Anorexia
What is anorexia?
Anorexia nervosa, commonly referred to simply as anorexia, is one type of eating disorder. More importantly, it is also a psychological disorder. Anorexia is a condition that goes beyond out-of-control dieting. A person with anorexia initially begins dieting to lose weight. Over time, the weight loss becomes a sign of mastery and control. The drive to become thinner is actually secondary to concerns about control and/or fears relating to one’s body. The individual continues the endless cycle of restrictive eating often to a point close to starvation in order to feel a sense of control over the body. This cycle becomes an obsession and is similar to any type of drug or substance addiction.
How is anorexia treated?
Anorexia may be treated in an outpatient setting, or hospitalization may be necessary. For an individual with severe weight loss that has impaired organ function, hospital treatment must initially focus on correction of malnutrition, and intravenous feeding may be required. A gain of between one to three pounds per week is a safe an attainable goal when malnutrition must be corrected.
The overall treatment of anorexia, however, must focus on more than weight gain. There are a variety of treatment approaches dependent upon the resources available to the individual. Because of increasing insurance restrictions, many patients find that a short hospitalization followed by a day treatment program is an effective alternative to longer inpatient programs. Most individuals, however, initially seek outpatient treatment involving psychological as well as medical intervention.
Different kinds of psychological therapy have been employed to treat people with anorexia. Individual therapy, cognitive behavior therapy, group therapy, and family therapy have all been successful in treatment of anorexia. Those with anorexia can be treated by a medical doctor, a clinical psychologist, or both, depending upon the progression of the disorder. A psychiatrist with both medical and psychological training is perhaps the best treatment provider. An appropriate treatment approach addresses underlying issues of control and self-perception. Family dynamics are explored, and often the family is included in the treatment plan. Nutritional education provides a healthy alternative to weight management for the patient. Group counseling or support groups often assist the individual in the recovery process. The ultimate goal of treatment should be for the individual to accept herself/himself and lead a physically and emotionally healthy life.
While no medications have been identified that can definitively reduce the compulsion to starve themselves, some of the selective serotonin reuptake inhibitor (SSRI) antidepressant drugs have been shown to be helpful in weight maintenance after weight has been gained, and in controlling mood and anxiety symptoms that may be associated with the condition.
What is the prognosis (outcome) of anorexia?
Anorexia is among the psychiatric conditions with the highest mortality rate, with an estimated 6% of anorexia victims dying from complications of the disease. The most common causes of death in people with anorexia are medical complications of the condition including cardiac arrest and electrolyte imbalances. Suicide is also a cause of death in people with anorexia.
Early diagnosis and treatment can improve the overall prognosis in an individual with anorexia. With appropriate treatment, about half of those affected will make a full recovery. Some people experience a fluctuating pattern of weight gain followed by a relapse, while others experience a progressively deteriorating course of the illness over many years and still others never fully recover. It is estimated that about 20% of people with anorexia remain chronically ill from the condition.
As with many other addictions, it takes a day-to-day effort to control the urge to relapse. Many individuals will require ongoing treatment for anorexia over several years, and some may require treatment over their entire lifetime.
Tags: anorexia, Eating Disorders, not eating