Anorexia

Anorexia nervosa has the highest mortality rate of all mental illnesses and can be frightening to parents, friends, and family members of those suffering. People who are suffering from Anorexia Nervosa often do not realize the impact of their illness and may be ambivalent about recovery. It is common for people with Anorexia Nervosa in Bucks County, PA, as well as other areas of the country and world, to be encouraged to seek treatment by their friends and family. For children and adolescents suffering from Anorexia Nervosa, family plays an integral part of treatment and are key members of the treatment team.  

The DSM-V (Diagnostic and Statistical Manual of Mental Disorders- 5th Edition) includes the following criteria for Anorexia Nervosa:

  1. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.  Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.
  2. Intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight. 
  3. 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 persistent lack of recognition of the seriousness of the current low body weight.

Behaviors Common to People Struggling with Anorexia:

  • Severely restricting food intake through dieting or fasting
  • Exercising excessively
  • Self-inducing vomiting to get rid of food 
  • Abnormal use of laxatives, enemas, diet aids or herbal products
  • A preoccupation with food, sometimes including cooking elaborate meals for others but not eating them
  • Frequently skipping meals or refusing to eat
  • Denial of hunger or making excuses for not eating
  • Eating only a few  “safe” foods, usually those low in fat and calories
  • Adopting rigid meal or eating rituals, such as spitting food out after chewing
  • Not wanting to eat in public
  • Lying about food intake
  • Fear of gaining weight 
  • Frequently checking in the mirror for perceived flaws
  • Covering up in layers of clothing
  • Flat, emotionless mood 
  • Social withdrawal

Potential Medical Complications:

  • Sensitivity to cold
  • Abnormal blood counts
  • Dizziness or fainting
  • Fatigue or insomnia
  • Abdominal Pain
  • Thinning or brittle hair
  • Low blood pressure
  • Dehydration
  • Soft, downy hair covering the body
  • Absence of menstruation in those who typically menstruate
  • Irregular heart rhythms 

As clinicians have known for a long time, Anorexia Nervosa can occur in people of all body sizes. The common perception that people with anorexia are all in lower weight bodies is untrue. The DSM-V recognizes this with the addition of “Atypical” Anorexia. People with “Atypical” Anorexia can have all of the same symptoms and medical complications as someone with Anorexia Nervosa. In fact, due to weight bias, people with “Atypical” Anorexia suffer with the illness longer before diagnosis and are frequently more medically compromised by the time they receive treatment. The word “Atypical” is being included in quotes here because “Atypical” Anorexia is actually more common than Anorexia Nervosa. The DSM-V notes that people with “Atypical” Anorexia meet all diagnostic criteria for Anorexia Nervosa except there weight is in a higher range. 

Our Approach

After we conduct our initial intake evaluation, we will work with our patient’s to support them in receiving necessary medical care. Based on the information provided by the pediatrician or primary care doctor, we may talk with the patient and/or family about considering inpatient or residential treatment. we direct our patients to visit their family doctor or pediatrician for a full medical workup. This will determine whether the patient is medically compromised and to what extent. If the patient is severely medically compromised,  they may be recommended for inpatient treatment. We will work with the patient and/or family to decide which treatment center is right for them and answer questions about the process. the client is not medically compromised, we proceed to form a treatment plan as a team that may include the therapist, a psychiatrist, the primary care doctor, a nutritionist, guidance counselors and parents/caregivers/family/friends. 

Call our offices today to set up an appointment with a therapist if you or a loved one are struggling with anorexia.