What is Anorexia Nervosa? How to Treat?

Have you ever met a person who is afraid to lick a postage stamp because he thinks he will gain weight? This comment, which may seem meaningless to most people, was shared by an anorexia nervosa patient with her therapist during therapy in 1973. Anorexia nervosa can be explained as refusal to eat, insufficient food intake, and weight loss as a result. You can find all you want to know about anorexia nervosa in the rest of the article.

What is Anorexia Nervosa?

Individuals with anorexia nervosa have a body weight below the ideal body weight, but despite this, they are extremely afraid of getting fat. These individuals do not accept that their extremely low body weight is a problem. In fact, what is in question here is the disorders these people experience in perceiving their body weight and body shape. In other words, patients with this eating disorder are actually people who cannot evaluate themselves objectively.

Anorexia nervosa and other eating disorders , which have become a nightmare for parents with children especially in adolescence, appear as one of the disease groups with the most obvious gender differences among psychiatric diseases. According to DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), the lifetime prevalence of this eating disorder is reported to be 1.7% in women and 0.1% in men. The onset of eating disorders is usually in adolescence and young adulthood. Studies show that the age of onset of anorexia nervosa is generally between 13-20.

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What are the symptoms of Anorexia Nervosa?

Individuals diagnosed with anorexia nervosa resist eating at the beginning of the disease, often follow a strict diet or aim to stay thin by doing excessive physical exercise. Generally, the disease is diagnosed when physical symptoms begin to show themselves. These patients may have their own food rituals. For example; Such as collecting recipes from wherever they can find them, completely eliminating carbohydrate foods from their lives, disappearing at meal times and avoiding eating with others.

Many of these patients see themselves as fat despite severe hunger. Individuals perceive the appearance of some body parts, especially hips and waist, as more exaggerated and overweight than other body parts. Individuals with anorexia are generally obsessed with food; Their eating behaviors are unique to them and they enforce them strictly. They usually eat very slowly and are extremely picky eaters. They show behaviors such as taking very small bites and avoiding fatty foods. Many patients frequently count calories, weigh themselves several times a day, and look in the mirror frequently to assess their body shape.

In addition to symptoms of restricting food intake in order to keep body weight under control, behaviors such as self-induced vomiting, abuse of various drugs, and uncontrolled and excessive exercise are also frequently observed in patients with anorexia nervosa . It is observed that the medications taken by patients are generally diarrheal or dehydrating drugs used to eliminate the weight-gaining effect of foods. With all these features , anorexia is shown as one of the psychiatric diseases with the highest mortality rate.

How is Anorexia Nervosa Treated?

Early diagnosis and treatment is very important to prevent the devastating effects of Anorexia Nervosa on human health. If it is too late to treat anorexia nervosa , the disease may become chronic and even untreated anorexia patients may face the risk of losing their lives. The causes of death of individuals who die as a result of this disease are generally other diseases that occur due to anorexia nervosa. Anorexic people who have a seriously wrong and inadequate diet may suffer damage to many organs, especially the heart, kidneys and brain. Osteoporosis, heart disease and kidney damage can be listed among the diseases that cause patients to lose their lives.

Anorexia nervosa is not a disorder that can go away on its own without treatment. The treatment process requires full team work consisting of a psychiatrist, dietitian and other specialist doctors. The disease can be treated on an outpatient basis, or depending on the progression of the disease, partial hospitalization or inpatient treatment methods are applied. If the individual has lost 30% of his ideal body weight during the disease process, he is usually hospitalized for treatment and his diet is kept under control. In individuals with advanced disease, treatment begins with nutritional support.

In the treatment of anorexia nervosa , there are treatment methods that include medication, different psychotherapy techniques, or a combination of medication and psychotherapy methods.After stability is achieved in the medical condition of anorexia nervosa patients, the most important part of their treatment is psychotherapy. For this reason, different psychotherapy methods are applied for the disease. Cognitive behavioral therapy (CBT), motivational interviewing, supportive psychotherapy, family therapy and cognitive therapy are among the frequently used psychotherapy approaches.

Anorexia Nervosa Diagnostic Criteria

To diagnose wasting disease , it is necessary to consider whether the individual who has lost significant body weight has another disease that causes weight loss. However,for the anorexia nervosa test, clinical evaluations of the patient’s low pulse , body temperature, constipation, liver and heart condition, and psychological findings such as depression, obsession, introversion, low self-esteem, and social phobia are observed.

As the patient loses weight , impairments in attention, memory and cognitive functions occur; The incidence of non-specific somatic pain, fatigue and sleep problems increases. Physical symptoms such as weakened arms and legs, wasting of subcutaneous fat tissue and muscles, prominence of ribs and facial bone protrusions, and erosion of tooth enamel due to repetitive vomiting may be observed in patients with anorexia nervosa . In addition, these patients may complain of conditions such as feeling cold, having dry skin, and thinning hair. Negative effects of hunger on the heart and low thyroid hormone levels; Explains low body temperature, hypotension, and orthostatic problems. Kidney dysfunction and chronic kidney diseases are among other complications and clinical findings.

The diagnostic criteria in the DSM-5 diagnostic criteria manual for anorexia nervosa are briefly as follows. Patient;

• Restricts calorie intake according to needs. This situation leads to a body weight that is significantly lower than the person’s age, gender and physical health.

• He/she is very afraid of gaining weight and engages in restricting, vomiting, or compensatory behaviors that prevent the increase in body weight despite being at a significantly low body weight.

• There is a problem with the individual’s perception of body weight or body shape. When evaluating himself, the person cannot understand the importance of low body weight and attaches meaningless importance to body weight and shape.

The causes of anorexia nervosa and other eating disorders are not attributed to a single factor. These diseases are generally associated with genetic and neurobiological predispositions; It is assumed that it occurs through the interaction of environmental, sociocultural and spiritual factors. Difficult experiences such as the idea of ​​being sexually attractive in adolescents, stress, social pressure, divorce, and loss of a loved one can be cited as some of the psychological reasons that increase the risk of developing the disease.

Although the death rate in eating disorders has decreased slightly in the last decade; Anorexia nervosa remains among the mental disorders with the highest mortality rate. For this reason, it is of great importance to recognize risky people before disease symptoms appear, to carry out preventive interventions, early diagnosis and correct treatment methods.