 What is Anorexia Nervosa
Anorexia Nervosa is a psychiatric diagnosis that describes an eating disorder, characterized by low body weight and body image distortion, with an obsessive fear of gaining weight. Individuals with anorexia are known to control body weight commonly through the means of voluntary starvation, purging, vomiting, excessive exercise or other weight control measures, such as diet pills or diuretic drugs. While the condition primarily affects adolescent females, approximately 10% of people with the diagnosis are male. Anorexia Nervosa, involving neurobiological, psychological, and sociological components, is a complex condition that can lead to death in severe cases.
"Anorexia nervosa" is frequently shortened to "anorexia" in the popular media. This is technically incorrect, as the term "anorexia" used separately refers to the medical symptom of reduced appetite (which therefore is distinguishable from anorexia nervosa in being non-psychiatric).
Anorexia is thought to have the highest mortality rate of any psychiatric disorder, with approximately 6% of those who are diagnosed with the disorder eventually dying due to related causes. The suicide rate of people with anorexia is also higher than that of the general population and is thought to be the major cause of death for those with the condition.
The first line treatment for Anorexia is usually focused on immediate weight gain, especially with those who have particularly serious conditions that require hospitalization. In particularly serious cases, this may be done as an involuntary hospital treatment under mental health law, where such legislation exists. In the majority of cases, however, people with anorexia are treated as outpatients, with input from physicians, psychiatrists, clinical psychologists and other mental health professionals.
A recent clinical review has suggested that psychotherapy is an effective form of treatment and can lead to restoration of weight, return of menses among female patients, and improved psychological and social functioning when compared to simple support or education programmes. However, this review also noted that there are only a small number of randomised controlled trials on which to base this recommendation, and no specific type of psychotherapy seems to show any overall advantage when compared to other types. Family therapy has also been found to be an effective treatment for adolescents with anorexia and in particular, a method developed at the Maudsley Hospital is widely used and found to maintain improvement over time.
Drug treatments, such as SSRI or other antidepressant medication, have not been found to be generally effective for either treating anorexia, or preventing relapse although it has also been noted that there is a lack of adequate research in this area. It is common, however, for antidepressants to be prescribed, often with the intent of trying to treat the associated anxiety and depression.
Supplementation with 14mg/day of zinc is recommended as routine treatment for Anorexia Nervosa due to a study showing a doubling of weight regain after treatment with zinc was begun. The mechanism of action is hypothesized to be an increased effectiveness of neurotransmission in various parts of the brain, including the amygdala, after adequate zinc intake begins resulting in increased appetite.
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