Eating disorders- Anorexia nervosa :


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


  1. Restricting subtype-  one has not not regularly taken part in bingeing or purging behaviors during the current episode. 
  2. Bingeing and purging behaviors-  use of laxatives, diuretics, enemas, and self-induced vomiting, regular binge eating



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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