Anorexia nervosa Symptoms and Features Flashcards
Anorexia Nervosa
Deffonition
Anorexia Nervosa
is an eating disorder manifested when a person refuses to eat an adequate amount of food or is unable to maintain the minimal weight for a person’s body mass index (BMI).
Individuals with anorexia often have a distorted body image
(seeing themselves as fat or bulky in certain areas)
and have an intense fear of gaining weight or becoming fat.
Therefore, restricting the intake of food serves the function of maintaining their desired weight or appearance.
Alternatively they may engage purging behaviors
(using laxatives, exercising excessively)
to lose weight
Anorexia Nervosa
DSM V diagnosis Criteria
Under the DSM 5 – a diagnosis requires all 3 of the following symptoms;
• Restriction of energy intake
Limiting what they eat to such an extent that they have significantly low body weight.
DSM-5 does not define
“significantly low body weight”, describing it instead as “less that minimally normal”.
ICD-10 defines it as
“maintained at least 15% below expected… or BMI is 17.5 or less.” In practise, clinicians using the DSM 5 tend to accept the ICD-10 definition
• Fear of weight gain / interfering behaviours
Person feels ‘intense fear of gaining weight or becoming fat’, according to the DSM-5.
They may engage in behaviours that prevent them gaining weight.
There is more to this than just avoiding fatty foods.
The DSM-5 gives no examples of such behaviour but the ICD-10 does, such as self-induced vomiting and/or purging,
excessive exercise and using appetite suppressants.
• Disturbed experience of body weight/shape
The cognitive element of an AN diagnosis.
The person has a disturbed experience of their own body weight or
shape (the ICD-10 calls it ‘body-image distortion’).
Weight and/or shape has a disproportionate influence on
the person’s self-evaluation (how they perceive/feel about themselves)
. They may also fail to recognise how seriously low their body weight is.
Anorexia Nervosa
Restricting Subtype
People with the restricting subtype place severe restrictions on the amount and type of food they eat.
Restrictive behaviours include counting calories, skipping meals, or eliminating certain foods (such as carbohydrates).
These behaviours are sometimes coupled with excessive exercise
Anorexia Nervosa
purging Subtype
Those with the binge-eating and/or purging subtype also restrict their food intake.
In addition, they also regularly engage in binge eating or purging behaviors,
such as self-induced vomiting or misuse of laxatives or diuretics, or both binge eating and purging
Anorexia Nervosa
Physical Symptoms
• Extreme weight loss or not making expected developmental weight gains
• Thin appearance
• Abnormal blood counts
• Fatigue
• Insomnia
• Dizziness or fainting
• Bluish discoloration of the fingers
• Hair that thins, breaks or falls out
• Soft, fine hair covering the body (lanugo)
• Absence of menstruation / irregular or no periods
• Constipation and abdominal pain
• Dry or yellowish skin
• Intolerance of cold / low body
temperature
• Irregular heart rhythms
• Low blood pressure
• Physical weakness
• Swelling of arms or legs
• Eroded teeth from vomiting
Anorexia Nervosa
Behavoural symptoms
• Saying they have eaten earlier or will eat later, or that they have eaten more than they have
• Not being truthful about how much weight they have lost
• Strict dieting and avoiding food they think is fattening
• Counting the calories in food excessively
• Eating only low-calorie food
• Missing meals (fasting)
• Avoiding eating with other people
• Hiding food
• Compromise of education and employment plans
• Cutting food into tiny pieces to make it less obvious they have eaten little or to make food
easier to swallow
• Eating very slowly
• Taking appetite suppressants, such as slimming or diet pills
• Obsessive and/or rigid behaviour, particularly around food
• Irritability
• Excessive exercising – this might involve exercising when not physically well enough to
do so, or feeling guilty or anxious about not exercising
• Vomiting or misusing laxatives
• Social withdrawal and isolation
Anorexia Nervosa
Emotional symptoms
• Fear of weight gain
• Low self esteem
• Depression
• Anxiety about eating in front of others
Anorexia Nervosa
cognative Synptoms
• Excessive focus on body weight
• Distorted perception of body shape or weight
• Denying seriousness of the problem / believing there is no problem at all, even after diagnosis
• Spending a lot or most their time thinking about food
• Difficulty concentrating
• Perfectionism and setting very high standards for themselves
Anorexia Nervosa
prevalence
• 40 in 100,000 10 to 14-year-olds are diagnosed with eating disorders, including anorexia and bulimia.
• Approximately 90-95% of those with anorexia are female. The prevalence rate of anorexia among young females is 0.4% according to current research.
• Approximately 1 in 10 cases of anorexia are males (this is rising)
• Between 20 and 43 % of those with AN report current suicidal ideation
• More common in the western cultures – 19% of British girls are AN
Anorexia Nervosa
onset and prognosis
• Most eating disorders develop during adolescence, although there are cases of eating disorders developing in children
as young as 6 and in adults in their 70’s, around 10% of people of people affected by an ED are diagnosed with AN.
• Research suggests that individuals who have family members with ED’s are more likely to develop ED’s that themselves compared to those who have no family history of the illness.
• Eating disorders have the highest mortality rate among psychiatric diagnoses and AN has the highest mortality rate of
any psychiatric disorder in adolescence.
• The earlier that eating disorder treatment is sought, the better the individuals chance to recovery
• 1/20 patients who are treated for AN are likely to die from the illness
• Between 20 and 43 % of those with AN report current suicidal ideation
• Patients with AN are also two to nine times more likely to attempt suicide than their peers.
Anorexia Nervosa
Symptom overlap and comorbidity
Comorbidity is when over disorders can co occur in most common of these with anorexia art mood disorders PTSD and obsessive compulsive disorder
Symptom overlap includes major depressive disorder as they both have weight loss and insomnia and fatigue and depression
Anorexia Nervosa
DSM IV TR TO V CHANGES
The description of the disordered change to incorp brigate more of the individual than just normal expected weight for the height and age as in also incorporates the context of age, sex and developmental trajectory and physical health etc
