The Anorexia Relapse Prevention Guidelines in Practice: A Case Report
Introduction
Anorexia Nervosa is a fairly common and very consequence psychiatric disorder that affects a person’s desire to consume nutrients because they believe that they are overweight. Women are more likely then men to develop this specific disorder and teenagers aged 15 to 19 are at the highest risk of anyone (Berends, Van Meijel, & Van Elburg, 2012). Individual’s affected by Anorexia Nervosa Disorder will refuse to maintain a healthy body weight for their size and instead will starve themselves in an attempt to loose weight. The lack of nutrients within their body and lack of fats left after starving themselves affects not only their physical functioning but also their psychological functioning. There has been much advancement in developing treatment for individuals affected by Anorexia Nervosa. Treatment typically consists of careful monitoring of the individual’s food intake, their weight, BMI, and their psychological state. However relapse is extremely common after full treatment occurs. It is estimated that 30-50% of individuals who are treated for Anorexia Nervosa will relapse, with the likelihood of relapse decreasing to almost zero two years after discharge (Berends, Van Meijel, & Van Elburg, 2012). Determining if an individual is going through relapse has been broken down into six key symptoms:
1. “Weight Loss leading to a body mass index below 18.5 or to body weight less than 85% of that
The three nationally recognized eating disorders are identified as Bulimia Nervosa, Anorexia Nervosa, and Binge-Eating Disorder. Eating disorders, although stereotypically viewed as a lifestyle choice, is a serious and often fatal illness that not only cause severe eating disturbances, but adverse psychological and physiological environments for the individual (National Institute of Mental Health, 2006). These disorders typically develop in the mid-to-late teen years and often carry out into early adulthood albeit also existing in late adulthood (Butcher, Mineka, & Hooley, 2004). Treatment for this class of disorder can range from various perspectives, current methodologies for binge-eating disorder point to cognitive therapies and pharmacotherapy (Reas & Grilo, 2014).
Even though eating disorders are less prevalent in society today than they have been in the past, they are still one of the most diagnosed mental illnesses today. These three illnesses have short term as well as long term effects that can leave a damaging toll on the patients’ lives and are very hard to overcome. This is shown through not only the characteristics of Anorexia nervosa, Bulimia Nervosa, Binge-eating Disease, but also through the psychological and physical harm these diseases leave on the body.
Anorexia nervosa, a medical condition defined by an abnormal or pronounced lack of appetite, has become a household recognized condition due to its prevalence and impact. Anorexia nervosa is a major eating disorder that disrupts everyday life, resulting in extreme thinness, hormonal imbalances, behavioral signs, and health issues that can lead to death. While the disease strikes across all gender, races, and classes, the victims affected are typically young, healthy, and attractive women of successful families. The average girl affected usually ages between thirteen and nineteen years old (Landau 3). This disorder has increased rapidly over the last ten years, becoming more common each year (Landau 2-3). Women faced with both a biological
Anorexia Nervosa is a DSM-5 psychological disorder characterized by energy restriction, weight loss and psychological comorbidities. The treatment of anorexia nervosa involves mainly medical and psychological interventions, and new treatments are being researched every day. Re-feeding is known to be the cornerstone, initial treatment. However, the specifics of treatment are not currently defined. Most therapeutic programs resort to a multidisciplinary treatment approach based off of clinical judgment and expertise. Treatment for anorexia nervosa is an ongoing challenge due to feeding complications and extremely high relapse rates. Future research is necessary to establish a gold standard initial treatment plan for anorexia nervosa and to continue finding new, more effective treatments.
Anorexia nervosa is a deadly eating disorder that has been an increasing problem over recent years for this generation, especially in adolescent females. Since almost everyone can access the media whenever and wherever they want, our society has been constantly shown images that have shaped our standards of beauty in which we then pass down to adolescents. In a society where mass media is so easily accessible, it 's not hard to see why images of extremely thin models can have a major impact on the minds of adolescent females who want to be accepted. Though the causes may be hard to change or impact, there are many possible treatments for those with anorexia nervosa ranging from psychological, biological, social and many other different treatments that target key components of this disorder in order to help those in need.
While the most important dissimilarities differentiating anorexia nervosa from avoidant / restrictive disorder, an overwhelming and severe fear of gaining weight and a disturbance in how an individual experiences their body shape and weight, are apparent, distinguishing bulimia nervosa from anorexia nervosa has proved to be the most challenging diagnostic difficulty. Bulimia nervosa is defined by “recurrent episodes of binge eating, recurrent compensatory behaviors to prevent weight gain and self-evaluation that is unduly influenced by body shape and weight” and, therefore, the subtype of binge-eating / purging anorexia nervosa falls in the middle of the spectrum between the two disorders. (American Psychiatric Association, 2013). Adolescents afflicted with anorexia nervosa and/or bulimia nervosa, often share similar characteristics of family conflict, excessive conformance and regimentation of behavior, and interpersonal insecurity (Herzog et al, 1991; Strober, 1980; Strober et al., 1985). However, adolescents with restrictive anorexia, often maintain a lower body weight while the bulimic and binging anorexic patients tend to be more prone to higher levels of depression, family conflict, self destructive behavior and are usually more sexually active than restrictive anorexic patients (Fisher e al,
Eating disorders are complex, challenging, and sometimes life-threatening psychiatric illnesses. There are specific diagnostic criteria and symptoms a person must exhibit in order to be diagnosed with anorexia nervosa or bulimia. These symptoms primarily relate to a disturbance in eating pattern, weight loss, an intense fear of being fat, and a disturbed body image. The etiology of eating disorders is not clearly understood, but psychological, sociocultural, and biological factors need to be considered. The treatment approach for anorexia nervosa and bulimia is also challenging and can present with serious medical complications and potentially death if not properly addressed. Recovery is possible, and the case study of Jenni Schaefer, who suffered from anorexia nervosa, binge-purge subtype since her childhood is presented to share this message of hope. More research is needed to help further understand the characteristics, cause, and treatment of eating disorders.
Anorexia is an eating disorder that affects men, women, and children of all ages, social backgrounds and socio- economic status’s. It is a lifelong struggle for people who suffer from Anorexia; however, recovery can be achieved when the eating disorder goes into remission. A person with anorexia has to change many things about themselves in order to have a successful recovery. One has to develop better eating habits with a combined lifestyle change of diet, exercise, and sleep. The underlying issues that cause the eating disorder have to be dealt with in order for a person with Anorexia Nervosa to heal. It is much more than their perception of how they look. Establishing a healthier lifestyle through diet, exercise and sleep will help prevent a person with Anorexia Nervosa from relapsing again after recovery.
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
Although it can sometimes be difficult to distinguish between normal eating behaviors and eating disorders, there are various warning signs that can identify the severity of an individual’s eating habits. Three commonly known eating disorders that will be discussed in this research paper are Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. An individual with Anorexia Nervosa is often not provided with sufficient nutrients and suffers from severe weight loss due to starving themselves. Anorexic individuals suffer from immediate effects such as brittle bones, severe dehydration, weakness and fatigue, and dry skin and hair. A person with Bulimia Nervosa is an individual that binges, or eats a large amount of food in one sitting, and
Anorexia nervosa is an issue in abnormal psychology. Anorexia nervosa is self-starvation and dramatic weight loss. The history of anorexia nervosa, basic demographics, and examples will be discussed. Systemic issues, like mortality, possible causes, and effective treatments will also be discussed.
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
The article, "Anorexia Nervosa," examines the background information, symptoms, and treatment of anorexia. Anorexia is defined as a disease in which a person starves themselves and exercises excessively in order to lose weight. In addition, as the person continues to lose weight, they have a distorted body image and perceives themselves as fat. In other words, the person is literally blind to the physical condition of their own body. The treatment process includes the help of a counselor, a dietitian, and a psychologist as they work to improve both the physical and mental well-being of the patient.
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,
Patients who suffer from this eating disorder are often meticulous and perfectionists and hold themselves to high standards of success (Merck Manual, 1997). They have a fascination with food, and will cook and bake elaborate meals for others, but not enjoy in its consumption. Often anorexic's will fanatically exercise, and count calories to balance out the food they have consumed, in order to remain in control. Eating disorders are affecting more young teens every day; although 95 percent of those suffering from anorexia nervosa are female, more males are being diagnoses daily. It can be mild and transient or severe and long lasting. The health consequences are