Proposal for Evidence Based Practice Paper for Anorexia Nervosa in Teenagers

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.

Dr. Levenkron talks about Anorexia Nervosa as a pathological distortion of today’s society of being “Fashion-model thin.” This source is reliable because it is told from a doctor's/psychotherapists perspective of the disease. It informs and broadens my research on the pathological aspect of the disease. Dr. Steven Levenkron uses case studies and specific strategies to explain and help cure the disease.

Thesis Statement: It is important to understand eating disorders and the types of eating disorders to overcome them and seek the proper treatment.

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.

After watching the video on “Dying to be Thin,” the one statement that really stuck with me was that in order for someone to have some kind of eating disorder, there has to be vulnerability. I find that statement to be extremely true. There needs to be a sense of vulnerability for someone to feel so down about themselves that in order for them to make them feel better, they have to change their body image for them to feel like they are attractive. The video really specifically highlights the issues with anorexia nervosa compared to bulimia nervosa and binge eating disorder. For clinicians and researchers, this may be a difficult to really find

Eating disorders have become an increasing public health problem once thought to be an affliction amongst young women, now an epidemic across culture and gender boundaries. Anorexia gives rise to serious socio-economic and bio-psychological circumstances of our ever vast, growing society. Awareness of eating disorders have increased but perhaps only in proportion to its advancement of its research and treatment. That which still leaves us in a position for a much greater demand for education and heightened awareness of this perplexing disease.

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 latest manual of mental disorders (DSM-5) includes various changes in the Feeding and Eating Disorders chapter as a significant number of professionals diagnosing patients realized individuals were not fitting into certain criteria and therefore being labelled with EDNOS “Eating Disorder Not Otherwise Specified”. Some of the substantial changes to the Diagnostic Manual include changes to the criteria for Anorexia Nervosa and Bulimia Nervosa. With this is mind my essay with focus on one of these specific subtypes. With evidence showing there has been an increase in Anorexia in the high risk-group of 15-19 year olds in the past decade, and Bulimia on the decrease since the early nineteenth century (Smink, Hoeken, Hoek 2012) my chosen subtype will be Anorexia Nervosa. As statistics are increasing further than those of other subtypes it merits singular discourse. AN remains the most deadly of all mental health disorders, with a 5-10% death rate within 10 years of developing the symptoms, and an 18-20% death rate within 20 years.

Anorexia nervosa is a disorder that in the majority of cases will start when the patient is a teenager. The mean age at onset is figured to be about 17 years of age. The distribution of cases appears 'to be asymmetrical with a skewness towards the higher ages (Theander, 1996).

As a person who personally was diagnosed with Anorexia (AN), I’ve experienced just how detrimental it can be to one’s family. “With 2,000,000 adolescents and young adults affected, AN is the third most common chronic condition among adolescent girls, behind obesity and asthma” (Carlton & Pyle, 2007, pg. 9). Not only does this disease affect women, it also affects men. Through the Parent Education and Support Program, COPE intervention, and accepting the many environmental, psychological, and sociocultural influences, the number of cases of AN can dramatically decrease. In addition, many lives can be saved because of these three interventions.

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.

Eating disorders are severe disturbances in eating behaviors, such as eating too little or eating too much. “Anorexia nervosa affects nearly one in 200 Americans in their lives (three-quarters of them female)” (Treating anorexia nervosa). Anorexia, when translated into Greek means “without appetite” which is not true for all suffering from anorexia most people with this disorder have not lost their appetite they simply have to ignore it. People with anorexia have an intense fear of gaining weight and have convinced themselves that they are overweight even if they are the opposite of overweight. Since the way that they view themselves is in a negative light they starve themselves and put their lives at risk. “In the most severe

Anorexia nervosa and bulimia are eating disorders that severely affect both men and women around the world. The cause of the eating disorder usually derives from psychological, biological and social forces. Eating disorders have become an epidemic in American society, twenty-four million people of all ages and genders suffer from an eating disorder in the U.S. (National Association of Anorexia Nervosa and Associated Disorders.\, 2011). There are many ways to address and treat an eating disorder. There have been multiple studies conducted to test the effectiveness of different types of treatment. My central research question analyzes the relationship between the continuation of the eating disorder with the presence of intervention or some

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,