Anorexia Nervosa is an eating disorder with
potentially life-threatening complications. Whilst this mental health condition can be
distressing for both patients and their families. Anorexia Nervosa requires the commitment of
patients, families, and healthcare professionals to tackle the problem.
A societal misconception that individuals self-inflict Anorexia to stay skinny exists,
plus the presumption that affected individuals need to eat more is a fallacy.
Improving our understanding helps us identify the warning signs in ourselves, or our loved
ones, ensuring rapid access to treatment. Want to learn more about this eating disorder?
Keep watching as we will break down here. So, Let's talk about mental health.
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Introduction I’m Dr Hart-Pinto and in this series, we
aim to break down the social barriers of mental health.
At JHP Medical we make weekly information videos designed to increase awareness and
help you better understand your medical condition. So, if you find this video helpful, subscribe,
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Ok so what is Anorexia Nervosa?
Anorexia Nervosa, known commonly as just anorexia, is an eating disorder associated with an intentional
weight reduction of 15% below expected or a body mass index of <17.5.
The condition can be exceedingly dangerous, with individuals starving themselves, even
excessively exercising to lose weight. Amongst mental health conditions, eating disorders
have some of the highest mortality rates.
Who gets Anorexia? Anorexia Nervosa affects around 9 in every
1000 women and 3 in 1000 men. Women, therefore, are disproportionately affected by the condition.
Most commonly, Anorexia affects those individuals during their adolescent and early adult years.
Anorexia is associated with an abnormality of the serotonin neurotransmitter system within
the brain. A genetic link for the condition exists, with a measurable increase in risk
amongst individuals with an affected family member.
The increasing use of social media, plus the societal view that thinness is attractive,
is theorised to play a crucial role in perpetuating body dissatisfaction and the rising number
of individuals affected by eating disorders. The condition is observed more frequently
amongst professional ballet dancers and models. Patients with anorexia nervosa may also have
other co-existing mental health disorders such as depression or personality disorder.
What do people with anorexia patients experience?
People with anorexia experience a distortion of their body image. They may believe that
they are overweight whilst at the same time friends and relatives are raising concerns
about their weight loss. Individuals will express a strong desire to be thin. To achieve
this pathological desire, patients will restrict oral intake, miss meals, even eliminating
fattening foods. Vomiting or purging after meals becomes routine, further expending calories
through or excessively exercise. An observable withdrawal from social interactions can present
plus signs of depression and increased irritability. The dietary restrictions and weight loss have
a knock-on effect on the individuals' hormones, resulting in; reduced energy, inability to
concentrate, poor memory and decision-making skills. Delays in sexual development are common
and include delayed puberty, poor breast development, reduced fertility, reduced libido and many
young women experiencing absent or irregular periods.
Anorexic people may develop brittle hair and nails, dry skin, and form fine body hair termed
lanugo hair. Circulatory changes cause cold hands and feet, even dizziness and fainting.
If they are purging, vomiting their stomach contents, the stomach acid can cause erosion
of their tooth enamel. Bowels slow down, resulting in constipation.
Slowed bowel activity, resulting from a reduction in oral intake, can cause constipation and
swelling of the bowels. Giving the appearance of a swollen abdomen.
How does your doctor diagnose Anorexia?
Your doctor will assess for evidence of psychiatric symptoms such as a distorted body image, reduced
self-esteem and self-induced weight loss. Detail of any weight change, plus diet and
exercise regime recorded. The exclusion of any potentially life-threatening medical complications
is of further importance. Measurements of height and weight form an
essential part of the examination. Permitting, therefore, the calculation of your body mass
index and quantifying your weight loss. Investigations inclusive of a blood test will
assess for anaemia, hormonal imbalances, or dysregulation of natural blood salts. ECG,
a tracing of your heart, provides an assessment of any irregular heartbeats.
Treatment The symptoms of Anorexia are not going to
improve on their own, but with the correct treatment, you can regain control. Recovery
can take time and will be different for everyone. Most importantly, commitment on the part of
the affected individual is required.
The goals of treatment are: To encourage you to eat healthily, gain and
maintain a healthy body weight Improve your mental health
Reduce your risk of death associated with anorexia nervosa which can be as high as 10-15%
Most patients can be managed at home using combination therapy:
Medications SSRIs, for example, fluoxetine, are commonly
prescribed. These medications help suppress pathological thoughts towards food and body
image. Psychotherapy
In adolescents, this usually takes the form of family therapy. Younger adults will require
ongoing family support. Parents have increased responsibility for what you eat. Over time,
as your symptoms improve, you will become more independent.
Cognitive behavioural therapy can be helpful to address your thoughts and feelings to promoting
better understand and ability to regain control. It's imperative to document your journey,
keeping a food diary and a record of your progress.
Improving your understanding of your Anorexia, challenging your beliefs, and the way you
think about your condition is crucial.
Where your doctor identifies any life-threatening changes caused by starvation and weight loss,
such as an irregular heart, altered blood salt levels, or a deterioration in mental
health, they will recommend a hospital admission. In some cases, hospital admission becomes
compulsory. Here patients are placed on a treatment regime of monitored feeds. Amongst
the worst affected patients, the risk of refeeding syndrome exists. The re-introduction of food
can trigger potentially fatal shifts in fluids and salts. Therefore, close monitoring is
required, using a slow re-introduction of feeds.
Prognosis Anorexia nervosa left untreated carries a
death rate between 10—15%.
Should patients receive suitable management, one third will make a full recovery, one third
will improve, and one third will experience ongoing challenges with their condition.
Conclusion
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Outro
Of course, this video does not provide individual medical advice and is intended for informational
purposes only. Do not consider this as a substitute for professional
medical advice, diagnosis or treatment. Please do not ignore professional medical
advice in seeking treatment because of something you have heard here.
If you believe you may have a medical emergency, immediately call your doctor or ambulance
service.