Anorexia is a disorder of eating behavior that involves a loss of weight caused by the patient himself and leads to a state of starvation. Anorexia is characterized by the fear of gaining weight, and by a distorted and delirious perception of the body itself that makes the patient look fat even when his weight is below the recommended. That is why it initiates a progressive decrease in weight through fasting and the reduction of food intake.
Since this is a disorder that usually begins in adolescence, the observation by the family is crucial to detect in the least habits that are a warning sign. Here are some risk factors:
Bad eating habits: Many teenagers eat alone while watching TV or communicate with friends via whatsapp. Lack of fixed schedules and parental supervision of what they eat increase the likelihood of developing an eating disorder.
Poor communication with parents: Knowing their children’s concerns, tastes, and circle of friends can help prevent this type of disorder or detect it at an early stage.
In compulsive anorexia, two subtypes can be distinguished:
Restrictive subtype: weight reduction is achieved by dieting or intense physical exercise and the patient does not resort to overeating, binge eating or purging.
Bulimic subtype: The patient resorts to purging even if he has ingested a small amount of food.
Anorexia nervosa is usually diagnosed based on severe weight loss and characteristic psychological symptoms. The typical anorexic is an adolescent who has lost at least 15 percent of her body weight, fears obesity, has stopped menstruating, denies being sick, and appears healthy.
The overall objectives of the treatment are the correction of malnutrition and psychological disorders of the patient. First of all, the aim is to achieve rapid weight gain and the recovery of eating habits, as this can lead to an increased risk of death. However, full recovery of body weight is not synonymous with cure. Anorexia is a psychiatric disease and should be treated as such. Treatment should be based on three aspects:
Early detection of the disease: knowledge of the symptoms by primary care physicians and of the protocols that set the criteria that the physician must observe.
Coordination between the health services involved: psychiatry, endocrinology and paediatrics.
Outpatient follow-up once the patient has been discharged, with regular visits. Hospitalizations are usually prolonged, which means a disconnection from the environment that can harm the normal development of the adolescent. For this reason, outpatient treatments are advisable whenever possible.
Admission to a medical centre is necessary when:
Malnutrition is very serious and there are alterations in the vital signs.
When family relationships are unsustainable and it is better to isolate the patient.
This is how treatment begins with feedback, which can sometimes cause digestive discomfort, as the body is not used to eating food. With time, the biological situation is restored and menstruation returns. Then begins the psychological treatment, which attempts to restructure rational ideas, eliminate misperception of the body, improve self-esteem, and develop social and communication skills between the patient and his environment. The family must take an active part in the treatment because sometimes the triggering factor of the illness is in its bosom and, in addition, the recovery is inevitably prolonged in the home.