Beyond The Bathroom Scale: Body Image and Disordered Eating Therapist Resources

View Original

What You Need To Know About Anorexia Nervosa

If you or someone you know is struggling with eating disorders, please reach out for support from the list of organisations Emergency Support

What is Anorexia Nervosa?

  • Intense fear of gaining weight or becoming fat

  • Weight and body image are a big factor for the individual's self-worth and self-esteem.

  • Obsessive behaviours centred around preventing weight gain

  • Food restriction

  • Concerns around weight often increase even as body weight decreases.

  • Weight loss is viewed as positive and an indication of self-control

  • Weight gain is perceived as failure and a complete lack of self-control

  • As with all eating disorders, Anorexia can and does, affect anyone of any age, gender, ethnicity or background.

Signs of Anorexia Nervosa

  • A person suffering from anorexia may develop “rules” around what they feel they can and cannot eat, as well as things like when and where they’ll eat.They may engage in body checking behaviours such as weighing and measuring themselves regularly (links with obsessive-compulsive features).

  • They may experience body dysmorphia (a distorted view of their own body).

  • Depressed mood, Irritability

  • Insomnia

  • Low-self esteem

  • Social withdrawal

  • Loss of interest in sex

  • Fear of eating in public

  • Limited social spontaneity (plans meals in advance, avoids meals out, taking Tupperware to parties)

Diagnostic Criteria for Anorexia Nervosa

Unfortunately, the diagnostic criteria used by medical professionals is based on weight and BMI

The DSM-5 (Diagnostic Statistical Manual) measures severity based on BMI:

  • Mild: BMI equal to 17

  • Moderate: BMI 16-16.99

  • Severe: BMI 15-15.99

  • Extreme: BMI Less than 15

The ICD-10 (WHO) suggests a BMI equal to or less than 17.5 for diagnosis.

See this gallery in the original post

What is ‘Atypical Anorexia’?

The term 'atypical anorexia' is increasingly being used in the eating disorder community to refer to individuals who are not underweight according to BMI, but present with the same behaviours and thoughts as seen in Anorexia Nervosa. This is just as serious and requires urgent treatment!

What treatment options are there for Anorexia Nervosa?

The focus of treatment tends to be on weight restoration and nutritional intervention. This might take place in a hospital setting (in-patient or outpatient services) and will most likely be overseen by a multi-disciplinary team of different professionals, such as:

•Registered Dietitians

•Mental health nurses

•Clinical psychologists

Talking therapy will very likely form part of the treatment plan, alongside nutritional intervention.

Cognitive Behavioural Therapy for Anorexia

•Challenging attitudes towards food & body shape

•Gain an understanding of the triggers & ‘thinking errors’

•Reframing and coping strategies

Family Therapy

Often the treatment of choice for adolescents. The research suggests that it’s twice as effective as individual therapy because family therapy requires the parent’s assistance in interrupting this child’s disordered behaviours.

A study suggested that it is “twice as effective as individual psychotherapy at producing full remission” (Digitale, 2010)

Patients will usually have 10-12 sessions over a 6-12 month period.

There are 3 phases:

  • Refeeding: This stage focuses on helping the parents become a functioning support network for the child’s recovery by reinforcing more structured family meals.

  • Negotiation for a new pattern of relationships: After the client starts to gain weight, this is when family issues begin to be addressed in the second phase. Psycho-educational programs around body image (such as what you’ll find in this app) are also part of the second phase.

  • Termination