Treatment Objectives
Anorexia Treatment
Anorexia Treatment
Anorexia treatment can be rather tricky due to the fact that anorexia has strong psychological link ups., both with the shame and secrecy of the disease., coupled with an emphasis on control. With anorexia nervosa, to be successful in treatment the anorexic patient will have to understand and agree that their condition could kill them and that they need professional help to recover completely.
Anorexia Nervosa Treatment and Recovery
The first step in anorexia recovery – admit that ones relentless pursuit of thinness is damaging – physically and emotionally.
The second step is to fess up. Talk to a professional. Explain to them what your obsessive mind is telling you, and what it believes is true. Then, open your eyes and ears to a wealth of information that will be introduced to you. A professional can provide the feedback your mind needs to hear. Eating disorder professionals can educate you on how to recover from the malnourishment you have put your body through. They will help you develop healthier attitudes about food and your body.
Anorexia and its tendencies are much like an addiction., therefore it is strongly advised that there are rules set in place with respect to triggers. Triggers are people, places and activities that “trigger” or “stimulate” the addict or anorexic to start obsessing about weight, weight loss, exercise and sets the wheels of destruction in motion. This includes hanging out with friends that similarly have obsessive thoughts regarding diet and exercise.
Anorexia treatment may include medical doctors, psychologists, counselors, and dieticians.
Medications for the Treatment of Anorexia
SSRIs and SNRIs
Fluoxetine (Prozac) may help patients with anorexia overcome depression after they have successfully gotten their weight and eating under control. In a class of drugs called selective serotonin uptake inhibitors (SSRIs), Fluoxetine works to increase serotonin levels – a neurotransmitter connected to mood levels.
Typical side effects of SSRI medication
- Loss of interest in sex
- Drowsiness
- Weight gain
- Agitation
- Excitability
Antipsychotics
Olanzapine (Zyprexa), is an antipsychotic drug ordinarily prescribed to treat schizophrenia, though it has been discovered helpful for those with anorexia and obsessive thinking.
Typical side effects of Antipsychotic medication
- Weakness
- Drowsiness
- Dizziness
Electrolyte Supplements
Psychological Treatment for Anorexia Nervosa
Psychotherapy treatment helps to identify the what, where, who, and why in the formation of the patient’s eating disorder. Utilising a variety of techniques to manage and treat an eating disorder., emphasis during psychotherapy is on motivation, thoughts, emotions, behaviours and relationships. Psychotherapy is oftentimes coupled with medication to relief the depressive /anxious state of mind prevalent in patients. Family intervention is oftentimes the abrupt eye opener necessary in treating this very private disease. Referred to as family-based treatment (FBT)., it has been shown to be the most effective treatment and is most suited for children and adolescents. Th highest success rates for adults has been with cognitive behavioural therapy (CBT). CBT helps patients change their behaviours that are maintaining the eating disorder. It also resolves the toxic thought patterns that contribute to the maintenance of the disorder.
Medical Cannabis and the treatment of Anorexia
Cannabinoid therapy – Anorexia treatment explained.
Studies have produced intriguing insights into the role played by the brain and how it interacts with the EDS (Endocannabinoid System). It has been discovered that the normal function of the endocannabinoid system becomes impaired in those patients suffering with either anorexia or bulimia.
A group of scientists from the Katholieke Universiteit Leuven in Belgium
Positron Emission Tomography (PET) – Brain Scan
30 Patients with Anorexia or Bulimia
Using positron emission tomography (PET) scientists went in to investigate the status of the endocannabinoid system in the brains of thirty women. These 30 women all had either anorexia or bulimia. Scientist then compared their results with aged- matched control women.
The scientists discovered that the brain’s cannabis-like neurotransmitter system was significantly underactive in the women scanned who had anorexia or bulimia. Essentially, because these women could not fully experience the pleasure of food they then developed inappropriate rituals and responses to it.
Significantly underactive in the Insula region of the brain.
The part of the brain responsible and linked up to other eating disorders is the insula. When there is an obsession with food- the insula is the part of the brain where this is occurring. It is the brain’s EDS that controls the pleasure we get from sensory experiences. When there is pleasure, this then motivates us to repeat based on the pleasure response. The insula is responsible for the integration of the taste of food with our response emotionally to eating. The insula processes information taking account of any and all sensations that determine how we feel. This factors in pain, temperature, stomach pH, intestinal tension. Integration of these internal feelings provides a compiled sense of the state of the entire body. The insula is the location within the brain where our sensory experience (from eating), our emotions (in response to eating) and thoughts (about why you should not be eating!) get together to discuss.
Statistics for Anorexia Nervosa in Australia
Eating disorders are serious and affect more people than one might imagine.
- Approximately 9% of the Australian population is affected by an eating disorder.
- Full recovery for Anorexia patients is slim with only 46% of patients recovering permanently.
- 20% of anorexia patients remain chronically ill for the long term.
- Eating disorders are the 12th leading cause of mental health hospitalisation costs within Australia.
- In Australia Bulimia Nervosa and Anorexia Nervosa are the 8th and 10th leading causes, of burden of disease and injury in the female population ages 15 to 24.
What is Anorexia?
Anorexia is an obsessive emotional disorder, where the patient refuses to eat out of a dysfunctional desire to lose weight.It is surmised that it may be a way where some individuals control areas of their lives. After all, no one can truly force a person to eat. Control and body image are key factors in this diagnoses. The patient feels increased self worth by abstaining from eating and becoming fat. To them, becoming fat or even showing any instance of “healthy fat” is a lack and loss of control which is unsightly and damages their “perceived” self worth.
- Restrictive Dieting
- Excessive Exercising
- Obsessive thoughts resulting out of a fear of gaining weight
- Disturbed body image
- Obsessive activities that revolve around abstaining from food intake and weight loss
Causes of Anorexia
- Genetic Predisposition
- Environmental Influence
- Social Influence
- Cultural Influence
These are people that come from a controlled parenting environment. Parents are typically authoritarian, and there may be a lack of early mother -child emotional development. (Connection) Those suffering from Anorexia are typically children in sporting and athletic families where the message of maintaining a thin and desirable physique is of greater worth than that of larger body frames. This will be of even greater influence in dance and gymnastics, where again the physique is one of a thinner frame. In families where the parent has gained success in these fields, children are given the impression rather early that a careful dieting / training regime is associated with worth within the family structure. This makes for confusion in the real world.
Symptoms of Anorexia
Those with an unhealthy and obsessive relationship with dieting, exercise and of losing weight. This would have begun early in adolescence. Individuals would start out with a propensity to count calories and fat grams. This could start as early as pre teens. Along with counting calories almost obsessively would be an individual who strictly adheres to a caloric regime, sometimes as little as 500 calories per day. These are of a definite concern especially when coupled with the desire to burn fat and exercise often to the point of exhaustion. Individuals will show obsessiveness in their desire to burn calories, exercise and build muscle. Rather than focusing on the nutritional value of a food, the patient only concerns themselves with the energy and fat contained within a product.
There are a few sub-types indicated for Anorexia Nervosa
1) Restricting Subtype
Severe restriction on the amount of food consumed, alongside the caloric quantity. This includes restricting particular food groups such as carbohydrates, sugars and fats, counting calories to the point of obsession, skipping meals, obsessive thought patterns.
2) Binge Eating / Purging Sub-type
Placing severe restriction on the amount and type of food consumed. This sub-type will also display purging behaviour alongside binge eating. Binge eating is where an individual loses control of their ability to stop eating. Binge eaters, eat everything they would normally refuse due to the type or caloric quantity. Sweets, foods high in fat, carbohydrates, even healthy packaged food, is overindulged when an individual is in a state of binge eating. The binge eater consumes such a large amount of food, they have almost preplanned the purge that will commence directly after. The purging is to relieve feelings of discomfort both physically and emotionally. To undo the sins of the binge. Purging behaviour involves self induced vomiting, misuse of laxatives, diuretics and enemas.
What are the warning signs of Anorexia?
- Physical Signs
- Losing weight at a rapid rate
- Loss and/ or disturbance of menstruation in girls and women
- Decreased libido in younger men
- Fainting or dizziness due to lack of nutrients and/or purge behaviours
- Feeling cold, even in warm weather which is caused by a lack of circulation
- Feeling bloated and/ or constipated
- Developing intolerances to food
- Not sleeping well, increased fatigue
- Low energy
- Pale, sunken eyes
- Fine hair appearing on face and body
- Psychological Signs
- Preoccupation with calories, eating, body shape and weight loss / weight gain.
- Feeling anxious and angry around meal times. May start up drama in order to get out of eating.
- Extreme fear of gaining weight
- Refusal to consider food as nutritious
- Unable to maintain a normal body weight for their height and age group
- Increased depression and anxiety
- Inability to think clearly
- Low self esteem, Perfectionist
- Distorted sense of what their body should look like
- Increased sensitivity to comments about food, exercise and body shapes
- Extreme body image dissatisfaction
- Behavioural Signs
- Obsessive Dieting behaviour
- Tasting food and spitting it out, for fear of gaining weight
- Deliberate misuse of laxatives, appetite suppressants, enemas and diuretics
- Repetitively weighing or evaluating body shape
- Evidence of binge eating such as hoarding food
- Evidence of purging – disappearance after meals to purge
- Privately eating and avoiding mealtimes with family and peers
- Spending an increased amount of time solo
- Compulsive or excessive exercising even in bad weather or when sick / injured
- Radical changes in food preferences
- Obsessive rituals around food preparation and eating
- Preoccupation with preparing food for others, recipes and nutrition – yet not eating themselves
- Self harm, substance abuse or suicide attempts
Clinical Studies / References:
