Anorexia Nervosa

Incidences of Anorexia Nervosa have appeared to increase sharply in the USA, UK and western European countries since the beginning of the 60s (Gordon, 2001). The increasing prevalence of the disease has led the World Health Organisation to declare eating disorders a global priority area within adolescent mental health (Becker et al. 2011). Anorexia has in many ways become a modern epidemic (Gordon, 2000) and with a mortality rate of 10% per decade (Gorwood et al. 2003), the highest of any mental disorder (Bulik et al. 2006), it is an epidemic that social and biological scientists have been working tirelessly to understand.

In 1981, a researcher named Fairburn conducted the first study applying cognitive-behavioral therapy to the treatment of bulimia nervosa. In a recently published report by D. L. Spangler (1999), CBT is touted as “a well-developed, theoretically grounded treatment for bulimia nervosa with the strongest empirical support for its efficacy of any form of treatment for bulimia nervosa.” Today cognitive-behavioral therapy (CBT) is a form of therapy commonly used to treat patients with bulimia nervosa (BN).

Anorexia nervosa, otherwise stated as anorexia, is an eating disorder that occurs when an individual restricts themselves from necessary energy intake which leads to significantly low body weight. Other characteristics of this disorder include: intense fear of becoming fat or gaining weight, persistent behavior that interferes with weight gain, and disturbances of perception and experience of their own body weight and shape (DSM V, 2013). Effective treatments are still trying to be researched for this disorder, as there is not a “one size fits all” for people of all age groups, living situations, etc. Since adolescents with anorexia are such a vulnerable population,

In this paper, I will discuss how cognitive behavioral therapy (CBT) can be utilized in the management of eating disorders. More specifically I will identify Anorexia Nervosa and provide statistics that relate to the disease. Etiologies will be discussed as well as symptoms. Various techniques of Cognitive Behavioral Therapy will be described as well as the rationale as it relates to the clinical issue.

It was very interesting to find that those with anorexia nervosa find more positives about their disorder rather than more negatives. Serpell (1999) states that, “One of the most interesting features of anorexia nervosas which sets it apart from many other conditions is the highly valued nature of anorexic symptoms. This is expressed in patients’ generally positive beliefs about their condition and contributes to their ambivalence about treatment (pg. 177). I think that with this article, it makes it more difficult for researchers to really find an effective treatment plan for those with anorexia nervosa partly because they find so many positive beliefs about their disorder and partly because maybe those with the disorder may not take treatment seriously or it may be more difficult to treat because they think so highly of their

This paper explores the proposed use of Dialectic Therapy (DBT) on adolescents between the ages of twelve and eighteen who are diagnosed with Anorexia Nervosa (AN). It will address the nature and extent of the issue of AN in the target population, weigh the positive and negative aspects of different types of therapies on the target population and show the potential limitations of the use of DBT versus other forms of therapies.

Bulimia Nervosa is an eating disorder characterized by recurrent episodes of binge eating with inappropriate compensatory behaviors to prevent weight gain. Cognitive Behavior Therapy and antidepressant drug therapy are treatment modalities that have shown promise with patients diagnosed with eating disorders, more so with Bulimia than with Anorexia, (Comer, 2014). In this case study analysis, a synthesis of researched outcomes-based treatment modalities is used to conceptualize a diagnosis and treatment plan for a 19 year-old female client presenting with symptoms of 307.51 (F50.2) Bulimia Nervosa; extreme.

Anorexia nervosa is an eating disorder that consists of self-regulated food restriction in which the person strives for thinness and also involves distortion of the way the person sees his or her own body. An anorexic person weighs less than 85% of their ideal body weight. The prevalence of eating disorders is between .5-1% of women aged 15-40 and about 1/20 of this number occurs in men. Anorexia affects all aspects of an affected person's life including emotional health, physical health, and relationships with others (Shekter-Wolfson et al 5-6). A study completed in 1996 showed that anorexics also tend to possess traits that are obsessive in nature and carry heavy emotional

The advice and support of trained eating disorder professionals can help one regain one’s health, learn to eat normally again, and develop healthier attitudes about food and one’s body (Smith). The treatment of choice for bulimia is cognitive-behavioral therapy (Smith). The initial goal of cognitive-behavioral therapy is to restore control over dietary intake. Cognitive-behavioral therapy principally involves a systematic series of interventions aimed at addressing the cognitive aspects of bulimia nervosa (Matthews 71). Breaking the binge-and-purge cycle is the first phase of bulimia treatment and restoring normal eating patterns. One learn to monitor one’s eating habits, avoid situations that trigger binges, cope with stress in ways that do not involve food, eat regularly to reduce food cravings, and fight the urge to purge. Changing unhealthy thoughts and patterns is the second phase of bulimia treatment that focuses on identifying and changing dysfunctional beliefs about weight, dieting, and body shape. Solving emotional issues is the final phase of bulimia treatment that involves targeting emotional issues that caused the eating disorder in the first

The average age was 16.6 years. All women had a diagnosis of Anorexia Nervosa as indicated by DSM-IV and never received FT prior to the study. Patients and family were informed of the study when admitted to impatient care. Unfortunately, the sample size is quite small and there is a gender bias. This study only generalizes its results to females in their teens and early twenties who are hospitalized in inpatient care. Randomization does not occur in the sample selection.

Similar to the form of group therapy in the previous case study, the use of family therapy is a common treatment for coping with an eating disorder. In a controlled study on the effects of family therapy as a source of treatment for adolescents with anorexia nervosa, an observational study was conducted comparing two forms of family therapy. In addition to observing the patients in treatment they also examined the five-year follow-up of 40 patients who utilized conjoined group family therapy and separate family therapy (Eisler, Simic, Russell and Dare. 2007). The study included interviewing 40 patients who received either separate or conjoint family therapy. In addition to the interviews with the families, all participants also took part in 6-question surveys. The data collected measured the relationship between symptomatic outcome and psychosocial

Fairborn (2005) points out that there is a range of treatment options and a variety of treatment settings for anorexia nervosa, however there is inadequate empirical support for this abundance of options as what minimal research on the treatment has been inconclusive. One reasoning behind this is that anorexia nervosa has been an uncommon disorder and sample sizes for studies have been low. Furthermore, the lack of evidence based treatment research can be attributed to the individual’s avoidance of treatment and dropping out of treatment. Many individuals with anorexia nervosa are unwilling to change as their identity and self-worth are intertwined with their distorted body image; they tend to deny that anything is wrong with their weight and are ambivalent on changing (Abbate-Daga, Amianto, Delsedime, De-Bacco & Fassino,

People suffering from eating disorders cannot solely help themselves. Although they may be able to stop for a short time, in the long run they will be back in the same path of self-destruction. Kirkpatrick & Caldwell (2001) state, "Because eating disorders are a complicated mix of physical and psychological abnormalities, successful treatment always includes treatment of psychological issues as well as restoration of a healthy diet" (p. 131). Trained therapists should treat eating disorders. The severity of the disorders will determine the need for outpatient therapy or an in-hospital program (Matthews, 2001, p. 178). There are many goals of therapy but the return to normalcy is the main goal. The eating disorder sufferer needs to restore and maintain a normal weight as well as develop normal eating and exercise routines. Kirkpatrick and Caldwell (2001) state,

Anorexia nervosa is listed in DSM-5 as a Feeding and Eating Disorder alongside bulimia nervosa and binge-eating disorder (American Psychiatric Association [APA], 2013). AN is characterised by symptoms that include dangerously low body weight, intense fear of fat or weight gain, abnormal cognitions that lead to an over-evaluation of the importance of body weight, shape and size, indifference about the disorders seriousness (APA, 2013). It is a multi-determined psychiatric disorder with an interplay between sociocultural, biological, physical and mental factors that make it extremely difficult to treat successfully (Chang & Bazarova, 2016; Boraska et al., 2014). AN affects approximately 3.7% of NZ population, the average duration is five years, with the highest prevalent rate (10%) in teenage females (M = 17 years). While predominantly a young white middle-upper class female disorder, recent research shows a significant increase in diagnosis of males,

Given that anorexia nervosa is associated with high rates of mortality, relapse, suicide, and a diminished quality of life, long-term prognosis does look very tragic, with recovery rates ranging from 25-70% (Guarda, 2008). The extant of anorexia nervosa long-term outcome studies have reported, “only one-third of individuals (37%) recover within 4 years after disease onset; this figure rises to almost half (47%) by year 10 and to 73% after 10 years post onset” (Zerwas et al., 2013). These statistics suggest that the road to recovery is possible, but only over very long periods of time. Zerwas and colleagues’ (2013) study on the prognostic factors associated with anorexia nervosa recovery found that higher levels of trait anxiety, and