Anorexia Nervosa (AN)
Anorexia Nervosa (AN) is characterized by restricted energy intake, which leads to significant and rapid weight loss or an inability to maintain a healthy weight. Individuals with AN are often afraid of gaining weight, and they see themselves as being at a normal weight or overweight even when they are dangerously underweight. Individuals with AN often limit the amount and types of food they eat. They might also feel out of control when eating and engage in self-induced vomiting.
About .5-1% of females and 0.3% of males suffer from AN. AN is the most common psychiatric diagnoses for adolescent females. AN has the highest death rate of any mental health condition. The longer a person has AN, the more likely they are to die from medical complications or suicide. The sooner a patient receives treatment, the more likely they are to overcome AN.
Signs of Anorexia Nervosa can also include:
- a child or adolescent falling below their previously established growth curve
- dieting behavior or refusal to eat certain foods
- radical changes in food preferences
- compulsive or excessive exercising
- preoccupation with eating, nutrition, food preparation, body shape, and weight
- avoiding meals with others
- skipping meals
- feeling anxious or irritable around meal times
- withdrawing from family and friends
- depression, anxiety, and difficulty concentrating
- body checking behaviors (e.g., pinching or measuring body parts, frequently evaluating the body in the mirror)
- frequently evaluating oneself in the mirror, or avoiding looking at oneself in the mirror
- frequently weighing oneself
- feeling bloated or constipated
- fainting or dizziness
- very slow heart rate
- feeling cold most of the time
- low energy and fatigue
- Excessive doubt
Treatment of AN can range from inpatient hospitalization to weekly outpatient therapy, depending on the severity of the presenting problem. A comprehensive diagnostic evaluation is used to determine the level of care that would best meet each patient’s needs. Treatment for AN requires a collaborative, multidisciplinary team. In addition to a psychologist, treatment teams can also include a medical doctor, psychiatrist, and a dietitian. We provide patients with referrals as needed and/or collaborate with providers with whom patients are already working.
We also offer an “Intensive Outpatient Program” (IOP) for OCD sufferers in cases where no available ERP specialists are in your geographic area, when services are simply not easily accessible, or because symptom severity is too high for weekly outpatient therapy. The treatment is customized to meet the level of need, availability, and readiness for change to address current symptoms and get the individual to a higher level of functioning whereby more traditional outpatient therapy can be the level of care. The goal of an IOP is to complete treatment with 4-6 weeks and therefore typically requires sessions back to back days, several hours per day, and sometimes over the weekend.
The gold standard, most effective treatment for children and adolescents with AN is called the Maudsley Approach or Family-based Treatment (FBT). FBT is conducted on an outpatient basis but can be conceptualized as an intensive outpatient treatment consisting of significant parental involvement. The psychologist coaches the parents on how to promote weight restoration in their child or adolescent. With the psychologist’s help, control of eating is eventually transferred back to the patient. Treatment then focuses on helping the patient re-engage in normative developmental activities that had been disrupted by the eating disorder. Treatment also targets thoughts and behaviors that contribute to and maintain AN, body image difficulties, and co-occurring anxiety and depressive disorders. FBT can be appropriate for some young adults and adults, depending on the patient’s and their family’s circumstances.