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Anorexia Nervosa

Anorexia nervosa is an eating disorder that’s prominent through extreme food restriction, inappropriate eating habits, the obsession of being thin, and the fear of gaining weight. Excessive weight loss is usually involved when it comes to this disorder, and is diagnosed roughly nine times more often in women than men.

Causes of Anorexia Nervosa

Studies have hypothesized that the persistence of “disordered” patterns of eating may be epiphenomena of starvation. Results of the Minnesota Starvation Experiment concluded that normal controls exhibit many of the behavioral patterns of anorexia nervosa (AN) with the introduction of starvation. This may be due to the numerous changes in the neuroendocrine system, which results in a self-perpetuating cycle. Other studies have suggested that initial weight loss (dieting, for instance) may triggering the development of anorexia nervosa, possibly because of an already inherent predisposition toward AN. One other study reported that cases of AN may arise from unintended weight loss due to a parasitic infection, medication (side effects), or a surgical procedure. Furthermore, other studies have suggested that males with a female twin have a higher chance of getting anorexia. Hence, anorexia might have a link with intrauterine exposure to female hormones.

Cultural factors also play a role in causing AN. There’s a strong thesis of a connection between culture and anorexia nervosa, in that a blueprint is provided for anorexia nervosa through the promotion of thin females.

Anorexia Nervosa Diagnostic Guidelines

Viral/bacterial infections, hormonal imbalances, neurodegenerative diseases, and brain tumors can imitate anorexia nervosa. Anorexia nervosa is classified as an Axis I disorder in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-V). Body mass index (BMI) serves as an indicator of the severity level of anorexia nervosa. Other psychological issues may factor into AN. Some satisfy the criteria for a separate Axis I diagnosis, or a personality disorder (coded Axis II). There are individuals who have a previous disorder that may increase their vulnerability to the development of an eating disorder. An eating disorder is developed in some people later on.

Treatment for Anorexia Nervosa

There’s lack of final evidence that any particular treatment for anorexia nervosa is superior to others. But, there’s sufficient evidence to suggest that early intervention and treatment are more effective. Treatment for AN aims at the restoration to a healthy weight, treating psychological disorders that relate to AN, and reducing or eliminating behaviours or thoughts that are responsible for the disordered eating. There have been some claims that olanzapine is effective in treating certain aspects of anorexia nervosa. This includes helping raise the BMI and chomping at obsession (constant thoughts about food). Olanzapine doesn’t increase the rate of BMI growth in patients with anorexia. Family-based treatment (FBT) has been proven to be more successful than individual therapy in most treatment trials.

Cognitive behavioral therapy (CBT) is an evidence-based approach which has shown to be useful in adolescents and adults with anorexia nervosa. The therapist focuses on using cognitive restructuring to modify distorted beliefs and attitudes about the meaning of weight, shape, and appearance. Specific behavioral techniques that aim at normalizing eating patterns and weight restorations are enforced. An example of this would be a meal plan, and gradual weight gain. Several professionals have expressed concerns about the minimum age threshold and level of cognition necessary for incorporating cognitive behavioral techniques. There are actually modified versions and elements of cognitive behavioral therapy that can be implemented with children and adolescents. Such modifications may include the use of behavioral experiments to disconfirm distorted beliefs and absolutistic thinking. Acceptance and commitment therapy is a type of CBT, which has shown promise in the treatment of anorexia nervosa. Participants witnessed clinically significant improvement on at least some measures. The condition of all participants didn’t worsen, nor lost weight even at a 1-year follow-up.

Cognitive remediation therapy (CRT) is a type of rehabilitation therapy that was developed at King’s College in London. It’s designed to improve neurocognitive abilities (attention, working memory, cognitive flexibility, planning, and executive functioning). Neuropsychological studies have shown that patients with anorexia nervosa have difficulties in cognitive flexibility. Studies that were conducted at Kings College and in Poland were proven to be beneficial in treating AN. Clinical trials in the U.S. are still being conducted by the National Institute of Mental Health on adolescents whose ages ranged from 10–17.

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