Introduction-
Anorexia nervosa is an eating disorder. It is defined by restriction of energy intake causing a significantly low body weight. Patients will have an intense fear of gaining weight.
Pathophysiology of anorexia-
- Biological and environmental factors play a role.
- Genetic corelations
- Altered brain function, reduced neuro transmitters, diminished neural activity.
- Associated psychiatric disorders.
Clinical Presentation-
- Amenorrhea
- cold intolerance
- constipation
- edema
- fatigue and irritability
- calorie counting
- self- induced vomiting
Diagnosis criteria of anorexia-
- a restriction of caloric intake
- low body weight
- unjustified fear of weight gain
- body dysmorphia
Types-
- Restricting subtype- one has not not regularly taken part in bingeing or purging behaviors during the current episode.
- Bingeing and purging behaviors- use of laxatives, diuretics, enemas, and self-induced vomiting, regular binge eating
Treatments-
Pharmacotherapy
Nutritional therapy guidelines-
- caloric intake should reach 1000-1600 kcal on a daily basis
- bathroom use should be restricted for two hours following each meal.
Body Mass Index (BMI) related guidance-
- Below 14: Exercise is not recommended
- Between BMI 14 and 15: exercises in lying and sitting
- BMI 15 to 17: moderate weight bearing activities.
- BMI 17 and above, towards a healthy weight: continue exercises
- At a healthy weight: Patients need to find a healthy balance between activity and diet
Strategies to reduce excessive exercise-
- Observing the patient during their exercising program
- Progression of exercise should be extremely slow
- Weight, BMI, dietary habits should be taken into account
- Encourage the patient to verbalise their thoughts and fears. Distraction strategies should be incorporated
- Maintainence and regular monitoring of healthy weight
- Promoting healthy eating habuts
- Encouraging CBT- cognitive behavioural therapy
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