ANOREXIA

JANA TODOROVIĆ IV3

WHAT IS IT ?

• Anorexia nervosa (AN) is eating

disorder which is characterized
by intentional weight loss,
toghether with disturbed
experience of body image and
intensive fear of gaining weight,
denying the seriousness of the
problem and amenorrhea.
EPIDEMIOLOGY

• Ussualy anorexia starts between

13 to 15 years and reaches highest
prevalence in age of 15 to 19.
• It happens more often in girls than
boys: close by 85-90% adolescents
with eating disorders are girls
• Anorexia can occur toghether with
other disorders in field of mental
health such as anxiety, depression,
obssesive-compulsive
disorder, drug use, or other
somatic diseases as diabetes.
ETIOLOGY
• Biological vulnerability, psychological predisposition
and social influence play a role in the development
of anorexia.Some of psychodnamically oriented
authors believe that anorexia is an attempt to avoid
growing up and extend childrens age.
• There are also social pressures in the form
of fashion industry that promotes slimmer figures
or books and magazines that advise weight loss
diets
CLINICAL PICTURE
• Patients with anorexia eat small amounts of food during meals,
skip meals, and consume low-calorie foods. Some patients divide
their food into small portions or they secretly throw it away.
• They complain of flatulence or abdominal pain even after eating
a small amount of food. They often carry large amounts of water
or caffeinated diet drinks to fool hunger or increase diuresis.
• Anorexia sufferers are generally very physically active. Some of
them constantly stand, move their arms or legs, walk up and
down the stairs, do exercises for the abdominal muscles. Some
patients resort to various methods of "purging" in order to lose
body weight quickly: induce vomiting, use diuretics, exercise
excessively, use laxatives or slimming preparations. Due to the
reduced intake of liquids and food, they suffer from constipation.
 PATIENTS IN SOCIAL
LIFE
• Important thing is to know how patients who suffer from
anorexia look and behave in public and in contact with
other people,
• In order to cover up the loss of body weight or because of
the pronounced feeling of cold, adolescents wear loose
and layered clothes. Parents often describe them as
strange, irritable. Adolescents suffering from anorexia
nervosa withdraw from their peers, family and friends.
On the one hand, they do this to avoid comments and
criticism regarding their body weight, diet and
appearance, and on the other hand, it can be a
consequence of low self-esteem and
underdeveloped communication skills. When
communicating with others, these adolescents feel
insecure and helpless.
PHYSICAL SINGS OF
ANOREXIA

• The following signs of anorexia

nervosa can be found in the physical
examination: low body weight; lack
of fat tissue; reduced muscle mass;
hypothermia even below 35°C;
bradycardia, hypotension;
acrocyanosis; dry skin, yellow or
orange discoloration of the palms,
changes in the nails in the form of
depressions and ridges; lanugo hairs
on the back, abdomen or face; hair
loss or thinning; edema; repeated
fractures that can also occur
spontaneously
 1. Body mass is maintained at least 15% below the
DIAGNOSIS expected (the expected weight is either lost or never
reached)

AND 2. Weight loss is caused by the patient avoiding fattening

foods and using one or more forms of behavior: inducing

DIAGNOSTIC vomiting, inducing defecation, excessive exercise, taking

diuretics..
3. Disturbed perception of one's own body mass and body
CRITERIA FOR shape (disorder of body shape), fear of obesity
4. Endocrine disorder (women - amenorrhea, men - drop in
ANOREXIA 5.
libido and potency)
If the onset is before puberty, puberty is slowed down or
interrupted. With healing, puberty often completes
normally, but menarche is delayed
• In the evaluation of patients suffering from anorexia
nervosa, a detailed history and physical examination and
basic laboratory analyzes are required: complete blood
count, erythrocyte sedimentation rate, urea and creatinine,
glycemia, serum electrolytes, including calcium, magnesium,
phosphorus, acid-base status, urine, ECG
TREATMENT
• The multidisciplinary team who need to work with anorexia
patients includes a psychiatrist, psychologist, pediatrician,
nutritionist, gynecologist, nurse-technician, if necessary, a
dentist and other specialists.
• It is very important to make the diagnosis earlier. Treatment
includes nutritional rehabilitation, restoration of normal body
weight and treatment of disease complications.
• The metaphor "food is medicine", which is often used in
working with patients suffering from AN, implies that food is
"prescribed" and taken in a precisely determined quantity and
at a determined time.
• Food intake is not negotiable, the only choice the patient can
make is the method of intake
• "Medication": oral intake of food, oral intake of energy
supplements or nasogastric tube.
 • Psychotherapy is very important and includes family education, individual and family
therapy. Family members are usually scared, helpless and angry.
• This high level of anxiety makes eating even more difficult. During family education, blame
PSYCHOLOGICAL should be avoided.The family should understand that AN is not something that the patient
chooses, but rather a disease that can have a fatal outcome.

TREATMENT • Treatment of anorexia nervosa can be carried out in hospital conditions, on an outpatient
basis or in the form of partial hospitalization (day stay). In cases where the patient's life is
threatened, forced treatment/hospitalization is also indicated.
PROGNOSIS
• The prognosis of anorexia nervosa is better in
adolescents than in adults, partly due to the
shorter duration of the disorder in adolescents.
About 50% of adolescents recover completely, 30%
partially, and 20% do not recover and have a
chronic course of this disorder.
• Mortality ranges between 2% and 8%. The main
causes of death are suicide and complications of
starvation.
 • Eating disorders are by day more
present among population and along
with other mental disorders, should not
CONCLUSION be denied or ignored
• Everyone who feels bad about own
AND body image, insecure, less valuable
should look out for some form of help,
EDUCATION even it is conversation it is
important, because it can prevent
serious conditions
• I recommend watching good influence
and body positivity things on the
internet and avoidance of contet which
promotes unreal beauty standards
• Also a good movie to watch- To the
bone, which is about young girl
suffering from anorexia
THANK YOU FOR
YOUR
ATTENTION