Anorexia Nervosa is one of the most common eating disorders, which refers to “lack of appetite due to nervousness” but it is not the correct definition as the lack of appetite cannot be the core difficulty to the effect that a person persistently doesn’t eat. It is the idea behind the action of not eating properly – to have a thin body just we see in magazines and television – which results in relatively low body mass. (Association, 2013)
Though it is thought that anorexia nervosa is a modern disorder, it goes centuries back. The first time Anorexia Nervosa was established as a clinically significant disorder was in 1689, by Richard Morton, in which he proposed that two teenage girls of approximately 16-18 years of age were suffering from “nervous consumption”, leading to malnutrition and decay of body tissues.
Because of how malnutrition is acting upon the body of an individual with anorexia nervosa, they seem to ignore the effects of this disorder on their health, whether it is physical or mental. Below are typical of damage caused by anorexia nervosa:
- Nutrition: In a study conducted by Hanachi (2019), it was found that the deficiencies of nutrients in 374 anorexia nervosa patients in which micronutrients like Zinc, Vitamin A, Vitamins B1 and B12, Copper and Selenium were prevalent in being deficient in the bodies of these patients. Because of the large number of deficiencies in the body, basic functioning was hindered. (Hanachi, 2019)
- Cardiovascular anomalies: Due to the deficit in nutrition intake, the body does not make enough blood to suffice all the systems. The most affected system is that of cardiovascular. The dysfunction of blood vessels, the valvular contradictions, Bradycardia, low blood pressure, and pericardial blood dysregulation are common in patients with severe Anorexia Nervosa. (MD, 2016)
- Gastrointestinal complications: As individuals are not consuming enough food, this upsets the gastrointestinal functioning. It reduces the ingestion process, the metabolic rate, and the motility of the gastric fluids. It also lowers the metabolism and hence the person would experience bloating. The self-induced purging increases the chance of not eating anything and making the body immune to this loss of appetite. This results in the difficulty of treating anorexic patients. (Norris, 2016)
- Neurological complications: The brain and cognitive processes are also affected by the low body mass due to anorexia nervosa. Processes like decision making, concentration, mood variations, and loss of memory are aggravated due to the disease. Changes in brain chemistry and the electrical neuron passages are reported in many individuals.
- Hormonal imbalance: In DSM-V, there was a reduction in factors like loss of menstruation as it is not the primary cause of anorexia, although anorexia does affect the endocrinal system in ways such as loss of periods and bone strength, reduced growth and a higher rate of having miscarriages and abnormal births.
There are various ways to treat anorexia nervosa, whether it is drug therapy or psychotherapy. But what is surprising, is that the success rates are very poor and the reason behind this is the dissatisfaction patients feel, even after recovery. They feel as if the focus should have been changing their self-image and self-worth rather than the concept of eating right and weight gain. (Rance, 2017)
Medications such as Olanzapine is used to treat anorexia patients by neurobiological aspect, through which the person not only adjusts to the reality of their situation, but also gains weight, which is a positive side-effect of this medicine. The disrupted thought process and cognitive restructuring are slightly efficient in this medication technique, so it is advisable to counsel the person in family based treatment and/or Cognitive Behavioural Therapy.
Family based therapy is used to increase the efficacy of the treatment of adolescent patients. It was reported that both separate parent and adolescent sessions as well as the combined sessions helped change the distorted perception of the patients. (Le Grange, 2016)
Cognitive-Behavioural Therapy (CBT) refers to the modification of maladaptive thinking and behaviour of the patients, which has been proven to be the most effective. It involves eliminating the disrupted thinking regarding food and weight; it also restructures the thinking about self and body image which has led to this disorder. (Zeeck, 2018)
Though psychotherapies are effective treatment strategies, there is still a need to develop new treatments for different sub-types of anorexia nervosa to maintain the efficacy of the intervention.
Orchestrate Health offers bespoke mental health services that people can access from the comfort of their own home or within their community, with rapid response times and even daily visits if needed. Orchestrate Health can provide help for those struggling with anorexia nervosa, and remove the inconvenience of travelling to and from appointments.
References:
- American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA., American Psychiatric Association, 2013.
- Hanachi, M., Dicembre, M., Rives-Lange, C., Ropers, J., Bemer, P., Zazzo, J. F., … & Melchior, J. C. (2019). Micronutrients deficiencies in 374 severely malnourished anorexia nervosa inpatients. Nutrients, 11(4), 792. https://doi.org/10.3390/nu11040792
- Le Grange, D., Hughes, E. K., Court, A., Yeo, M., Crosby, R. D., & Sawyer, S. M. (2016). Randomized clinical trial of parent-focused treatment and family-based treatment for adolescent anorexia nervosa. Journal of the American Academy of Child & Adolescent Psychiatry, 55(8), 683-692. https://doi.org/10.1001/archgenpsychiatry.2010.128
- Norris, M. L., Harrison, M. E., Isserlin, L., Robinson, A., Feder, S., & Sampson, M. (2016). Gastrointestinal complications associated with anorexia nervosa: A systematic review. International Journal of Eating Disorders, 49(3), 216-237. https://doi.org/10.1002/eat.22462
- Rance, N., Moller, N. P., & Clarke, V. (2017). ‘Eating disorders are not about food, they’re about life’: Client perspectives on anorexia nervosa treatment. Journal of health psychology, 22(5), 582-594. https://doi.org/10.1177%2F1359105315609088
- Sachs, K. V., Harnke, B., Mehler, P. S., & Krantz, M. J. (2016). Cardiovascular complications of anorexia nervosa: A systematic review. International Journal of Eating Disorders, 49(3), 238-248. https://doi.org/10.1002/eat.22481
- Zeeck, A., Herpertz-Dahlmann, B., Friederich, H. C., Brockmeyer, T., Resmark, G., Hagenah, U., … & Hartmann, A. (2018). Psychotherapeutic treatment for anorexia nervosa: A systematic review and network meta-analysis. Frontiers in psychiatry, 9, 158. https://doi.org/10.3389/fpsyt.2018.00158
