Anorexia Nervosa


Warning Signs of Anorexia

  • Resistance to maintaining body weight at or above a minimally normal weight for age and height
  • Intense fear of weight gain or being “fat” even though underweight
  • Disturbance in the experience of body weight or shape, undue influence of weight on self-evaluation, or denial of the seriousness of low body weight

 
Physical Complications of Anorexia Nervosa

  • Cognitive impairment, depressed, irritable mood
  • Fainting, fatigue, and overall weakness
  • Dry hair and skin, hair loss common
  • Loss of menstrual periods
  • Slow heart rate and low blood pressure and body temperature
  • ECG abnormalities
  • Reduction in bone density
  • Electrolyte abnormalities
  • Anemia
  • Abdominal distension

Anorexia nervosa is an extremely complicated disorder with many medical complications, some of which are life-threatening. There is a 5.6% mortality rate per decade due to either cardiac arrest or suicide. Therefore, treatment offered for anorexia nervosa is comprehensive and extensive.

 
Treatment of Anorexia Nervosa

Initial assessment involves a comprehensive medical and psychiatric evaluation. Inpatient hospitalization for either medical stabilization of a physical complication or initiation of nutritional rehabilitation may be needed.

Nutritional rehabilitation is the most pressing priority and may be achieved in some circumstances in an outpatient setting. If severely underweight, initial nutritional rehabilitation will be achieved in an in-patient or residential treatment setting. If nutritional rehabilitation is begun in an outpatient setting, consultation with a nutritionist and home-health organization for monitoring will be done along with weekly follow-up visits in this clinic.

Medications for food and anxiety symptoms can also be effective. Formal psychotherapy with severely underweight patients is often ineffective. Once some significant amount of weight gain has been achieved, either individual or group psychotherapy focusing on body image, social anxiety or obsessive compulsive traits can be initiated.