Anorexia research paper

Further research is required in order to connect the different findings to further investigate the neurobiological differences between the subtypes of anorexia nervosa. We use cookies to help provide and enhance our service and tailor content and ads. By continuing you agree to the use of cookies. Download PDF Download. Clinical Nutrition Experimental Available online 13 February Author links open overlay panel Sophie Scharner a Andreas Stengel a b. Electrolyte imbalances can kill without warning; so can cardiac arrest.

Facebook Instagram Twitter Pinterest. How Do I Help? Intense fear of gaining weight or becoming fat, even though underweight. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

Related articles. Becoming a Champion. While acutely ill, metabolic changes may produce a number of biological findings in people with anorexia that are not necessarily causative of the anorexic behavior. For example, abnormal hormonal responses to challenges with serotonergic agents have been observed during acute illness, but not recovery. Nevertheless, increased cerebrospinal fluid concentrations of 5-Hydroxyindoleacetic acid a metabolite of serotonin , and changes in anorectic behavior in response to tryptophan depletion a metabolic precursor to serotonin support a role in anorexia.

Anorexia nervosa - causes, symptoms, diagnosis, treatment & pathology

The binding potential of 5-HT 2A receptors and 5-HT 1A receptors have been reportedly decreased and increased respectively in a number of cortical regions. While these findings may be confounded by comorbid psychiatric disorders, taken as a whole they indicate serotonin in anorexia.

Neuroimaging studies investigating the functional connectivity between brain regions have observed a number of alterations in networks related to cognitive control, introspection, and sensory function. Alterations in networks related to the dorsal anterior cingulate cortex may be related to excessive cognitive control of eating related behaviors. Similarly, altered somatosensory integration and introspection may relate to abnormal body image.

Compared to controls, recovered anorexics show reduced activation in the reward system in response to food, and reduced correlation between self reported liking of a sugary drink and activity in the striatum and ACC. Increased binding potential of [11C]raclopride in the striatum, interpreted as reflecting decreased endogenous dopamine due to competitive displacement, has also been observed.


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Structural neuroimaging studies have found global reductions in both gray matter and white matter, as well as increased cerebrospinal fluid volumes. Regional decreases in the left hypothalamus , left inferior parietal lobe , right lentiform nucleus and right caudate have also been reported [76] in acutely ill patients. However, these alterations seem to be associated with acute malnutrition and largely reversible with weight restoration, at least in nonchronic cases in younger people.

Reduced white matter integrity in the fornix has also been reported. A diagnostic assessment includes the person's current circumstances, biographical history, current symptoms, and family history.

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Anorexia Essay: How to Write a Good Paper on This Critical Issue

The assessment also includes a mental state examination , which is an assessment of the person's current mood and thought content, focusing on views on weight and patterns of eating. There are two subtypes of AN: [18] [80]. The DSM-5 states these as follows: [81]. Medical tests to check for signs of physical deterioration in anorexia nervosa may be performed by a general physician or psychiatrist, including:.

A variety of medical and psychological conditions have been misdiagnosed as anorexia nervosa; in some cases the correct diagnosis was not made for more than ten years. The distinction between the diagnoses of anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified EDNOS is often difficult to make as there is considerable overlap between people diagnosed with these conditions. Seemingly minor changes in people's overall behavior or attitude can change a diagnosis from anorexia: binge-eating type to bulimia nervosa. A main factor differentiating binge-purge anorexia from bulimia is the gap in physical weight.

Someone with bulimia nervosa is ordinarily at a healthy weight, or slightly overweight. Someone with binge-purge anorexia is commonly underweight. There is no conclusive evidence that any particular treatment for anorexia nervosa works better than others; however, there is enough evidence to suggest that early intervention and treatment are more effective.

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Although restoring the person's weight is the primary task at hand, optimal treatment also includes and monitors behavioral change in the individual as well. Psychotherapy for individuals with AN is challenging as they may value being thin and may seek to maintain control and resist change. Initially developing a desire to change is important. Diet is the most essential factor to work on in people with anorexia nervosa, and must be tailored to each person's needs.

Anorexia nervosa: What you need to know

Food variety is important when establishing meal plans as well as foods that are higher in energy density. Family-based treatment FBT has been shown to be more successful than individual therapy for adolescents with AN. There is tentative evidence that family therapy is as effective as treatment as usual and it is unclear if family therapy is more effective than educational interventions. Cognitive behavioral therapy CBT is useful in adolescents and adults with anorexia nervosa; [] acceptance and commitment therapy is a type of CBT, which has shown promise in the treatment of AN.

Pharmaceuticals have limited benefit for anorexia itself. AN has a high mortality [] and patients admitted in a severely ill state to medical units are at particularly high risk. Diagnosis can be challenging, risk assessment may not be performed accurately, consent and the need for compulsion may not be assessed appropriately, refeeding syndrome may be missed or poorly treated and the behavioural and family problems in AN may be missed or poorly managed.

The rate of refeeding can be difficult to establish, because the fear of refeeding syndrome RFS can lead to underfeeding. It is thought that RFS, with falling phosphate and potassium levels, is more likely to occur when BMI is very low, and when medical comorbidities such as infection or cardiac failure, are present.

In those circumstances, it is recommended to start refeeding slowly but to build up rapidly as long as RFS does not occur. AN has the highest mortality rate of any psychological disorder.

Argumentative Essay on Anorexia

Alexithymia influences treatment outcome. According to the Morgan-Russell criteria, individuals can have a good, intermediate, or poor outcome. The good outcome also excludes psychological health. Recovery for people with anorexia nervosa is undeniably positive, but recovery does not mean a return to normal. Anorexia nervosa can have serious implications if its duration and severity are significant and if onset occurs before the completion of growth, pubertal maturation, or the attainment of peak bone mass.

In such cases, provided that growth potential is preserved, height increase can resume and reach full potential after normal intake is resumed. Anorexia nervosa causes alterations in the female reproductive system; significant weight loss, as well as psychological stress and intense exercise, typically results in a cessation of menstruation in women who are past puberty.

Metabolic factors likely contribute to anorexia

In patients with anorexia nervosa, there is a reduction of the secretion of gonadotropin releasing hormone in the central nervous system, preventing ovulation. Both height gain and pubertal development are dependent on the release of growth hormone and gonadotrophins LH and FSH from the pituitary gland. Suppression of gonadotrophins in people with anorexia nervosa has been documented. Buildup of bone is greatest during adolescence, and if onset of anorexia nervosa occurs during this time and stalls puberty, low bone mass may be permanent. Hepatic steatosis, or fatty infiltration of the liver, can also occur, and is an indicator of malnutrition in children.

Wernicke encephalopathy , which results from vitamin B1 deficiency , has been reported in patients who are extremely malnourished; symptoms include confusion, problems with the muscles responsible for eye movements and abnormalities in walking gait. The most common gastrointestinal complications of anorexia nervosa are delayed stomach emptying and constipation , but also include elevated liver function tests , diarrhea , acute pancreatitis , heartburn , difficulty swallowing , and, rarely, superior mesenteric artery syndrome.

Other symptoms of gastroparesis include early satiety, fullness, nausea, and vomiting. The symptoms may inhibit efforts at eating and recovery, but can be managed by limiting high-fiber foods, using liquid nutritional supplements, or using metoclopramide to increase emptying of food from the stomach. Anorexia nervosa increases the risk of sudden cardiac death , though the precise cause is unknown.

Cardiac complications include structural and functional changes to the heart. Cardiac complications can include arrhythmias , abnormally slow heart beat , low blood pressure , decreased size of the heart muscle, reduced heart volume, mitral valve prolapse , myocardial fibrosis , and pericardial effusion. Abnormalities in conduction and repolarization of the heart that can result from anorexia nervosa include QT prolongation , increased QT dispersion , conduction delays, and junctional escape rhythms.

Hypokalemia most commonly results in anorexic patients when restricting is accompanied by purging induced vomiting or laxative use. Hypotension low blood pressure is common, and symptoms include fatigue and weakness.

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Orthostatic hypotension, a marked decrease in blood pressure when standing from a supine position, may also occur. Symptoms include lightheadedness upon standing, weakness, and cognitive impairment, and may result in fainting or near-fainting.