Characteristics of Anorexia: Symptoms, Causes, Treatments

The characteristics of anorexia treatment are to overestimate the value of thinness, excessive worry about weight and an exaggerated fear of gaining weight.

These ideas alter eating behaviors and facilitate behaviors that have the purpose of avoiding gaining weight.

Anorexia, treatment, symptoms and causes

anorexia treatment

The term anorexia and anorexia treatment means “lack of appetite”, although in this disease that is not quite correct.

In fact, in the early stages the person experiences a feeling of hunger, since it is when he begins to reduce intake, denying hunger and repressing it with willpower.

Due to the multitude of medical complications you may have, it is important to start treating it as soon as possible.

It is estimated that 5-20% of anorexic people die, usually due to complications related to heart problems, kidney problems, pneumonia…

The longer the disease is suffered, the higher the mortality rate and the more urgent the initiation of treatment.

INDEX

1-Types of anorexia

2-Statistics

3-Characteristics

4-Causes

5-Evaluation

6-Treatment

7-Treatment model

 

1-Types of anorexia

According to the DSM-IV anorexia nervosa is divided into two subtypes:

  • Compulsive / purgative: the person frequently resorts to purges or binges.
  • Restrictive: the person does not resort to binges or purges.

The most common purges are excessive use of laxatives, vomiting, enemas or diuretics.

2-Statistics

  • In the female population, it reaches 3%
  • In the general population, it affects 1%
  • It is much more common in women than in men with a ratio of 9 to 1 (at least). Other authors believe that this ratio is 15 to 1
  • The group of young people of 14-19 years is the one of greater risk
  • Because anorexia has a higher mortality rate than other psychiatric disorders (8-10%), it is important to start treatment as soon as possible
  • Although treatment is received, there is a high probability that the disorder will be chronic (approximately 25% of cases). Hence the importance of keeping tracks.

3-Physical and cognitive characteristics

  • Alteration of body image
  • Excess of concern about body shape and size
  • Great fear of gaining weight
  • Presence of important physical alterations such as amenorrhea
  • Very significant loss of body weight
  • Overvalued idea of ​​thinness
  • Physical exercise controls the person. You cannot stop practicing it because not doing so causes anxiety.

4-Causes of Anorexia Nervosa

There are several models explaining the factors that explain the causes of anorexia.

Precipitating factors

  • Body image: bullying , body changes, teasing of the body image of the affected
  • Stressful events: divorce, change of school, break ups , rapid weight gain

Predisposing factors

  • Family members: psychopathologies in family members, family conflicts, parents worried excessively by the physicist, obese parents
  • Social: idealization of thinness, social pressure towards thinness
  • Personal: having or having been overweight, being adolescent, being a woman, low self-esteem, perfectionism, idealization of thinness

Maintenance factors

  • Decreased basal metabolic rite: it facilitates the chronicity of the table and the weight gain
  • Reaction of people: there may be people who reinforce the behavior
  • Frustration and hunger: decreases self-esteem and increases the level of personal hyperresponsiveness
  • Restrictive diet: hunger generates anxiety which is reduced by restricting diet to show that it is able to control intake

5-Evaluation

To assess eating disorders such as anorexia it is necessary to take into account several factors due to their complexity.

Probably a multidisciplinary approach is needed with psychologists, psychiatrists, nutritionists and internists.

To ensure that the information given by the patient is real, it is advisable to consult other sources of information (family, teachers).

The following are the main areas in which to evaluate patients with anorexia:

Cognitive factors

  • The level of self-will and perfectionism will be known
  • Assess self-esteem
  • It will be necessary to evaluate and detect cognitive distortions or irrational beliefs related to body image, weight, fear of gaining weight and food
  • The specific content of the patient’s beliefs and distortions will be identified.

Ingestion behavior

The information needed to know the person’s eating pattern is:

  • Average intake: number of intakes a day, time, place, how you eat
  • Content and quantity: calorie content, types of food, way of preparing food
  • Presence of loss of control: what triggers it, if followed by purgative behaviors
  • Attitudes towards food: nutritional requirements of the adult, misconceptions, knowledge of nutrition
  • Restricted intake: forbidden foods, how much is avoided, fasting …

Body weight

Here are some indicators that allow you to know if you suffer from anorexia:

1-Quetelet Body Mass Index (BMI) = Weight (kg) / height (m)

  • BMI> 25 = overweight
  • BMI 20-25 = normal
  • BMI 18-20) = underweight
  • BMI <17 = excessive weight

2-Relative Weight Index = Actual Weight / Ideal Weight x 10

  • IPR> 120 = obesity
  • IPR of 100 = weight corresponding to size and age
  • IPR <80 = underweight
  • Ideal weight: the expected for the age and size of the person

Body image

The alteration of the body image of the person with anorexia can be a trigger or a maintenance factor.

The most important thing to keep in mind is:

Avoidance behaviors

Evaluate if there are avoidance behaviors such as: do not put on the bathing suit, do not look in the mirror, always wear wide clothing, avoid buying new clothes.

Reinsurance behavior


Evaluate if there are reassurance behaviors such as looking at oneself frequently in the mirror, weighing yourself continuously, measuring body parts …

Degree of distortion of body image

  • Calculate the distortion index from the body’s perception index (BIS).
  • Evaluate the tendency to overestimate the body dimensions of certain parts of the body (abdomen, glutes, hips).

Degree of satisfaction with the body

Evaluate if there is the will to lose weight or modify the body image.

Value the person’s assessment of his own body, emotional state, attributions, misconceptions about his figure, degree of satisfaction with the body.

Family environment

It will be necessary to know information related to the family of the type:

  • Excessive Conflicts and Worries
  • Presence of reinforcements and punishments
  • Wrong beliefs of the family towards food, image or weight
  • Family environment
  • Attitude of the family towards the disease of the person

Associated psychopathologies

Evaluating whether the person has any psychopathology in addition to anorexia is important in establishing diagnosis and treatment.

Some psychopathologies such as anxiety or depression may be the cause and consequence of anorexia.

People with anorexia may also have:

  • Social phobia
  • Generalized anxiety
  • Depression
  • Aggressive behaviors
  • Alcohol abuse
  • Obsessive-compulsive disorder
  • Lack of impulse control

6-Treatment of anorexia nervosa

The treatment of anorexia nervosa aims to:

  • Improve physical fitness
  • Modify erroneous beliefs related to weight, image and food
  • Improve family and social relationships
  • Eliminate harmful eating habits
  • Start a healthy eating habit
  • Improve eating habits
  • Duration: the duration is usually long, from a year to at least four years.

Depending on the severity of the person, it will be decided whether to proceed to hospitalization.

It is recommended that the person’s life be altered as little as possible and if hospitalization is necessary, for as short a time as possible.

This decision will be based on:

Psychological criteria

  • Failures in previous treatments
  • Risk of suicide

Medical Criteria

  • Hypoglycemia, amenorrhea, electrolyte imbalance
  • IPR, BMI

Cognitive behavioral therapy

The goal of cognitive-behavioral treatment is to eliminate irrational thoughts about food and personal image and replace them with more correct ones.

The important cognitive aspect and the emotional alterations contribute to maintain the anorexia nervosa.

From Beck’s cognitive therapy:

  • Self-esteem is improved: the patient does not base their assessment or their physical or in the opinions of others
  • Irrational ideas about weight and food are modified

Behavioral treatment

Behavioral treatment aims to increase weight and change eating habits.

If the person is in the hospital, he will be deprived of internet, television, visits, etc., until he has reached the desired weight.

It is important that you provide feedback to the person about the weight you are in and about the calories and foods you are ingesting.

In addition, the patient will be educated on how to structure meals. To plan meals and ensure a correct intake of calories, you will need to consult a nutritionist.

On the other hand, the nutritionist’s information will serve to correct the erroneous beliefs that the person with anorexia has.

Some techniques for establishing desired behaviors are chip economics and behavioral contracts.

To overcome the fear of getting fat you can use the technique of systematic desensitization.

Pharmacological treatments

The use of pharmacological treatment should be prescribed by a doctor or psychiatrist and used if there is no remedy, due to the side effects that these drugs cause.

  • Narcoleptics may be used to treat changes in body image and delusions about weight
  • Use of appetite stimulants
  • Antidepressants are used to treat depressive symptoms

7-Treatment model

The treatment of anorexia nervosa should have as main objectives:

1-Improve weight and physical condition of the person

The most important points will be:

  • Establish a healthy patient-therapist relationship
  • Specify the ultimate goal of treatment / hospitalization
  • Delimit activities and visits that the person can do
  • Obtain information about erroneous beliefs
  • Restore weight, teaching you to ingest more and eat normally with a pattern of regular meals of 4-6 meals a day
  • It is recommended that the person eat with other patients and control between them that everything in the plate is finished
  • Control purges after meals
  • Set the gain that you want to get every week until you reach the ideal weight
  • Establish the frequency with which the weight test will be performed, ideally 3-4 times a week
  • The person will be fed back on the weight he / she is getting
  • Establish appropriate relationships between family and anorexic person
  • Reestablish normal meals in the person’s home progressively

2-Correct and modify erroneous beliefs about image, food and weight

The most important point will be to modify the erroneous thoughts that keep the disease

3-Improve symptoms associated with the disorder

The most important points will be:

  • Training in relaxation techniques
  • Depressive, obsessive compulsive and anxiety symptoms will be treated.

4-Improve body image

The most important points will be:

  • Correct Body Image Distortions
  • Expose the person to the situations he or she previously avoided
  • Modify wrong thoughts about image and body.

5-Improve and build personal and social relationships

The most important points will be:

  • Provide family members with information about the disorder
  • Encourage the active participation of family members
  • Avoid guilt in parents or other family members.

6-Prevention of relapses

The most important points will be:

  • Identification of high-risk situations of relapse
  • Preparation for action in high risk situations
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