Anorexia Nervosa

​    Anorexia Nervosa (AN) is one type of eating disorder that has a lifetime prevalence of 4% among females and 0.3% among males (van Eeden, 2021). AN, like all other eating disorders, is classified as a mental disorder. The three criteria for diagnosing AN are: prolonged self-restriction of nutrient intake, fear of gaining weight, and a distorted self body image or self-perceived weight. Due to their obsession with self-body image, patients with AN will often find extreme measures of losing weight, such as calorie counting, starvation, excessive exercise, purging, and taking laxatives (Morris, 2007). There are other factors that lead to extreme weight loss, such as depressive episodes and medical conditions; however, AN is different in that there is an underlying psychological fear of gaining weight that fuels this unhealthy behavior.
    What causes AN? There seems to be both biological and environmental bases for the development of AN. Many patients with AN seem to differ in the structure and function of their brains. For example, AN patients show decreased dopamine (reward system) and serotonin (impulse control) levels (Moore, 2022). The median age of onset is around 15, and the disorder is most common among female teens. AN is also significantly more prevalent in Western cultures, which suggest an environmental basis for the condition. This may potentially be due to how the media portrays body expectations and weight loss. For instance in Western cultures, models and actors exhibit unrealistic standards for thinness, often accentuated by photoshop and make up, and athletes in sports like ballet, running, martial arts have to lose weight to optimize performance. There also exist other risk factors for AN, like childhood obesity, mood disorders, sexual abuse, and familial problems (Moore, 2022).  
    Out of all psychiatric disorders, AN has the highest mortality, with most of the deaths  resulting from suicide or complications from nutrient deficit (Morris, 2007). Patients with AN often have comorbid disorders like major depressive disorder, generalized anxiety disorder, or obsessive compulsive disorder. This means treatment of AN often necessarily involves treating the mental health of the patients. There are also numerous physical complications from malnutrition, such as delayed onset of puberty, amenorrhea (absence of menstruation), bone weakness, and respiratory, cardiac, or gastrointestinal problems (Peterson, 2019). Therefore, AN is a serious disorder that requires a careful, multidisciplinary approach to treatment.  
    Because there is no known cure or cause of AN, it is incredibly important to recognize the disorder early and help patients manage it. The two most common intervention methods are nutrition rehabilitation, where patients are slowly given nutrients to restore their body homeostasis, and psychotherapy, which aims to target the underlying mental health issues. In severe cases, partial hospitalization may be necessary. Another method of treatment is family intervention and education (Moore, 2022). In this way, family members are educated on how to reduce risk factors for AN and help manage the symptoms of the disorder. Medications, like antipsychotics or antidepressants, may also be helpful in the treatment of AN. 

References
Moore, C. A., & Bokor, B. R. (2022, August 29). Anorexia nervosa - statpearls . NIH National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK459148/ 
Morris, J., & Twaddle, S. (2007). Anorexia nervosa. BMJ, 334(7599), 894–898. https://doi.org/10.1136/bmj.39171.616840.be 
Peterson, K., & Fuller, R. (2019). Anorexia nervosa in adolescents. Nursing, 49(10), 24–30. https://doi.org/10.1097/01.nurse.0000580640.43071.15 
van Eeden, A. E., van Hoeken, D., & Hoek, H. W. (2021). Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Current Opinion in Psychiatry, 34(6), 515–524. https://doi.org/10.1097/yco.0000000000000739