Treatment of Anorexia Nervosa: After the diagnosis of Anorexia Nervosa , the goal is to prevent the associated complications that can lead to organ damage or even death. Treatment begins by addressing the underlying metabolic conditions.  It is imperative that these be addressed slowly to avoid the re-feeding syndrome.   Re-feeding syndrome is life-threatening and results in heart failure, decreased phosphate, and dangerous changes in potassium, sodium and magnesium.  It is essential that a physician and nutritionist collaborate so that re-feeding can occur without fear of re-feeding syndrome occurring.   Cardiac failure is most worrisome within the first 2 weeks of re-feeding.  The heart cannot take the sudden increased metabolic demand that occurs with eating after a long period of starving.  Therefore, it is essential that re-feeding occur slowly and with a daily weight gain of 0.2-0.4 kg to reduce the risks of developing this syndrome. Addressing the psychological component of anorexia nervosa is essential to treating this disease.  Speaking with a psychiatrist to determine an individualized therapy treatment plan that will focus on the underlying issues will allow for sustained recovery.  Involving the patient and their loved ones is a key factor in successful treatment. Family and loved ones can offer support and keep an eye on the patient for relapses in behavior.

There are many signs and symptoms you need to be aware of if Anorexia Nervosa is the suspected disease. These include- Hypotension Bradycardia Hypothermia Dry skin Lanugo body hair Atrophy of breasts Thinning hair Peripheral edema Lanugo body hair (thin, soft non-pigmented hair) Patients with anorexia may develop hypercarotenemia, which is the orange pigmentation of the skin. It is thought to be a result of either increased carotene and vitamin An intake, or a defect in which the utilization or metabolism of Vitamin A is impaired. Acrocyanosis is another sign that can be seen in anorexia nervosa. It is a blueish color change of extremities that results from the small vessels in the fingers and toes constricting, which is called vasospasm. The result is that less oxygen delivered through the blood is getting to those peripheral areas. Swelling of the parotid and/or submandibular glands, loss of muscle mass, low blood glucose, decreased parathyroid hormone levels, increased liver function, and diminished WBC count is also signs/symptoms of anorexia. When trying to evaluate an individual to determine if they are exhibiting warning signs of anorexia, it is important to pay attention to their behavior over time. Noticing if an individual is dieting chronically or is severely underweight can be the first clue that something isn’t quite right.

Diagnosis of Anorexia Nervosa can be difficult because in many instances it is the family that wants the patient to seek help, and the patient may be resistant or refuse treatment. It is imperative to get the patient to be open to help and that first step is through diagnosis. The length of time that the individual has been suffering undiagnosed with this disorder will determine the number of complications that may be faced. For example, if the patient has been suffering from this disease for several years, they will most likely have chronically low electrolyte levels and decreased protein levels. These levels can be tested for with routine lab work which may include: CBC, CMP and a urinalysis. It is imperative, to begin with, a physical examination by a physician, as well as a mental status evaluation. Because anorexia is considered to be a clinical diagnosis with a psychological component, the criteria for diagnosis must meet the DSM-5 requirements, which are as follows: Restriction of food relative to what is necessary to significantly lowered body weight. Significantly low weight is defined as weight that is less than what is minimally required. Intense fear of gaining weight or becoming overweight.

Because Anorexia Nervosa is an eating disorder , it affects many different organ systems. The consumption of food and liquids is essential to life, and the functioning of all organ systems within the body. Malnutrition and vitamin/mineral deficiencies are a common complication associated with anorexia. Starvation leads to protein deficiency and complications in the cardiovascular, renal, gastrointestinal, neurological, endocrine, integumentary, hematologic and reproductive systems. Cardiovascular system disturbances are responsible for most of the deaths associated with anorexia nervosa. These worrisome signs include: hypotension, bradycardia, and decreased left ventricular mass. Patients who have this disease will likely be hypokalemic. Low potassium (hypokalemia) can result in QT prolongation, which in turn can result in heart arrhythmias and death. Endocrinological system disturbances include amenorrhea, infertility, euthyroid sick syndrome, diabetes insipidus, and osteopenia (bone loss). Gastrointestinal system complications can include constipation, prolonged GI transit, and gastric atrophy. Neurological system disturbances can include atrophy of the brain, especially the cerebral portions, loss of brain volume, generalized muscle weakness, and fatigue. Integumentary system disturbances such as dry scaly skin with brittle hair and nails can also result. Renal (Kidney) system complications may include dehydration and kidney damage, that results in diminished urine output. Electrolyte disturbances are very serious and can lead to life-threatening complications.

Anorexia Nervosa is a complex eating disorder . It stems from biologic, environmental/social and psychological factors. It can affect both men and women, though statistics have proven that it affects women more often. Many professionals believe that pre-pubescent patients who develop anorexia do so in an effort to compensate for their inability to control their own lives. These patients seem to lack autonomy and feel that the only control they have is what they place into their body. Having control over their food intake and body weight allows for these patients to exert their autonomy in an altered fashion. Another common cause of anorexia nervosa is the body image that has been paraded around in magazines and in Hollywood. The notion that women/men who are a size 0 are normal, and that women who are a size 6 are overweight is an unacceptable perception of the average women/man. Today’s society has set the standard for poor self-image and unattainable expectations. While there have yet to be any published studies on this specific relationship, there have been many personal interviews of those who are in recovery from anorexia that have identified this reason as the root of their disease. Other environmental factors that may contribute to the development of anorexia nervosa include the societal expectation for thin individuals to be a job duty.