Treatment of Anorexia

Anorexia nervosa, classified as an eating disorder, is a psychiatric disorder characterized by a serious deterioration in the eating habits of the affected person and the associated thoughts and emotions. In anorexia nervosa the person is constantly preoccupied with eating routines and his or her own body weight. Due to the self-destructive behaviour with regards to food, the physical health of the sufferer is jeopardized.

It is believed that there are millions of people in the world who suffer from eating disorders. A large part of these consists of women between the ages 12-35. Compared to Bulimia, which is another eating disorder, anorexia nervosa seen less frequently. The disease has a slower progression, but a larger number of associated physical problems.

What kind of an illness is anorexia nervosa?

A large percentage of anorexia nervosa sufferers have low self-respect, a tendency to judge themselves and their body mercilessly, and a tendency to perfectionism. Anorexia nervosa sufferers regard themselves as “overweight” although they are not, and insist on this belief when in reality they are often extremely skinny and undernourished. The fear of gaining weight and looking fat is very strong and persistent. During the initial stages of the illness anorexic patients are usually not aware that they have a problem.

It is thought that anorexia nervosa occurs in 1 out of 100 girls and young women. The diagnosis is made if the patient weighs at least 15% less than what would be expected from a healthy person of the same height. Anorexia nervosa patients do not gain weight because they refuse to eat adequately, sometimes make themselves throw up deliberately , and do excessive amounts of exercise. Over time their weight can reach dangerously low levels.

Anorexia nervosa is generally accompanied by psychiatric disorders such as anxiety disorder, panic disorder, or obsessive compulsive disorder. Although it is thought that hereditary factors play an important role in the development of the illness, in many cases there is no history of eating disorder in the families of the sufferers.

What physical problems develop in anorexia nervosa?

If left untreated, anorexia nervosa can lead to physical illnesses like heart conditions, metabolic problems and malnutrition . However, with the appropriate treatment it is possible to correct the eating habits of anorexic patients and prevent associated psychological and physical problems.

Physical problems that develop in anorexia nervosa are often related to extreme malnutrition. These are as follows:

– Amenorrhoea

– Osteoporosis, weakening of the bones

– Brittle hair and nails

– Dry skin, yellowish skin colour

– Anaemia and loss of muscle volume (there may also be a deterioration in the heart muscle)

– Severe constipation

– Reduced blood pressure, slow pulse and respiration

– Reduced body temperature

– Lethargy, depression

– Metabolic problems that arise due to decreased potassium, calcium and magnesium levels in the blood, can be life threatening.

How do we treat anorexia nervosa?

In the treatment of anorexia nervosa the primary aim is to restore the patient to a healthy body weight. If the patient refuses treatment or has developed serious metabolic problems, he or she may have to be hospitalized involuntarily. In the treatment of metabolic problems that have arisen in connection with malnutrition, the help of doctors from the branch of Internal Medicine should be sought. During the inpatient stay the patient’s nutrition is carefully monitored.

With a predetermined and closely monitored dietary program the patient is restored to a healthy body weight. Any psychological or physical problems that are likely to arise during this phase, require treatment with additional precautions. Psychotherapy both during inpatient stay and during treatment on an outpatient basis contributes to positive changes in the progression of the illness. It should not be forgotten that anorexia nervosa is a long-term illness in which patients require close psychiatric follow-up, and that after periods of improvement anorexia may still flare up intermittently.