ATING D IS O R
E Anorexia Nervosa DER
What is Anorexia?
Anorexia is an eating disorder
characterized by an abnormally low
body weight, an intense fear of
gaining weight and a distorted
perception of weight.
Eating disorders are and should be
classified as serious mental illnesses
It's an extremely unhealthy and life-
threatening way to try to cope with
emotional problems. When you have
anorexia, you often equate thinness
with self-worth.
Predominant in girls Epidimiology
Anorexia nervosa occurs
predominantly in girls and
young women (90%) and
usually present in late
adolescence (median
onset 17 years of age). The Longitudinal Management
estimated prevalence of
the disorder in the general Longitudinal management of
population is 0.3% of anorexia nervosa is difficult,
females; however, a even in cases where weight
subthreshold level of restoration is achieved.
symptoms is estimated to Rates of relapse requiring
affect 0.37% to 1.3% of hospitalization within 1 year
the population. are estimated to exceed
30%.
ETIOLOGY
The potential etiologic or
exacerbating factors for eating
disorders encompass physiologic,
biochemical, developmental,
genetic, psychosocial, and
psychiatric phenomena.
The biologic basis for eating
disorders is difficult to delineate.
PATHOPHYSIOLOGY
Abnormalities in the
hypothalamic pituitary axis
Roles of
neurotransmitters
Strong genetic
influences
Social stress
THE EXACT CAUSE OF
ANOREXIA IS UNKNOWN
PSYCHOL ENVIRON
OGICAL MENTAL
GENES CULTURAL
DIAGNOSTICS
Careful medical and psychiatric
assessment at baseline is
essential. Some do not show
symptoms unless evaluated by a
healthcare provider.
Health Professionals can easily
diagnose them if they are showing
core features of anorexia.
SIGNS AND
SYMPTOMS
Obsessions and fears about eating and gaining
weight.
Complain about feeling full even when they have
eaten very little food.
Inappropriate exercise.
Denial of symptoms and low self-esteem
Lethargy or weakness and vomiting
Medical Complications
of Eating Disorders
METABOLIC AND
ELECTROLYTE
DISTURBANCES
GASTROINTESTINAL
COMPLICATIONS
HORMONAL CHANGES
RELATED TO THE
HYPOTHALAMIC-PITUITARY-
GONADAL AXIS
BRAIN ATROPHY
PHYSICAL AND
LABORATORY
ASSESSMENT OF
EATING DISORDERS
MANAGEMENT
What are the desired
outcomes?
reduce distorted body image
restore and maintain healthy body
weight
establish normal eating patterns
improve psychologic, psychosocial, and
physical problems
resolve contributory family problems
enhance compliance
prevent relapse.
NON PHARMACOLOGIC
TREATMENTS
Cognitive Interpersonal Nutritional
Behavioral Psychotherapy Counseling
Therapy
PHARMACOLOGIC TREATMENTS
Antidepressants Antipsychotics Miscellaneous agents
SSRIs atypical Metoclopramide,
(Fluoxetine) antipsychotics short-acting
BZD, Estrogen
monitoring
Do's
Antidepressants can
assist
Do's
Patients receiving
A reduction in the
SSRIs should be
frequency and severity
monitored.
of abnormal eating
habits,
A diary especially in the
outpatient setting.
monitoring
Follow-up laboratory tests and ECGs are not part of routine
monitoring unless the patient is restricting food intake, is
purging, or continues to lose weight despite treatment. A
healthy weight gain of no more than 0.2 to 0.5 kg (0.4 to 1.1 lb)
per week toward a goal of 90% to 95% of normal weight or a
BMI greater than 18.5 kg/m 2 is a critical sign of treatment
success. A patient’s use of coping skills and contingencies for
dealing with stress other than manipulating food consumption
also should be assessed.
CASE STUDY
Emma’s parents were worried about their 16 year old daughter; for
over a year she had been on a diet that didn’t seem to stop. Emma's
dieting behaviours made her more withdrawn, depressed and
anxious. one day, her parents received a phone call from school to
say that Emma had fainted and was in hospital. She was
immediately admitted to a hospital as an inpatient because her
weight was dangerously low. Emma also had a very low heart rate
(bradycardia) and a low temperature (hypothermia).
FINDINGS ASSESSMENT
Underweight A thorough assessment of
Depressed her physical condition & her
Anxious mental health, Emma had
Bradycardia repeated blood tests and an
Hypothermia electrocardiogram (ECG).
Distinct features found in a
diagnosis are present.
RESOLUTION MONITORING
NON -PHARMACOLOGICAL
Gradually increasing and Follow up check up
healthy diet/meal plan Evaluation was carried
Cognitive Behavioral out at 3rd, 6th, and 12th
Therapy month
Family Therapy Diary
PHARMACOLOGICAL
Antidepressants
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