Anorexia Nervosa: Nursing Interventions

Characteristics of anorexia are dieting despite being thin and having an obsession with caloric intake as well as fat grams. An anorexic person often pretends to eat or will lie about their intake of meals because of their belief of being overweight. With all of the food restrictions many problems occur in the body and outside of the body. Some of these risks include the drastic change in brain chemistry that makes it difficult for them to think correctly, decrease in memory, fainting, or they may become sad, moody, irritable, or depressed. Other changes would include, hair may become thin and brittle, skin is dry and easily bruises, they get cold easily, and nails often get brittle. However those are not the most dangerous risks. If one is anorexic,

With Anorexia Nervosa, there is a strong fear of weight gain and a preoccupation with body image. Those diagnosed may show a resistance in maintaining body weight or denial of their illness. Additionally, anorexics may deny their hunger, have eating rituals such as excessive chewing and arranging food on a plate, and seek privacy when they are eating. For women, they go through immediate body changes from abnormal to no menstruation periods and develop lanugo all over their bodies. Characteristics of an anorexic individual also consist of extreme exercise patterns, loosely worn clothing, and maintain very private lives. Socially, to avoid criticism or concern from others, they may distant themselves from friends and activities they once enjoyed. Instead, their primary concerns revolve around weight loss, calorie intake, and dieting. In regards to health, many will have an abnormal slow heart rate and low blood pressure, some can develop osteoporosis, severe dehydration which can result in kidney failure, and overall feel weak (Robbins, 27-29). It has been reported that Anorexia Nervosa has one of the highest death rates in any mental health condition in America (www.NationalEatingDisorders.org).

For many the term “Anorexia” conjures up memories of bone thin, weight obsessed teenage girls, models, and actresses. However, as the spotlight has been shined on Anorexia bringing this secretive and quiet disorder to a wider public perception, many still suffer in silence: either too ashamed to seek treatment, or because of an improper diagnosis.

Anorexia nervosa is an eating disorder and a mental health condition that could potentially be life-threatening. People with anorexia try to keep their weight as low as possible by restricting the amount of food they eat. They often have a distorted image of themselves, thinking that they're fat when they're not.  Some people with the condition also exercise excessively, and some eat a lot of food in a short space of time (binge eating) and then make themselves sick. People affected by anorexia often go to great attempts to hide their behaviour from their family and friends by lying about eating and what they have eaten. Anorexia is linked to

In the book “Boys Get Anorexia Too : Coping with Male Eating Disorders in the Family,” author Jenny Langley briefly describes about anorexia nervosa, and the short-term and long-term effects of it. Anorexia is a disease involving intentional starvation, an obsession with food and weight related issues, and extreme weight loss. Langley notes that people with anorexia will deprive themselves of vital nutrients through severely restricting food intake. Despite this excessive weight loss, the person will continue to feel overweight. They deny the fact that they are at a dangerously low body weight and fear being fat. Thus, the body is forced to slow down all of its processes to conserve energy, or resulting in serious medical consequences. Langley

Being obsessed with weight, people with anorexia nervosa tend to weigh themselves repeatedly, portion food and eat very small quantities are certain foods – no fats, no carbs, no sugars (Pinel, 2011). Just like with drugs, some people get better after one bout of anorexia nervosa, while some relapse and some, unfortunately, lose the battle as their health declines.

Eating disorders are diseases in which people have an unhealthy relationship with their food, and negative image reflecting how their body looks, such as, the fear of gaining weight. This type of body dysmorphia can lead to damaging eating habits, such as; starvation, purging, and even binging. Furthermore, there are numerous eating disorders recognized today, the most common being binge disorder, causing the affected person to eat far too much and experience pain, discomfort, and irritable bowel symptoms, bulimia which causes the affected person to purge their food through vomiting, and one of the most common eating disorders -- anorexia nervosa. (Eating Disorders, 2008) Many of these disorders can be treated in multiple ways, the most common way is through counselling with a social worker, the social worker helps develop a treatment plan for the client and aids them in their recovery.

This article explored the topic of identifying symptoms in patients with anorexia nervosa (AN). The Eating Disorder Inventory led a study, conducted by D. Garner, that studied females with AN to classify behavior exclusive to the psychological disorder. The researchers recognized the problem of trying to identify any restrictive manners or detrimental behaviors that could identify a person with AN. The purpose of the research was to find tell-tale symptoms or psychological indicators of AN in patients.

People with anorexia nervosa have a tendency to look in the mirror and see their body as overweight and ugly even when in reality they are dangerously thin. A sufferer of anorexia nervosa can be underweight, emaciated with protruding bones or a sunken appearance. They can experience fatigue, dizziness or even fainting. The nails become brittle, the hair can fall out, and women can even experience loss of menstruation or irregularities in their menstrual cycle (Timberline, 2005).

The clinical presentation of Anorexia Nervosa are; patient have low body weight, amenorrhea, yellow skin, lanugo, cold extremities, peripheral edema, muscle weakening, constipation, abnormal laboratory values, abnormal computed tomographic scans, electroencephalographic changes, Cardiovascular changes and impaired renal

Anorexia Nervosa is the condition when an individual abstains from food in order to lose weight or prevent more weight gain. In the Diagnostic and Statistical Manual of Mental Disorders IV(DSM-IV) there are four aspects of criteria to be diagnosed with anorexia: a refusal to maintain weight above what is minimally normal for one’s age and height, and extreme fear of weight gain, distorted body image, and (in females) having amenorrhea(missing three or more consecutive menstrual cycles.)(DSM-IV, 2000:589) Anorexia not only affects weight, but also alters bone growth, neurotransmitters and hormones in the brain, and electrolytes.

Underweight: With anorexia nervosa, a serious side effect is under weight. Due to the lack of eating, and some extreme cases, vomiting to remove weight from food, extreme weight loss and very dangerous and potentially life threatening. Due to the fact that the human body needs to support itself, it cannot do that without the right amount of food and nutrition to support. And as a result, deat could occur if not treated and taken care of. This can also cause dizziness, lazyness, lack of energy and nutrtion, and muscle and bone pain and discomfurt.

The Diagnostic and Statistical Manuel of Mental Disorders 5th edition defines anorexia nervosa as an eating disorder characterized by self-starvation and excessive weight loss; it is a serious and potentially life-threatening disorder. According to the DSM 5, the typical diagnostic symptoms of anorexia nervosa are: dramatic weight loss leading to significant low body weight for the individuals age, sex, and health; preoccupation with weight; restriction of food, calories and fat; constant dieting; feeling “fat” or overweight despite weight loss and fear about gaining weight or being “fat.” Many individuals with anorexia nervosa deny feeling hungry and often avoid eating meals with others, resulting in withdrawal from usual friends and activities

Self-esteem is reliant upon body shape and weight. Physical implications may include disruption of the menstrual cycle also known as amenorrhea, signs of starvation, thinning of hair or hair loss, bloated, yellowish palms/soles of feet, dry and pasty skin. The risks that people take while indulging in anorexia can also become physiologically and mentally damaging. There are several effective treatments. One of which is hospitalization, this occurs when the weight loss is greater than 30% in 3 months time. Some other effects to be taken into consideration when hospitalizing a patient are the risk of suicide and depression, severe binging and purging, and serious metabolic disturbance. Therapy and counseling is used to help the patients with depression and family complications that may have led to the state they’re in. Clinical studies have not yet identified a medication that could improve the core symptoms of anorexia.

In-patients with anorexia, starvation can damage vital organs such as the heart and brain. To protect itself, the body shifts into " slow gear ": monthly menstrual periods stop, breathing, pulse and, blood pressure rates drop, and thyroid function slows. Nails and hair become brittle, the skin dries, yellows, and becomes covered with soft hair called lanugo. Excessive thirst and frequent urination may occur. Dehydration contributes to constipation, and reduced body fat leads to lowered body temperature and inability to with stand cold. Mild anemia, swollen joints, reduced muscles mass, and light headedness also commonly occur in anorexia. If the disorder becomes severe, patients may lose calcium from their bones, making them brittle and prone to breakage. Scientists from the National Institute of Mental Health (NIMH) have also found that patients suffer from other psychiatric illnesses. They may suffer from anxiety, personality or substance abuse disorders, and many are at a risk for suicide. Obsessive compulsive disorder, an illness characterized by repetitive thoughts and behaviors, can also accompany anorexia.