¶ … Anorexia Criteria for Diagnosis

Physical and Mental Signs and Repercussions

Different Treatments of Anorexia

Personal Reflection

Anorexia Nervosa, a type of eating disorder, continues to plague some of the world's population, particularly white adolescent females obsessed with looking thinner. This paper endeavors to explore what exactly anorexia is, in relation to the category of 'eating disorder' as well as other eating disorders such as bulimia. The criteria for diagnosis will be identified as well as the population in our society most susceptible to falling victim to this mental illness. Physical and mental signs and repercussions will also be highlighted along with 3 case studies advocating different treatments to combat this sickness. Traditional treatment normally consists of hospitalization, followed by psychotherapy. However, family or support therapy is gradually gaining credibility and popularity over traditional treatment routes.

BODY

Despite the fact that there is greater understanding amongst the medical profession and general society about the causes and effects of anorexia on its sufferers, there are still many people, both men and women, who suffer from what is largely considered a psychological disease. This paper endeavors to explore what anorexia is and how it differentiates from other eating disorders. The criteria for diagnosis will be highlighted and the demographics of the primary sufferers of this illness will be identified. The physical and behavioral signs of anorexia will be examined, as well as the physical and psychological repercussions of this sickness. Three different case studies will also be proffered by way of analyzing the effectiveness of current treatments, followed by a personal note on the significance of studying this illness.

Prior to undertaking a comprehensive analysis of anorexia, it is important to define the parameters of this study. Anorexia is driven by the victim's fixation with being thinner. The sufferer's body is normally starved and emaciated due to harsh dieting or purging.

Anorexia is a form of eating disorder, which is defined as "an abnormal relationship with food. A person who uses food to cope with life's stresses has an eating disorder." Eating disorders are brought on by factors such as personality or emotional imbalances, pressures from the family or friends, physical or sexual abuse, and biological or cultural susceptibility (the family may cook lots of rich food all the time but also be preoccupied with being thin). Eating disorders encompass anorexia nervosa, bulimia nervosa, and binge eating disorders.

Bulimia and compulsive exercise are affiliated with anorexia because they all fall under the banner of 'eating disorder.' "Bulimia involves forcing oneself to throw up after eating and/or the abusive use of diuretics, laxatives, rules, restrictions, or exercise." It frequently involves binge eating. Compulsive exercising is just another outlet of behavior; "Compulsive Exercise is another way to "purge" and disordered eaters who suffer with these symptoms are typically considered to be suffering from Anorexia, or Bulimia non-purging type (no use of laxatives, diuretics or self-induced vomiting)." However, these illnesses are not mutually exclusive - a victim can suffer all three simultaneously.

If one is diagnosed with anorexia, the sufferer usually harbors "an intense fear of obesity despite slenderness, an overwhelming body-image perception of being fat, weight loss of at least 25% from baseline or failure to gain weight appropriately (resulting in weight 25% less than would be expected from the patient's previous growth curve), absence of other physical illnesses to explain the weight loss or altered body-image perception, and at least 3 weeks of secondary amenorrhea or primary amenorrhea in a prepubescent adolescent."

In the U.S., 1 out of 100 adolescent females suffers from anorexia. It is also found more in middle-to-upper socioeconomic classes, as well as in white populations (more than any other race).

Physical signs exhibited by anorexics involve weight loss, slow metabolism, possible organ failure (even without warning), osteoporosis (brittle bones), agonizing pain, sluggish digestive system, poorly functioning large and small intestines, extreme constipation and indigestion, general tiredness, or anemia. Psychological signs and repercussions involve a distorted mind where the sufferer is continuously overcome by fear over everyday matters. Behavior may also appear irrational even though the sufferer will be unaware of their strange conduct. Sufferers can feel restless and anxious, and may even suffer from insomnia, in which case doctors often prescribe anti-depressants to help them sleep. Long-term effects could take the form of addiction to medication even after achieving their normal weight. Also, anorexia owns the highest mortality rate compared to all other mental sickness. "Relapses are common...

Psychotherapy deals with identifying healthy thinking processes and behavior patterns, in regards to food, and psychological issues like self-esteem. Support group therapy tackles the effect anorexia has on the family as well as the sufferer and comes up with strategies to combat the negative effects. Families are usually heavily involved in this treatment. Medication comes in the form of anti-depressants or drugs that temporarily remove the sufferer's feeling of anxiety. Hospitalization is normally a last resort, when the sufferer could be facing impending death. The victim is forced to be an inpatient at a hospital where their weight is monitored and bolstered to normal proportions. However, this does not address the mental or emotional issues that sustain this mental illness.
There are plenty of case studies promoting the success of various treatments. One case study, which investigated the effectiveness of psychotherapy, involved a 23-year-old woman, Nancy Duval, who has suffered from anorexia since she was 14. Duval was diagnosed with anorexia. She harbored an overwhelming fear of becoming fat even though she was near skeletal. She lost 30% of her body weight by continuous dieting and exercising, purging, abuse of laxatives. For the past three years, she did not have her period. She underwent psychotherapy twice a week, without the support of her family. Six months later, she is described as improving. She was back in college and sticking to a healthy eating regimen with the help of her nutritionist. She was of normal weight, menstruating and was seeing a counselor about her personal issues. Even though she would still engage in occasional bouts of binge eating and purging, these lapses were less frequent.

Another case involved hospitalization of an anorexic as the main form of treatment:

Over the last 10 years, Alison [a 32-year-old], has been hospitalized many times for her eating disorder... Measurements taken last week indicated that Alison's body fat was at 12%. This week it is at 11%. Her community care worker tells the attending physician that Alison has shown signs of suicidal ideation. Alison desperately wants to avoid another hospitalization. The clinic's nurse thinks that Alison's cognitive state seems to be deteriorating, but the team psychiatrist doubts that her state has deteriorated sufficiently to warrant committing Alison under the Mental Health Act. The team decides to "make clear to Alison" that their worries about her might lead to forced hospitalization "if she doesn't soon show signs that outpatient treatment is working."

Despite numerous hospitalizations over the years and threats for more in the future, Alison is unable to get out of the cycle of starvation, bingeing and purging. Hospitalization only addresses the immediate physical danger - not the emotional and mental causes, which keep anorexics trapped in the illness.

Family therapy has also met with relative success, more so than hospitalization on its own. The case involved a family bandying together to support a member's fight to break free from the hold of anorexia:

Although the treatment in this case was relatively uncomplicated and brief, the family had to overcome their initial exasperation with the client's self-starvation in order to be helpful in the process of the adolescent's weight restoration. When this initial stumbling block was resolved, in part by the therapist's modeling of an uncritical stance toward the client's dilemma, the family was successful in nurturing their daughter back to health. Once the client's weight was restored, and the adolescent reintegrated with her peer group, she could negotiate her continued individuation from her parents, but without the eating disorder to cloud their relationship."

While the popular form of treatment is hospitalization followed by psychotherapy, family therapy is gaining popularity since its success rate seems higher than traditional treatment processes.

The subject of anorexia is very significant, particularly since I have been exposed to it on a personal level. One of my work colleagues suffers from this debilitating mental illness and some of us are thinking of performing an intervention, especially since family or support therapy is enjoying a greater amount of success in the treatment of this illness. Apart from the obvious physical and behavioral effects anorexia manifests in my work colleague, the many instances of her lying about her condition, such as not having lunch with us because 'she's just eaten' (although no-one can actually verify that), or everyone knowing what she is doing when she heads to the ladies' washroom after lunch. It pains me to see her literally kill herself through this illness.

Society has to accept much of the blame for the population of…