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Treating Adolescents With Anorexia Nervosa
Anorexia nervosa is an eating confusion described by a terror of fatness experienced during the adolescence period that leads to them to starving themselves leading to harmful low body weight, a moody fear of being fat and compulsive hunt for thinness. Though not limited to a certain age or sex, it mostly affects the female. The eating disorder affects both the physical appearance; thin appearance and psychological health. Though the origin of anorexia nervosa is blurred, severe fasting and weight loss are regularly linked with efforts to manage the increasing psychological and social burden of adolescence, the disorder leads to a reported death rate of 6-10% of the adolescent who do not seek medication in time Berkman et al., 2006.
The worry among most clinicians is whether to focus on anxieties the adolescence have during this period of growth or addressing the rigorous dieting and weight loss. The management of severe Anorexia nervosa involves a multidimensional move that include; nutritional, psychopharmacology and psychological therapy, and regularly involves hospitalizing the malnourished individuals.
The duration that is preferred in the treatment of this disorder is the short-term; as the patients are taken through a weight restoration period, while they are undertaken through attitude changing sessions that will enable them to practice healthy eating habits that will enable them maintain proper size without starving themselves. A study by Lock et al. 2006 compared the outpatients in the short-term courses of six months and that of long-term course of ten months. The patients were in the ages of 12-18 years, and their mothers were involved as they were found to be close to the female children. The treatment were carried out in the family therapy; which scrutinizes conducts where the family might be an issue in the growth or continuation of the adolescent's poor health and examines how the family will assist in resolving the Anorexia nervosa disorder. The therapist aim at addressing family developments, for example, improper groupings in the family, communication troubles, argument or evading of disagreement, and the ignoring the views of the adolescents.
The study showed that initially there were no difference between short-term and long-term treatment within the 12 months where the 71 participants were used; which included 10% male adolescents were taken through the course. The average age was 15.2 years; the study examined the efficacy at the end of 1 year with the use of body mass index and in female the observation on the occurrence of the menstrual flow. The process of treatment involves the check if the affected adolescent is in the conditions of being an inpatient or an outpatient. In some cases of inpatient, it may go to an extent of using feeding support through tube feeding, if the patient had reached the undernourished stage. The clinician has to understand the conditions well for the treatment to work. The study by Schmidt & Treasure, 2006, suggests that inpatients responded well to treatment as opposed to the outpatients who sometimes shy away from treatment or stopped taking the course as its feared that they may add weight to the extent that they shape, and size will be affected Cachelin & Rebeck, 2000()
A proper family therapy encourages the family members to supervise the meals and snacks the family eats. The process also encourages the family members to involve the patient's best friends to help them in recovering. This is referred to social and emotional support that the adolescent requires to regain from the Anorexia nervosa disorder. The patient must be made to understand that no food eating is not tolerated and is not an option. The clinicians ensure that they first restore the physical condition, then the psychological restoration and the normal eating process will just follow thereafter. The family therapy requires that all the family members be present at the therapy course Lock, Couturier, & A., 2006()
The treatment of the Anorexia nervosa involves acute stabilization and weight restoration. Acute stabilization entails the monitoring of cardiac condition, check for vital signs and re-feeding of low weight patients, at this stage the medical treatment involves restoration of proper heart conditions. While weight restoration, which is conducted, on the emaciated patients, by the aid of behavior changing technique and nurse support. This is crucial to ensure that the patient's weight is restored. Anorexia nervosa treatment was conducted with the main objective on weight restoration on 167 adolescent youths for a period of 2 years, and it found out that 37% of the patient fully recovered and 27% showed signs of weight recovery, but the study found out that weight recovery is suitable for the outpatients, as opposed to inpatients Shepphird, 2010.
The treatment was carried in Ontario Canada, and adolescents delivered from Native American middle class regions of Caucasian and African-American as the disorder is found to affect them most; although it also affects other races Berkman, et al., 2006()
The outpatient process of treatment requires the individual psychodynamic therapy which assumes that the origin of the Anorexia nervosa is related to developmental worry about the bodily changes linked with teenage years, the social burden of adolescence, and the developmental duty of being separated from their parents. Treatment entails investigating and attempting to determine the adolescents' anxieties associated with the developmental worries and encouraging them to eat wisely to add weight. Parents may play a part in the treatment, but they normally play the supportive role of allowing the adolescents to be independent and desist from demanding behaviors change on weight and food issues.
The treatment success is defined by the change of behavior among the adolescent concerning the association of severe dieting and having a healthy body size that is usually related to admirable body weight and shape. The success is also seen when the support of the family members improves by the end of the treatment process as the parents should play a pivotal role in encouraging the adolescents to practice good eating habits without affecting their health. Success is also defined by the youths being open to talk on the way the feel and how they can be helped with the clinicians and the parents, so that they avoid over excising to lose weight or engaging in severe dieting in-order to maintain their shape Swain, 2006()
The goals of the treatment were both long-term and short-term objectives. The long-term objectives is the focus on the symptom management which leads to a lasting improvement of the patients under treatment and long-term objectives involves the feeding and weight gain course to the patients to slowly restore the patients' psychological condition. Another goal was to train the family members on techniques to notice early behavior changes in adolescents that will lead them to slowly acquire the disorder. The treatment objective was to incorporate all family members to be responsible in taking care of the adolescent youths by watching their eating habits that may result into acquiring this disorder.
The limitations that were incurred included the reluctance of the adolescent to seek treatment as they fear the backlash from the peers. The limitation of family therapy is that family members are not always intact making the main objective of the family therapy not to be met. The therapy requires that all family members be trained to work together as a unit to help the anorexia nervosa patients recover. Another limitation is the lack of commanding treatment as most patients wait until the disorder is overblown and the patient is malnourished. Lastly, another limitation is the patients tend to eat small bits of food hindering the normal prescribed quantities of food. For example; for the patient to gain 1-2 pounds, one is required to take 3000-4000 calories per week, this makes the period of recover to prolong. Another limitation that the clinicians face is effects of the youths who want to enter in the modeling industry who after some point of treatment process stop to take the sessions as they fear they may spoil the shape and size or after fully recovering, they relapse as they start to starve themselves again Cachelin & Rebeck, 2000()
The gaps that need more research on the treatment of Anorexia nervosa are; the government should carry out follow up studies to check on the progress of Anorexia nervosa patients, this will ensure that the adolescent youths do not relapse to the disorder that they previously experienced. Another gap that needs study is the innovation of a well-balanced snack, with vitamins, proteins and carbohydrates; the snack may contain essential minerals. This will be beneficial to the adolescent who are on diet.
I have learnt that the adolescents most be always be attended to and guided to ensure that they don't engage in destructive practices without the family members noticing. Some practices like severe dieting and over exercising can be easily be noticed if the family members are closer to them hence notices any behavior change. The disorder may not be taken serious by the teenager, but…[continue]
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