Anorexia Nervosa

Question 1

Diagnostic criteria

Answer 1

Eating disorder characterized by significantly low weight, fear of weight gain, and body image distortion or denial of the seriousness of weight loss. Often starts with dieting or exercising to lose just a little weight, but spirals out of control.

3 criteria:

1. Restriction of intake leading to a significantly low weight that is less than minimally normal
2. Intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain
3. Body image disturbance, over-concern with weight/shape, lack of recognition of the medical seriousness of low weight

Question 2

Unhealthy, debilitating pattern with refusal to obtain healthy weight

Answer 2

• Highly restrictive and selective eating pattern
• Excessive exercise
• Purging in 15-20% of cases
• Hours spent calculating calories and planning meals
• Fear, distortion, denial, harsh resistance to help
• Avoid social situations to avoid being “found out” or simply because they have no energy

Question 3

Physiological symptoms

Answer 3

-Malnutrition: blood flow decreases, skin dry, hair fall out, menstruation stops or becomes irregular, fertility impaired, calcium lost, growth stunted, low heart rate and blood pressure, brain shrinks

Question 4

Prevalence

Answer 4

• 0.1-0.9% of population
• 5-10% males (may be higher)
• Typical age of onset in females ~14-18YO
• Prevalent across ethnicities and socioeconomic status, but definitely higher in industrialized Westernized countries

Question 5

Comorbidities

Answer 5

• Anxiety disorders: OCD, generalized anxiety, social phobia

- Depression

Question 6

Interventions

Answer 6

Few systematic studies. Low base rate and medical complications/risks contribute to difficulty conducting randomized trials… Need for more treatments and studies.

3 outpatient interventions:

• Psychodynamic therapy
• CBT
• Family-based therapy (studies suggest this is the superior method)