Abstract
Anorexia Nervosa is a disorder that mostly affects young women at puberty age. It involves being obsessed with the fear of adding on weight and was first described by Sir. Williams Gull in 1868. Some people do believe that once one is anorexic, they can’t get back their lives and also that these group of people do not eat, all of which are not true. Studies have proved beyond any reasonable doubt the influence of the neurotransmitters in relation to this disorder. Those who are anorexic are associated with digestion problems, thin hairs, and dry skin. They over personalize their immediate surrounding and exhibit queer behaviors. Treatment of the disorder involves enlisting the services of nutritionist as well as psychiatrists. The patient is counseled by professionals together with their immediate family members and observed over a period of time for the gains made not to be reversed due to the influence of the external environment. History of Anorexia Nervosa Those people who deliberately deny themselves food out of fear of adding on weight are said to suffer from a disorder known as anorexia nervosa and is very popular amongst young ladies in the industrialized society where culture encourages thin bodies. This disorder, in many instances, start at puberty when the young people are rediscovering themselves and involves weight losses of up to 15% below the normal person’s body weight. The affected persons are so obsessed with the idea of losing weight to the extent that he/she ignores the body’s food requirement; those who suffer from this disease do have uncontrolled fear of adding weight (Grohol, 2006).
It has been observed that this disease has been on the rise in the modern days than it used to before, and this has been attributed to many factors like fashion whereby people associate thinness as the fashionable way to look like and therefore many people adopt different ways to slim while in the process start to avoid food in spite of the body’s desire. Other reasons include modern technology whereby most work is done while sitting down thus people tend to eat less. Lastly, the media has ‘over-emphasized’ on exercise and sport thus one can strain the body to unreachable ideal levels. The disease was first described in the seventeenth century (1868) by Sir William Gull, but it was up to until 1870s that it was not only identified but also described together with its diagnosis. Even though the existence of the disease has been known by the medical practitioners for such a long time, it was not known to the public until later years in the 1970s, approximately three centuries after it was first described. In 1984, one of the comedians hosting the ‘‘Saturday night live’ comedy show was heard making a joke of the disease, showing a proposal about the way anorectic cookbook would look like. Currently, people have come to appreciate the seriousness of the disease. While tracing the history of the disease, many authors have come to the conclusion that the disease is to some extent due to the living styles that people have adopted over the years and also due to the societal social structure.
Myths and Misconceptions about Anorexia Nervosa
Anorexia has been known to affect people both mentally and physically. The greatest myth people have had is that those who suffer from the disease can never get cured. Statistics however show that over 80% of the patients have successfully recovered from this condition and have their lives back in track within a desirable time period. For this to be a success, the disease has to be discovered in good time and prompt action taken. Some people have also believed that anorexics don’t eat. The truth of the matter is that they restrict a lot whatever they eat and usually keep strict diets so as to achieve their target of slimmer bodies. They tend to keep of fatty foods rich in calories and instead heavily rely on the vegetables, but they occasionally go over board by consuming abnormally large amounts of food. People also tend to perceive any thin person to be anorexic, and this is not usually the case as others might have been caused by other diseases rather than failure to eat enough food quantities for fear of adding on weight.
Signs and Symptoms and Diagnosis of Anorexia Nervosa
Symptoms of the disorder are normally categorized into three broad classes that include the physical signs, psychological and behavioral signs: Physical signs include such features like dry skin and thinning hair, swollen or cold feet and hand, bloated stomach as well as absent or fewer menstrual periods, constant headaches, nerve deterioration in extreme circumstances, brittle fingernails and the person easily get bruised. The eyes sunken as well as tooth decay and dry lips. Extreme weight loss may make movement a little difficult. Those who suffer from this disorder don’t usually behave normally; they are preoccupied with the size of the body and weight control especially through dieting, they have compulsive exercises and portray unusual eating or food habits. Generally these people are depressed with clear signs of loss of interest in the activities they were doing previously and even keep off from their friends and even reduced interests in sexual activities. They develop poor judgment with chronic inability to remember issues while at the same time are obsessed with the need to have control over their personal environments. Most of the times, they fail to recognize or rather appreciate the gravity of their illness; they are simply in denial. Also, they develop a completely different perception of themselves such that there is a sharp contrast between their physical outlook and their perception of the same and constant mood swings.
During diagnosis of the disorder, the doctor would first have to assess whether the anorexia exists by formulating a number of questions. The most commonly used set of questionnaire is the SCOFF (was formulated in Great Britain). Here, a “yes” answer to any two questions provides a very strong indication as to the presence of the disorder. The questions include:
- the patient is asked whether he/she feels sick because of being full;
- the doctor asks if the patient does lose control of how much they eat;
- here, the patient is asked if he/she has lost body weight as much as 13 pounds recently;
- the doctor inquires whether the patient believes that she believes that she is fatter than what other think;
- the patient is asked whether food and thoughts of food dominate his/her life.
If the results of the questionnaire are positive, the doctor then conducts several tests in the laboratory so as to ascertain the levels of blood count for any signs of anemia, electrolyte levels for any signs of magnesium, potassium, and calcium deficiencies, amylase since its levels usually arise in cases of frequent vomiting, protein and thyroid, kidney and liver functions. The doctor may also decide to carry out electrocardiogram to get the graphic record of the heart’s electrical activity. If the diagnosis is made, then the doctor will be required to make frequent visits to the office so as to closely monitor the conditions.
Neurotransmitters Associated with Anorexia Nervosa
According to Kaye (2005), from his reviewed scientific literature, anorexia is closely being associated to a disturbance on the serotonin system, a neurotransmitter that controls such factors as one’s appetite, moods, sexuality, vomiting, and anxiety. This has been identified to occur within the brain, in the 5HT1A receptor. It has been deduced from the available evidence that disturbances to the serotonin system and personality features like trying to be a perfectionist and anxiety still persist even after the person has recovered from the disorder, fueling speculation that they could be the risk causal factors (Kaye, 2005).
Suggestions have been floated to the effect that starvation is as a response to the effects of anxiety and moods since it has an effect of lowering steroid hormone and tryptophan metabolism. This has an effect of lowering the levels of serotonin in the sites thereby eliminating anxiety. Those who are underweight and suffer from anorexia do have relatively low levels of leptin, a hormone which is responsible for fat storage in the body tissues. Also, high serotonin levels have been found to be responsible for the rigidity and perfectionism behaviors that are observed in the anorexics (Walsh, 1998). Treatment and Influence of the Environment Before any kind of treatment commences, there are a number of factors that are looked at. They include the patient’s age and the duration over which the person has had the disorder, the living standards at present, and the medical situation of the person including the body weight, the seriousness of other related mental symptoms as well as symptoms of other eating disorders. While treating the disorder, an approach that takes care of both the psychological and physical phases is addressed. During treatment, the doctors do try to treat any conditions that might have resulted from the disorder. In this regard, emphasis is laid on the results of the previously conducted test results. Such medications like anti anxiety and anti depressants or simply anti-psychotic drugs can be administered. The services of a nutritionist are also employed so as to help the patient take the recommended healthy foods. This way the patient will get to learn about the nutrient requirement of the body and the minimum healthy body weight to maintain. This is commonly referred to as nutritional therapy.
The patient also requires psychotherapy whereby the services of other people close to the person like family members and friends are enlisted. During this process, the focus is shifted towards such issues like self belief and the misplaced thinking and the wayward behavior they are associated with. This is really emphasized one on one with the patient, otherwise called individual therapy. Family therapy shifts to address any conflict within the family, and is most important especially when the patient is still living with their family’s members. It helps the parents to appreciate the patient and come to terms with her condition. Group therapy help provide confidential environment when the patient interacts with others like her. This gives her the morale boosting feeling that she is not unique and the only one that suffers from the disorder. For those who do not require the usually intensive inpatient care, a package called day treatment program is used. This is n normally tailored to meet the patient’s treatment targets and needs. To restore the wholeness and balance in the patient, she is taken through a period of regular meditation (Maria, 2008). It has also been suggested that herbs, to a large extent help to tone down the systems of the body. Theses herbs are often used as tinctures, extracts of glycerin or dried extracts. This can be conducted together with body massage and physical therapy as well as homeopathy.
During the recovery process, in ideal circumstance, the patient should be placed in an ideal environment from where they get the desired support, which includes the moral support. The recovering anorexic can easily fall back into the old practice due to pressure from the surrounding, especially friends whose views impact on her decision making patterns. The success of the recovery process therefore requires that it gets the much needed positive impact from the people surrounding the patient at all the times. Moreover, the family therapy, to some extent, is aimed at making the family members to understand the anorexic and also get to know how to help her best. Over the years, the approaches that have been given towards the recovery of anorexic have not witnessed much transformation since the basics have been maintained all through.
References
Erica Smith (1999). Anorexia Nervosa: When Food is the Enemy. The Rosen Publishing Group. 2008. Web.
Kaye WH, Frank GK, Bailer UF, Henry SE, Meltzer CC, Price JC, Mathis CA, Wagner A. (2005). “Serotonin alterations in anorexia and bulimia nervosa: new insights from imaging studies”. Physiol Behav, 85 (1), 73-81. PMID 15869768.
Kaye WH, Bailer UF, Frank GK, Wagner A, Henry SE. (2005). “Brain imaging of serotonin after recovery from anorexia and bulimia nervosa”. Physiol Behav, 86(1-2), 15-7. PMID 16102788.
Maria, S. (2008). “Eating Disorders-Anorexia Nervosa.” Break Free Beauty-Love your body, live your dreams. Web.
Walsh BT, Devlin MJ. (1998). “Eating disorders: progress and problems”. Science; 280(5368):1387-90.