Anorexia nervosa is defined by the obsession to not be fat and a fear that one is fat. It characterized by huge caloric deficit by abstaining from food and excessive amounts of exercise in conjunction with it disproportionate obsession with body shape. DSM-5 states that for a patient to be purely anorexic they are required to have food restriction leading to abnormally low weight, fear of gaining weight and behaviors to prevent weight gain, disordered body image (misperceiving weight or shape, self-evaluation based on thinness, lack of recognition of the seriousness if ones weight (Boland et. al., 2022, p.470).

            It is important to note that though anorexia is characterized by a lack of eating some anorexics have binging and purging episodes. What distinguishes them from those with bulimia is that they are still far below their ideal weight whereas bulimic persons are normal to overweight (Boland et. al., 2022). 

            It can be more challenging to diagnose anorexia nervosa as those afflicted by the disease are likely to hide their symptoms. It is not uncommon for the disease to go undetected until their weight has reached a point where the need to seek medical attention due to complications of the disease. During the medical exam it becomes apparent that there is a disproportionate obsession with body shape (Boland et. al., 2022).

             Treatment for anorexia includes hospitalization, family-based therapy, cognitive-behavioral therapy, dynamic therapy, and pharmacotherapy. Hospitalization can use a combination of therapies while regulating caloric intake and self-destructive behaviors such as excessive exercise and purging. Family-based therapy is effective for adolescences as the patient is likely to be living at home. Having a strong support system in the house has proven in many mental illnesses to be a key component in recovery. Adult therapy is based on patient preference, availability, and cost. The effectiveness of therapy is related to the amount of time in which the patient has suffered with the disease. The longer the patient has gone without remission the poorer the prognosis (Boland et. al., 2022).

               There is no drug of choice to treat anorexia nervosa. However, there are many comorbid illnesses that can occur such as depression and obsessive-compulsive disorder. These conditions need to be treated. Treating an anorexic persons depression can have a positive impact on the treatment of their anorexia (Boland et. al., 2022).

                An important consideration while caring for an anorexic patient is suicide. One in 5 deaths of anorexic persons is due to suicide (Boland et. al., 2022). Anorexic patients are also more likely to attempt suicide with a higher anticipation of dying then patient than those that have bulimia (Guillaume et. al., 2011).

References

Boland, R., Verduin, M., &Ruiz, P. (2022). Kaplan & Sadocks Synopsis of Psychiatry (12th ed.) Wolters Kluwer.

Guillaume, S., Jaussent, I., Oli, E., Genty, C., Bringer, J., Courtet, P., & Schmidt, U. (2011). Characteristics of suicide attempts in anorexia and bulimia nervosa: a case-control study. PloS one, 6(8), e23578. https://doi.org/10.1371/journal.pone.0023578

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