, hormone levels change, and mild anemia may occur. Some people lose hair from the scalp, and they may develop lanugo- a fine, soft hair- on their bodies. Levels of electrolytes, such as potassium and sodium are altered. These ionized salts, present in various bodily fluids, are essential to neural transmission, and lowered levels can lead to tiredness, weakness, cardiac arrhythmias, and even sudden death (Davison & Neale, 2012).

Factors that Effect Anorexia Nervosa

There are some factors that effects the anorexia nervosa. One of them is personality type. According to research perfectionalism prospectively predicted the onset of anorexia in young adult women. In addition that, perfectionalism is higher among girls with anorexia and even after a successful treatment anorexia, perfectionalism remains high. Furthermore, acccording to a research on mothers of girls with anorexia, perfectionalism is higher among mothers of girls with anorexia than mothers of girls without anorexia (Davison & Neale, 2012).

Another factor is the relationship in family members and parents. It is not directly related with family but in the process the behavior of the parents and responses to children can make worse the anorexia nervosa process.

The third factor is sociocultural factors. The standards of societies about ideal body weight have changed greatly but in recent years it becomes thinner and less body weight. Especially, effect of social media, tv shows and magazines, can trigger body dissatisfaction. In addition that there are a lot of ‘thinsperation’ and ‘fitsperation’ websites. According to a research on thinsperation and fitsperation posts on websites and social media accounts, thinspiration posts included more women in the image description than fitspiration, whereas fitspiration included more men, objects, and graphics than thinspiration. In addition that fitspiration posts included more images of the entire body than thinspiration. Fitspiration posts emphasize appearance and attractiveness, rather than health, as motivation for engaging in fitness behaviors. Female subjects in fitspiration images are frequently thin and sexually objectified. Additionally, Boepple et al. found that 45% of fitspiration images included figures posed to appear thinner or smaller than reality (e.g., positioning the camera from above or tilting the hips to minimize body size). These findings suggest a problematic emphasis on thinness and physical attraction as the motivation and reward for exercise and suggest that the female body ideal has shifted to emphasize both extreme thinness and fitness (Alberga, Withnell & Ranson, 2018) and according to some research these websites have the potential to cause unhealtful changes in eating behavior (Davison & Neale, 2012).

In addition that, some sports such as jockey and ballet dancer requires low weight. If the person want to be a jockey or ballet dancer, s/he should have appropriate weight and should keep this weight. So, it effects these people’s eating pattern and may cause eating disorders.

Finally, there are some evidence about biological basis of anorexia. A genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa (Watson, Yilmaz, Thornton et al., 2019).  So in some part, biological basis of anorexia can effect the person.

Psychological Treatment Techniques for Anorexia Nervosa

Psychological treatment techniques are useful for anorexia nervosa. The urgent goal of the treatment is to help the person gain weight. Because if person continue to loss weigh, some medical complications ocur or person may die. If the person is too weak and has too physiological disturbances, hospital treatment is necessary. In the short term, operant conditioning behavior therapy program is successful to achieve weight gain. In addion that, the combination of Cognitive Behavioral Therapy and hospital treatment is successful to reduce anorexia symptoms after 1 year treatment. Family therapy is another psychological treatment technique. It focuses the interactions among members of the patient’s family and interpersonal issues rather than individual issues. Therapist organizes family lunch sessions because conflicts related with anorexia are most evident at mealtime. There are 3 major goal of family therapy. The first one is changing the patient role of the person with anorexia; the second one is redefining the eating problem as an interpersonal problem; the third one is preventing the parents from using their child’s anorexia as a means of avoiding conflict. Finally, according to research the most effective technique that is helpful to long term maintenance of weight gain is family therapy technique.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington.

Locke, A. & Arnocky, S. (2020). Eating Disorders.

Davison, G., Neale, J. (2012). Abnormal Psychology (12th ed.). University of California, Berkeley.

Alberga, A.S., Withnell, S.J. & von Ranson, K.M. (2018). Fitspiration and thinspiration: a comparison across three social networking sites. J Eat Disord 6, 39.

Watson, H.J., Yilmaz, Z., Thornton, L.M. et al. (2019). Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa. Nat Genet 51, 1207–1214.

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