Topic 1: Nutrition intervention and a certain disease

By Abdullah Niyas (ID 160013)

Anorexia Nervosa

Eating Disorders are defined as irregular changes or disturbances in an individual’s normal

eating behaviors. Among the multiple types, Anorexia Nervosa is the most common disorder. It is
characterized by a strong aversion to food, fuelled by intense fear of gaining weight and a wrongful
perception that one is overweight or obese. These patients usually severely restrict their diet and
reduce calories by inducing vomiting or using diuretics. This leads to a dangerously low body weight
(less than 85% of ideal) and a below par supply of daily nutritional requirements. As a result, major
health complications could develop such as anemia, constipation, dehydration, electrolyte
imbalances, orthostatic hypotension and decreased bone density.

The goals of therapy for Anorexia Nervosa include returning to health eating habits and
restoring a healthy body weight. Treatment is multi-disciplinary and usually involves a medical
doctor, a dietician or nutritionist and a mental health professional.

The medical doctor is required to treat the complications of anorexia. In such cases, it is
crucial to monitor vital signs, hydration levels and electrolyte balance. In severe conditions, a doctor
may be required to place a nasogastric tube to initiate feeding for the patient. If seriously
underweight, the doctor will place the patient in hospital care to monitor recovery and potential
complications.

The psychological therapy varies between adults and children. In adults, it includes Cognitive
Behavioural therapy (CBT) and Specialist supportive clinical management (SSCM). In children, it
includes family therapy and adolescent focused psychotherapy. CBT is divided into 40 weekly
sessions, which makes clear the effects of starvation and the different ways to manage causative
feelings. SSCM is primarily focused on explaining the cause for the disorder as well as display how
poor eating habits cause the symptoms. Family therapy is used in teens who struggle to make the
right choices and so the parents can help with restoration of normal eating habits. Adolescent-
focused psychotherapy is usually around 40 sessions in which the therapist makes clear how to cope
with fears of gaining weight and what needs to be done to return to healthy eating.

The dietician helps prepare a meal plan with sufficient calories to return to normal body
weight. These plans are concentrated on high energy density foods. It is important to focus on
correcting biochemical imbalances first before proceeding to weight gain, in order to prevent
harmful consequences such as refeeding syndrome. A weight gain rate of 2-3 pounds per week is
recommended for most patients. This can be achieved by caloric prescriptions of about 1000
kcal/day, with increments of about 200 kcal every 3 days. For complete weight restoration, caloric
intake of 3000 to 4000 kcal/day maybe required.

In conclusion, Anorexia Nervosa is a very common eating disorder that causes severe weight
loss and fatal health complications. It requires a combination of medical, psychological and
nutritional therapy to achieve complete recovery and long-term remission.

References:
https://www.nutritionist-resource.org.uk/articles/anorexia-nervosa.html
https://www.nhs.uk/conditions/anorexia/treatment/
https://www.mayoclinic.org/diseases-conditions/anorexia/diagnosis-treatment/drc-20353597
Weight Management and Eating Disorders – Lecture by Dr. Razan Dukmak