Anorexia Nervosa

Nafisa T., Puja B., Lucy C., Mariama B.

What is Anorexia Nervosa?

Anorexia Nervosa is a mental health disorder often characterized by the "distortion" of body image - in which, a person of normal weight may often view themselves as obese and/or overweight. This may lead to the desire to lose weight through extreme methods such as,

● Self induced vomiting

● Dieting and exercising excessivelyThere are two types of Anorexia :

○ The first type is when a person often limits their eating, to at most one meal a day. Some may often eat nothing, however only drink water.

○ The second type is characterized as a more extreme form of Anorexia, when a person eats, however throws up the food they've eaten.

What can cause Anorexia Nervosa?

It is not certain what causes Anorexia, however there are similar ideas as to what triggers such ideas.

● Environment seems to largely impact the minds of many adolescents .

● The media promotes the idea of being thin - leading for many adolescents to strive for a thin image.

● Biologically, it is unclear whether genetics plays a role in anorexia however Serotonin may play a role in Anorexia.

What are the symptoms of Anorexia?

Some symptoms of anorexia include :● Deliberate self-starvation with weight loss● Intense, persistent fear of gaining weight● Refusal to eat or highly restrictive eating● Continuous dieting● Excessive facial/body hair because of little protein in the diet● Compulsive exercise● Abnormal weight loss● Sensitivity to cold● Absent or irregular menstruation● Hair loss

● The graphs show that an estimate of 2.7% of 13-18 year olds suffer from an eating disorder and that girls are more than two times as likely as boys to have an eating disorder.

● About 50% of teenage girls and 30% of teenage boys use unhealthy weight control behaviors like skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives to control their weight.

● Data collected from a national health survey estimates the prevalence of eating disorders in 8-15 year olds to be about 0.2%, and girls are still more than two times as likely to have an eating disorder.

Incidence rates anorexia nervosa (AN), bulimia nervosa (BN), and other eating disorders (EDNOS) by year for females aged 10-49 years.

● These results measure the incidence rates of eating disorders for females between the ages of 10 and 49, over the course of 9 years.

● The incidence rate of anorexia nervosa remained constant at about 14 people out of 100,000.

● Overall, incidence rates of eating disorders increased between 2000-2009.

● The study based its results off of clinical diagnoses recorded in the GPRD and therefore provides more backing that the results are accurate

Micali, N., Hagberg, K., Petersen, I., & Treasure, J. (n.d.). The incidence of eating disorders in the UK in 2000... [BMJ Open. 2013] - PubMed - NCBI. National Center for Biotechnology Information. Retrieved July 28, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/23793681

Incidence rates anorexia nervosa (AN), bulimia nervosa (BN), and other eating disorders (EDNOS) by year for males aged 10-49 years.

● These results show that the incidence rate of anorexia in men also stayed constant, but in this case, it was only at about 1 person every 100,000.

● Girls are obsessed with the way they look because in general, the ideal is a thin female.

● Men have a multitude of “acceptable” body types, ranging from thin models, to muscular giants. In general, there’s more pressure on girls, from friends, family, T.V., and themselves.

● The eating disorders in women may be significantly higher than for men.

Micali, N., Hagberg, K., Petersen, I., & Treasure, J. (n.d.). The incidence of eating disorders in the UK in 2000... [BMJ Open. 2013] - PubMed - NCBI. National Center for Biotechnology Information. Retrieved July 28, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/23793681

Micali, N., Hagberg, K., Petersen, I., & Treasure, J. (n.d.). The incidence of eating disorders in the UK in 2000... [BMJ Open. 2013] - PubMed - NCBI. National Center for Biotechnology Information. Retrieved July 28, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/23793681

Incidences of anorexia per 100,000 population for 2009.

● Based on these results, the greatest number of incidences of anorexia in females is between 15-29 years.

● In contrast to females, eating disorder diagnoses in boys was greatest between the ages of 10– 14 years.

● In 2009, the female to male ratio for anorexia nervosa was 11.8:1.● Although there are possibilities of undetected cases of anorexia in this data, it’s not as

significant because of the clinical measures taken to ensure accuracy.

HEALTH IMPACTS

Psychological Impacts Include:● Depression● Suicidal Thoughts ● Low Self Esteem● Self evaluation based solely on weight and

appearance ● Mood Swings● Obsessive thoughts and preoccupation with

weight and appearance

HEALTH IMPACTS

Neurological Impacts Include: ● Altering of serotonin levels● Seizures● Disordered Thinking ● Numbness/Odd Nerve Feelings

HEALTH IMPACTS

Physical Impacts Include:● Lower levels of reproductive hormones,

estrogen, testosterone, growth hormones● Heart disease● Low blood pressure● Less blood flow● Higher risk of miscarriage or C-Section● anemia● Bone calcium loss● Multiorgan failure

HEALTH IMPACTS

Physical Impacts Include:● Lower success with fertility treatments● Infants born with birth defects or low birth

weight

HEALTH IMPACTS

Social Health Impacts Include:● Isolation and Secrecy● Social Anxiety● Loss of friends and lack of most social

contact● Poor communication between family

● Annual incidence rates for diagnosed anorexia nervosa remained stable for females aged 10-39 years. The rate in 1988 was 18.5 per 100,000 and in year 2000 the rate was 20.1 per 100 000 with minimal variation.

● In 2000, the incidence rate for females was 8.6 per 100 000, as compared to 0.7 per 100,000 for males, translating to a relative risk for females to males of 12:1. The highest incidence, was found in females between the ages of 10 and 19.

Annual incidence of anorexia and bulimia nervosa in women aged 10-39 years from 1988 to 2000

CURRIN, L., SCHMIDT, U., TREASURE, J., & JICK, H. (n.d.). Time trends in eating disorder incidence . The British Journal of Psychiatry . Retrieved July 28, 2013, from http://bjp.rcpsych.org/content/186/2/132.full

Treatments

● Medical Care- Frequent monitoring of vital signs, hydration levels, electrolytes, and related physical conditions● Healthy weight- Can't recover without a healthy weight- Psychologist will help with behavioral habits to get back to a healthy weight- Dietitian: will help develop meal plans and calorie requirements

● Men with anorexia are a lot less likely to present for treatment than women, supporting the huge discrepancy between male and female numbers of hospitalizations.

● Only about one third of individuals struggling with anorexia nervosa in the United States obtain treatment.

● 20% of people suffering from anorexia prematurely die from complications related to their eating disorder, including suicide and heart problems.

● Once past the 15-29 year age range, there’s a huge decrease, most likely due to unnatural deaths due to the anorexia

Psychotherapy1. Individual Therapy- Help deal with behavior and thoughts- Healthier self esteem- Cognitive Behavioral Therapy (CBT)

a. Type of talk therapy, focuses on identifying and altering destructive thought patterns

b. Is time-limited; have specific goals in mind2. Family - Based Therapy- Assumption that patient can no longer make sound decisions about their bodies- Involved with making sure eating plans followed- Important for patients that still live at home

Psychotherapy (cont.)

3. Group Therapy- Connect with others who have eating disorders- Can be helpful- Potential danger: members may try to compete to see who can be the thinnest

Medication

● No medications for anorexia

● Antidepressants and other psychiatric medication can be helpful to treat other mental health disorder (such as depression or anxiety)

● In severe cases, patients will need to be hospitalized

● Medical or physical ward

● Specialized clinics● After hospitalization

is complete - ongoing therapy and nutrition necessary

Hospitalization

Treatment Challenges

● Some cases are more severe than others- Less severe cases require less recovery time● Problems with mindset of patient- People may not want treatment- May think they do not need it- Don't see it as an illness, but rather a lifestyle choice

References● Anorexia nervosa: Treatments and drugs - MayoClinic.com. (n.d). Mayo Clinic. Retrieved July 29, 2013, from http://www.

mayoclinic.com/health/anorexia/DS00606/DSECTION=treatments-and-drugs● Grohol, J. M. (n.d.). Treatment for Anorexia | Psych Central. Psych Central - Trusted mental health, depression, bipolar,

ADHD and psychology information .. Retrieved July 29, 2013, from http://psychcentral.com/lib/treatment-for-anorexia/000101

● Micali, N., Hagberg, K., Petersen, I., & Treasure, J. (n.d.). The incidence of eating disorders in the UK in 2000... [BMJ Open. 2013] - PubMed - NCBI. National Center for Biotechnology Information. Retrieved July 28, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/23793681

● Merikangas KR, He J, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J. Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):980-989.

● Anorexia Nervosa « « National Association of Anorexia Nervosa and Associated Disorders . (n.d.). National Association of Anorexia Nervosa and Associated Disorders . Retrieved July 29, 2013, from http://www.anad.org/get-information/get-informationanorexia-nervosa/

● CURRIN, L., SCHMIDT, U., TREASURE, J., & JICK, H. (n.d.). Time trends in eating disorder incidence . The British Journal of Psychiatry . Retrieved July 28, 2013, from http://bjp.rcpsych.org/content/186/2/132.full

● Culley, G. (2013, July 26). Anorexia stories: My battle started when I was 10 - I even cut feeding tube that kept me alive - Mirror Online. Mirror Online: Number one for news, opinion, sport & celebrity gossip. Retrieved July 26, 2013, from http://www.mirror.co.uk/news/real-life-stories/anorexia-stories-battle-started-10-2089989

● Evidence-Based Mental Health Treatment for Children and Adolescents. (n.d.). Internet Archive: Wayback Machine. Retrieved July 29, 2013, from http://web.archive.org/web/20100421114028/http://www.abct.org/sccap/?m=sPublic&fa=pub_AnorexiaNervosa

● Anorexia nervosa - National Library of Medicine - PubMed Health. (n.d.). National Center for Biotechnology Information. Retrieved July 29, 2013, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001401

References ● Anorexia nervosa | University of Maryland Medical Center. (n.d.). Home | University of Maryland Medical Center. Retrieved

July 29, 2013, from http://umm.edu/health/medical/altmed/condition/anorexia-nervosa"Anorexia Nervosa ● Anorexia Nervosa Complications of Anorexia - Anorexia Nervosa Health Information - NY Times Health. (2013, March 8).

Health News - The New York Times. Retrieved July 26, 2013, from http://health.nytimes.com/health/guides/disease/anorexia-nervosa/complications-of-anorexia.html

● EDV - Psychological Effects - Anorexia . (2013, February 6). EDV - Eating Disorders Vic. Retrieved July 26, 2013, from http://www.eatingdisorders.org.au/eating-disorders/anorexia-nervosa/psychological-effects