Anorexia Nervosa
Anorexia nervosa is an eating disorder characterized by an intense fear of gaining weight, distorted body image, and extreme restriction of food intake. Individuals with anorexia often have a relentless pursuit of thinness, leading to severe weight loss and malnutrition. This condition can have serious physical and psychological consequences, and typically requires a comprehensive treatment approach involving medical, nutritional, and psychological interventions.
7 Key excerpts on "Anorexia Nervosa"
eBook - ePub- Carlos M. Grilo(Author)
- 2014(Publication Date)
- Psychology Press(Publisher)
...3 Understanding, assessing, and treating Anorexia Nervosa Introduction Anorexia Nervosa (AN) is the least common and the most serious eating disorder. AN is characterized by refusal to maintain a minimal body weight and by extreme weight control methods including severely restricted and controlled eating. These patients have severe disturbances in how they experience and evaluate their bodies. Persons with AN have a remarkable degree of denial about their problem, which unlike the other eating and weight disorders, tends to be “egosyntonic” (i.e., not seen as a problem or something foreign or unwanted by the self). AN results in high rates of serious medical problems and has one of the highest death rates for any psychiatric problem. Despite the seriousness of this problem, limited progress has been achieved either in understanding the nature of this frequently chronic and debilitating disorder or how best to help persons suffering from it (Agras et al., 2004; Fairburn & Harrison, 2003; NICE, 2004; Wilson, 2005). This chapter begins with an overview of the major assessment issues relevant to AN. The major research findings about treatment and management will then be summarized. Assessment of Anorexia Nervosa The challenge The assessment of Anorexia Nervosa (AN) is complicated by several factors. The most challenging issue is the denial of the problem. Many persons with AN will deny or refuse to acknowledge that they are underweight or unable to maintain (or work toward) a healthy weight. Since they see and experience themselves as overweight or even “fat,” despite the reality of their very thin states, they are very resistant to clear feedback about their weight and medical complications. They frequently have somatic complaints (e.g., feeling cold, fatigue, headaches, and constipation) and insist that they have “special” or different metabolisms...
- (Author)
- 2020(Publication Date)
- Wiley(Publisher)
...Eating Disorders Jennifer Barney, Arielle Wolinsky, and Adrienne S. Juarascio Drexel University Eating disorders (EDs) are complex psychiatric disorders characterized by disturbances in an individual’s eating and related behaviors, resulting in psychological distress, health concerns, and reduced quality of life. These disorders can arise from many combinations of psychological, biological, and social risk factors and can lead to potentially life‐threatening behaviors and thought patterns surrounding one’s eating and weight. Individual variability of symptomology, diagnostic crossover, and difficulty distinguishing disordered eating from normal‐range eating behaviors, often make diagnosing and treating EDs very difficult. While the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM‐V), outlines some of the more common presentations of ED symptoms, (which are described in greater detail below), individual risk factors and various treatment methods that have been utilized for varying EDs are also reviewed. Anorexia Nervosa AN is characterized within the DSM‐V as: (1) persistent restriction of energy intake resulting in significantly low body weight; (2) intense fear of gaining weight or becoming heavy, or persistent behaviors that interfere with necessary weight gain; and (3) disturbance in the way one’s body weight or shape is experienced. Two subtypes may also be specified within the diagnosis of AN when appropriate: (1) Restricting, describing presentations of symptoms in which only caloric restriction and/or excessive exercise are present or (2) binge/purge (AN‐BP), describing presentations where binge eating and purging behaviors (e.g. self‐induced vomiting, laxative misuse) are also present, concurrent with the first three diagnostic AN criteria...
- Amy E. Wenzel(Author)
- 2017(Publication Date)
- SAGE Publications, Inc(Publisher)
...However, eventually these behaviors become more severe until the individual abandons social and emotional pursuits and instead spends an inordinate amount of time calculating calories and planning meals. Exercise typically becomes a compulsion, and purging behaviors develop in 15% to 20% of cases in an attempt to prevent weight gain. These behaviors become reinforcing and often are described as a source of support and comfort for the individual with Anorexia Nervosa. Some individuals with Anorexia Nervosa recover fully after experiencing a single episode, whereas others exhibit a fluctuating pattern of weight gain followed by relapse. Others experience a chronic course; for these individuals, hospitalization is often necessary to restore weight and address medical complications. Individuals diagnosed with Anorexia Nervosa also commonly experience body image dissatisfaction and distortion (i.e., a disturbance in the perception of body weight and shape) whereby individuals excessively focus on their bodies and frequently engage in body checking, which leads to increased distortions and misperceptions. More significantly, this often leads to an inability to appropriately recognize and evaluate the medical consequences associated with malnutrition. Individuals with Anorexia Nervosa commonly experience comorbid impairments such as depression, anxiety, substance use, irritability, lability of mood, impaired concentration, loss of sex drive, and obsessional behaviors. Because many of these impairments are the consequences of starvation, they tend to worsen as more weight is lost and usually improve with weight gain. It is typical for individuals to become disinterested in the outside world and socially withdraw and isolate themselves from others. Prior to the onset of Anorexia Nervosa, many individuals report the presence of either an anxiety disorder or symptoms...
eBook - ePub- Linda Smolak, Michael P. Levine(Authors)
- 2015(Publication Date)
- Wiley-Blackwell(Publisher)
...8 Diagnosing Anorexia Nervosa Emily K. Gray, Helen B. Murray, and Kamryn T. Eddy Eating Disorders Clinical and Research Program, Massachusetts General Hospital, USA Anorexia Nervosa (AN) is a complex syndrome characterized by physical, behavioral, and cognitive criteria and is associated with substantial medical morbidity and psychiatric comorbidity (Diagnostic and Statistical Manual of Mental Disorders, 5th ed. [ DSM-5 ]; American Psychiatric Association, 2013). The illness commonly onsets during adolescence (see Chapter 55) and historically has affected predominantly females (see Chapters 5 & 27). Epidemiological studies (see Chapters 5 to 7) indicate lifetime prevalence rates of 0.3% among male and female adolescents (Swanson, Crow, Le Grange, Swendsen, & Merikangas, 2011), and 0.3% and 0.9% among adult males and females, respectively (Hudson, Hiripi, Pope, & Kessler, 2007). The etiology of AN is thought to involve a confluence of biological, psychological, and social factors (see Chapters 22 to 34 & 67). Although AN was first described in the medical literature in the 17th century (see Chapter 2), much about how to recognize, understand, and in turn, treat this illness remains unknown. A core objective of the DSM-5 (2013) is to provide a common language through which clinicians and investigators may diagnose, communicate, study, and treat people with mental disorders. As a clinical tool, the DSM-5 is a practical guide wherein criteria for psychiatric illnesses are carefully outlined in order to facilitate diagnosis, case formulation, and treatment planning...
eBook - ePubThe Handbook of Child and Adolescent Clinical Psychology
A Contextual Approach
- Alan Carr(Author)
- 2015(Publication Date)
- Routledge(Publisher)
...17 Anorexia and Bulimia Nervosa DOI: 10.4324/9781315744230-17 Anorexia Nervosa and bulimia nervosa are the main eating disorders of concern in child and adolescent clinical psychology (American Psychiatric Association, 2006 ; Agras, 2010 ; Le Grange & Lock, 2011 ; Lock, 2012 ; NICE, 2004c). These eating disorders typically have their onset in adolescence. In both conditions there is an over-valuation of body shape and weight, with self-worth being judged almost exclusively in terms of these personal attributes. With anorexia, the primary feature is the maintenance of a very low body weight, whereas with bulimia the main feature is a cycle of binge eating and self-induced vomiting or other extreme weight control measures including dieting, excessive exercise, and laxative use. An example of a typical eating disorder case is presented in Box 17.1. Eating disorders are of concern because they are dangerous (Arcelus et al., 2011 ; Gowers, 2013 ; Klump et al., 2009 ; Mitchell & Crow, 2010 ; Steinhausen, 2011). In chronic cases they lead to many medical complications including growth retardation, osteoporosis, gastrointestinal bleeding, dehydration, electrolyte abnormalities and cardiac arrest. The mortality rate among women with anorexia is 12 times that of the normal population and about double that in other psychological disorders such as schizophrenia, bipolar disorder or depression. Eating disorders are associated with a raised suicide risk. It is ironic that in our Western industrialized culture where food is plentiful, self-starvation and a pattern of bingeing and purging are major problems affecting teenage girls. In this chapter, after considering the classification, clinical features and epidemiology of eating disorders, a variety of theoretical explanations concerning their aetiology will be considered along with relevant empirical evidence...
eBook - ePubExercise and Eating Disorders
An Ethical and Legal Analysis
- Simona Giordano(Author)
- 2010(Publication Date)
- Routledge(Publisher)
...1 Eating disorders Symptoms and facts Anorexia and bulimia nervosa: The terms This chapter offers a comprehensive and accessible account of eating disorders. The term ‘eating disorders’ refers to a broad group of disorders, which includes Anorexia Nervosa, bulimia nervosa, obesity, binge eating, extreme dieting, fasting–bingeing cycles and other forms of subclinical anorexia and bulimia nervosa. By ‘eating disorders’ I will, however, mainly intend Anorexia Nervosa and bulimia nervosa (I will often use ‘anorexia’ and ‘bulimia’ to refer to ‘Anorexia Nervosa’ and ‘bulimia nervosa’), which are those eating orders mainly considered in the clinical literature. 1 I shall, however, also discuss briefly what these other eating disorders, such as binge eating, are. The points raised on anorexia and bulimia nervosa can help with a more general understanding of other (sometimes less extreme) forms of disordered eating. Anorexia Nervosa The term ‘Anorexia Nervosa’ was coined by William Gull in 1873. In 1888 this illustration appeared in his article ‘Anorexia Nervosa’, published in the Lancet. 2 However, this phenomenon was noticed much earlier by Richard Morton, in London...
eBook - ePubWorking With Eating Disorders
A Psychoanalytic Approach
- Geraldine Shipton(Author)
- 2017(Publication Date)
- Bloomsbury Academic(Publisher)
...3 A NOREXIA N ERVOSA Anorexia Nervosa is described in the ICD 10 (International Statistical Classification of Diseases and Related Health Problems [10th Revision]) Classification of Mental and Behavioural Disorders as: ‘… deliberate weight loss, induced and/or sustained by the patient’ (WHO, 1992). For a definite diagnosis, all the following are required: Body weight is maintained at least 15 per cent below that expected either because it has been lost or never achieved. Weight loss is achieved by avoiding fattening foods. One or more of the following self-induced strategies should be present: vomiting; purging; excessive exercise; use of appetite suppressants and/or diuretics. There is a body-image distortion with a dread of fatness experienced as an intrusive overvalued idea with resulting self-imposed low weight. There is endocrinal disorder leading to amenorrhoea in women and loss of potency or sexual interest in men. There may be elevated levels of growth hormone and cortisol, changes in thyroid hormone and abnormalities of insulin secretion. If onset is before puberty, development is delayed or arrested and growth ceases so that girls do not develop breasts and there is primary amenorrhoea, and in boys the genitals remain juvenile. With recovery, puberty is often completed normally but girls may have their first period delayed. Some physical results of anorexia are coldness, rough, dry skin, sometimes fluid retention in the ankles or face, loss of hair on the head and a fine down-like growth of hair on the body (lanugo). Emaciation causes the muscles to waste away and there is a risk of osteoporosis in later life if emaciation has been for a long period. There may be a fast heart rate and sleep is disrupted. The diagnostic criteria for anorexia show how anorexia and bulimia are closely related, with only the overeating bouts as a clear distinguishing factor in bulimia...
