Anorexia Nervosa is a serious eating disorder which can be cured by treatment…
Anorexia Nervosa :
Essential features of anorexia nervosa (AN) include persistent energy intake restriction; intense fear of gaining weight or of becoming fat or persistent behavior that interferes with maintenance of appropriate weight; and a disturbance in self-perceived weight or shape. Two diagnostic subtypes are restrictive eating only and restrictive eating interspersed with purging, and crossover between the subtypes is possible over the course of illness. The DSM-5 is the first to allow clinicians to document a severity rating for a case of AN: mild, moderate, severe, and extreme. Severity ratings are differentiated based on current body mass index (BMI, adults) or BMI percentile (children/ adolescents).
However, the rating may be increased at the clinician’s discretion to reflect clinical symptoms, degree of functional disability, and the need for supervision.
In the general population, lifetime prevalence of AN is approximately 1% in women and less than 0.5% in men (Hay et al, 2014). Presentation typically occurs during adolescence or young adulthood, but prepubertal and late-onset (after age 40) cases have been described. Although AN occurs across culturally and socially diverse populations, increased prevalence occurs in post industrialized, high-income countries. Within the United States, prevalence appears to be comparatively low among Latinos, African Americans, and Asians; however, presentation of weight concerns among individuals with eating disorders may vary substantially across cultural and ethnic groups. Risk and prognostic factors associated with this disorder include genetic, physiologic, environmental, and temperamental characteristics.
The crude mortality rate is approximately 5% per decade with death attributed to medical complications directly related to AN or suicide (APA, 2013).
A. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal, or for children and adolescents, less than that minimally expected.
B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
Restricting type: During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas). This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.
During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
Specify current severity:
The minimum level of severity is based, for adults, on current body mass index (BMI) (see below) or, for children and adolescents, on BMI percentile. The ranges below are derived from World Health Organization categories for thinness in adults; for children and adolescents, corresponding BMI percentiles should be used. The level of severity may be increased to reflect clinical symptoms, the degree of functional disability, and the need for supervision.
Mild: BMI 17 kg/m2
Moderate: BMI 16-16.99 kg/m2
Severe: BMI 15-15.99 kg/m2
Extreme: BMI ,15 kg/m
Diagnosis Temperament Environment Genetic and Physiologic AN Obsessional traits in childhood Anxiety disorders Cultures/settings that value thinness Occupations/avocations that encourage thinness, e.g., modeling, elite athletics
First-degree biological relative with AN, BN, bipolar disorder, or depressive disorder Higher concordance rates in monozygotic vs. dizygotic twins Functional imaging studies indicate a range of brain abnormalities but unclear if changes are primary anomalies or secondary to malnutrition.
An Article by Nutrition student ‘Syeda Ruhina Raushan’