Anorexia Nervosa
Anorexia nervosa is an eating disorder. The patient has an extremely deteriorated perception of body (e.g. Seeing oneself fat). Apprehensions on the body appearance, or pathological fears concerning getting fat cause a poor diet. Thus, the patient would have the 85% of the weight she/he needs to have, or even less.
Although the lexical meaning of “anorexia” is “loss of appetite”, patients continue to feel hunger. Nevertheless, they ignore or resist it. They may even lie to their relatives on having eaten.
The development of the disorder is based on physical, genetic, emotional and cultural reasons. It is frequently observed in women between the ages of 12-35. In addition, it is observed in people of a perfectionist character having low self-esteem and tending to mercilessly criticize themselves and their bodies. When these attributes are combined with the fear of gaining weight, the patients start to be more merciless to themselves and develop a destructive diet. In the first phases of the disorder, they generally are of the opinion that they have no problems.
Excessive weight loss, malnutrition, forgetfulness, lack of attention, confusion, exhaustion, indifference, anger, nails broken easily, hair loss, dry skin, cold hands and feet, amenorrhea, constipation, slowdown in pulse and respiration, a decrease in the levels of potassium, calcium and magnesium in blood, and weakening in bones are observed.
Hereditary transmission rate is 50-80%. Furthermore, environmental factors and personality structuring may also become risk factors. The perception of an impaired body causes the person to be afraid of gaining weight; they impose the state of hunger upon themselves. This can be interpreted as a self-punishment or an attempt to self-control. Emotional conflicts like guilt, anger, loss of control, negative self-image, etc. cause a physical expression.
The amount of researches made on anorexia nervosa in men is very few. Because the probability of prevalence is nearly 10 times less than the women. It is considered in order for men to develop this disorder, the physical, emotional, genetic and environmental factors have to be stronger. Because the cultural imposition is not as high as that of women.
The tendency to praise slimness or judging the weight that started after World War I caused an increase in the rate of prevalence of eating disorders. The models used in pictures in that era were generally slightly fat women and men. It appears that the change of fashion started to be effective after World War I.
Until the 19th century, eating disorder had not been considered a psychiatric disease. Researches indicate that the rate of prevalence of anorexia nervosa started to increase in women and men born after 1945. Nevertheless, it attracted attention by the rise of the mortality rate from 5% to 10% in past 10 years.
Anorexia nervosa treatment
The treatment of anorexia nervosa is challenging. The initial purpose is to bring the patient’s weight down to the desired levels. The metabolic impairments that appear along with the disorder are intervened. The patient is closely monitored with a nutrition program prepared. Backed by Psychotherapy, the process of treatment takes a positive direction. If deemed necessary, the patient may take antidepressants.
It is difficult and takes a long time to treat it; it may exacerbate sometimes during the lifetime. It has been observed that 50% of the patients fully recovered through the treatment. However, it is also considered that it may become chronic by 20% if not treated.
Anorexia nervosa has the highest mortality rate among psychiatric disorders.. One of every then anorexia nervosa patients die because of hunger, suicide, metabolic collapse, heart attack or kidney failure. That’s why, once the aforementioned criteria are recognized, the patient must start a multilateral treatment. It is impossible for the patients to recover themselves; a professional intervention is mandatory. If the patient refuses the treatment, she/he may be admitted to a hospital.
In brief, anorexia nervosa is a decent example for the bio-psychosocial model as a general principle of the modern medicine.
Genetic transmission and brain function disorders, etc. biological factors, while deformity in parent-child relation is psychological, and the media and social effects are considered social factors.
