Diagnosing A Patient With Anorexia Nervosa

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).

The first step in the treatment of anorexia is to aid the client in adapting a more standardized eating pattern. A dietitian may intervene at this point to assist the affected person to adopt more healthy eating behaviors. The counselor's role is to gradually help the client begin to adopt a more normal eating style (Shekter-Wolfson et al 13). In all cases, however, there are six goals of any treatment process:

An individual with Anorexia is unable to recognize the severity of their condition; they are so far gone into their disorder, all they can see is a shrinking number on a scale. “ In Anorexia Nervosas’ cycle of self-starvation, the body is denied the essential nutrients it needs to function normally. Thus, the body is forced to slow down all of its processes to conserve energy .” (NEDA. “Health Consequences, Including Mortality”). The symptoms of Anorexia Nervosa include: abnormally slow heart rate, low blood pressure, reduction of bone density, muscle loss and weakness, fainting, fatigue, and overall weakness. According to Walter Kaye, in the article, “Mortality and Eating Disorders”, Anorexia Nervosa has a mortality rate of four percent (Walter.“Mortality and Eating Disorders”).

Van Ommen, J., Meerwijk, E., Kars, M., van Elburg, A., & van Meijel, B. (2009). Effective nursing care of adolescents diagnosed with anorexia nervosa: the patients' perspective. Journal Of Clinical Nursing, 18(20), 2801-2808.

Today in society it is founded that Anorexia Nervosa is of most common disorders that affect multiples of women and men across the country. The DSM-V at 307.1 (F50.01) (F50.02) finds Anorexia Nervosa to be a persistent restriction of energy intake leading to significantly low body weight, as related to minimally expected for age, sex, developmental trajectory, and physical health. The DSM-V also finds the criteria of Anorexia Nervosa to be an intense fear of gaining weight or becoming fat, persistent behavior that interferes with weight gain, the disturbance in the way one’s body weight or shape is experienced, the undue influence of body shape and weight of self-evaluation, or persistent lack of recognition of the seriousness of the current

Anorexia nervosa patients often have compulsive ways of organizing nutrition and physical activity. They can, for example, eat only certain foods and strictly avoid the others, and exercise too much. Sometimes the disease with depression precedes the development of anorexia nervosa and even leads to suicide. “The truth is that when women or girls with severe anorexia attempt suicide, instead of using the action as a possible cry for help or a plea for attention, they genuinely want to die. Therefore, there may be fewer attempts, but far more deaths” (Kofod).

Eating disorders is a big and serious problem in our society, unfortunately society give us a wrong idea of how our body should be, every day every person is exposed to have a wrong idea of beauty because advertisements and magazines .According to national institute of mental health, problem whit eating disorders most of the time include issues whit their behavior, their thinking , feelings and of course with food because they have an extremely fear to gain weight .Eating disorder is a psychological problem that can bring to our life’s an unending threatening costs. People who suffer of Anorexia nervosa usually had a distorted body image, extremely weight loss and low self-teem. Also, this physiological

Patients have not "lost" interest in food, they have intentionally restricted their food intake because of an irrational fear of being or becoming fat. Anorexia nervosa is a mental illness that has no cause its more caused by a biological environment and psychological factors Being underweight and not having a normal diet may have an effect on the brain which reinforces behaviors and obsessive thoughts related to anorexia nervosa. In other words, under-eating and being underweight can set off a cycle of further weight loss and under-eating. Anorexia nervosa is associated with severe health consequences related to malnutrition. Health effects can include dry skin, hair loss, difficulty regulating temperature, slow heart rate and blood pressure, muscle weakness, loss of bone density and severe dehydration that can lead to kidney failure. Women can experience a loss of menses and infertility. Men may experience a loss of sexual desire and impotency. Anorexia nervosa has the highest mortality rate of any psychiatric illness—between 5-20%. The causes of death associated with anorexia nervosa are medical consequences associated with malnutrition and suicide. The mortality rate is higher amongst individual’s concurrently experiencing anorexia nervosa and a substance use disorder. Signs of anorexia are unexplained weight loss Food rituals (eating only specific foods, taking small bites, cutting food in small pieces) Social isolation (including avoidance of social situations with food) Extreme anxiety about weight gain Body dissatisfaction Denial of hunger Preoccupation with food, calories, collecting recipes and cooking Checking body parts, frequent

The mortality rate for anorexia is a staggering 19 percent, leaving it at the highest rank out of any other psychiatric condition. A lot of individuals that fall in 19 percent are lost due to the refusal of treatment (Matusek and Wright). It has been noted that many individuals that are affected by anorexia nervosa are also affected by other harsh conditions which leave medical professionals questioning their competence in decision making involving medical treatment (Tan et al). If these individuals are not competent and reliable enough to eat the necessary amount for comfortable and healthy living, how can they be trusted to make medical decisions?

The treatment process for anorexia is much more complex and intricate then that of bulimia’s. “The biggest challenge in treating anorexia nervosa is helping the person recognize that they have an illness. Most people with anorexia deny that they have an eating disorder. They often seek treatment only when their condition is serious” (1). With treating anorexia nervosa, the main goals are to regain normal eating habits and gain the healthy weight needed for the person’s height and age. According to Medlineplus, “Different programs have been designed to treat anorexia. These may include... increasing social activity, reducing the amount of physical activity, and using schedules for eating” (1). The person may also have to stay in the hospital for a few days and follow it up with a treatment program. Sometimes a hospital stay is longer than anticipated if, the person has lost around 70% of their recommended body weight, weight loss continues even after starting treatment, medical complications (heart problems, confusion, or low potassium levels, and suffers from severe depression or thoughts of suicide (1). There are also talk therapies provided to people with anorexia such as, cognitive therapy, group therapy, and family therapy. The goals of talk therapy is to change the beliefs of the person with the disorder and encourage them to eat in a healthier way. The last thing used is

Anorexia nervosa is a psychological disorder in which a person has an abnormal eating behavior, to be able to lose weight. The word anorexia nervosa was first used in 1873, by one of Queen Victoria’s physicians known as Sir William Gull. There are two types of anorexia which are the restricting type and the binge-purge type. According to the medical term, this disorder is said to be lack of appetite (Kaye, 2009, p.450). A person who is suffering from anorexia has a fear of gaining weight. This prompts them to do whatever it takes to lose weight. Anorexia is mostly experienced among girls and some men. In general, adolescent girls usually look at their figure more and that is why they are the ones who are mostly affected. By

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.

As Anorexia is a fatal disease there are then some vital symptoms people will have a loss of at least 15% of the person’s body weight this is due to the Anorexic sufferer refusing to consume any food no matter how hungry the sufferer may be (Unkown, The department of health, 2007) The sufferer may gain a negative mind set leaving them to consider themselves as too fat no matter how underweight and thin they will be. Anorexics have the urgent desire and need to exercise excessively. Anorexics have an intense fear of

In severe cases of anorexia and bulimia inpatient care is needed. Inpatient care has access to 24-hour a day clinical care and is a very structured environment. This may be just what the patient needs because many times the lives of patients with eating disorders are not very organized. There are different levels of care in the hospital that gives the patients the option to “step-up” or “step-down” to. One reason that patients with eating disorders are placed in inpatient care in a hospital is when they also have a psychiatric disorder. Their psychiatric disorder may also require some special care that interferes with an eating disorder. Sarah is not at the point of needing inpatient care. In patient care is usually only implemented in severe cases of anorexia or bulimia.

Individuals who have anorexia nervosa may perceive their body as overweight even if they are thin and underweight. People with this disorder often weight themselves, refuse to eat and restrict the amount of food received, may refuse to eat in front of others, and exercise compulsively (http://www.apa.org/helpcenter/eating.aspx: p. 1). Some people may misuses laxatives, diuretics, or enemas (https://www.nimh.nih.gov/health/publications/eating-disorders-new-trifold/index.shtml: p. 1). Anorexia has the highest mortality rate. Some may die from starvation others die of suicide. Suicide is most common in women with anorexia than in people with other mental illnesses. (http://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml: p. 1).