The eating disorder anorexia nervosa is
classified as individuals that have a fear of weight gain and thus will over
exercise or starves themselves or both to prevent them from gaining any weight. “People with anorexia
nervosa have a
distorted body image that causes them to see themselves as overweight even when they're dangerously thin” ("American
Psychological Association", 2015).
The disorder is typically seen as coming on in
adolescence and doesn’t really have a lot to do with food, but rather the
person dealing with problems that are difficult in their life or emotions that
are difficult so they deal with them in unhealthy ways. Anorexia nervosa is a
serious disorder in which the sufferer needs help for otherwise the disorder
may continue to progress to the point where the individual loses so much weight
they begin to suffer from health problems as a result of it, which can include
the death of the person if they continue the weight loss path. There is no cure
for anorexia nervosa, but there is a variety of recommended treatments
available to help people that suffer from the disorder. The following paper
will compare three therapeutic interventions and contrast them in treating
anorexia, it will compare the measures of effectiveness, cover symptoms of
anorexia, rates of reduction or management, and the approaches that would be
recommended to treat this disorder. The
paper will also analyze the neurophysiological underpinnings of disease and
examine contemporary attitudes toward the treatments discussed in the paper.
Anorexia Nervosa
Of the individuals that are affected by anorexia
nearly 95 percent of them will be female though that doesn't mean that men
cannot also develop the psychological disorder (Gentile, 2010). Anorexia
nervosa has no known cause, but research studies have found evidence that there
may be a genetic component in place that determines a person’s likelihood of developing
the disorder. Gentile (2010), states
that researchers have found evidence that implies that the hypothalamus of an
individual may have a dysfunction in individuals suffering from the disorder
and may be a contributing factor to a person's development of the anorexia.
There are many theories about how an individual may develop the anorexia
disorder including ideas about an infant being underfed or the infant's mother
having maternal depression that contributed to the development of the disorder.
The theory that is most favored by psychologists is that the individual
suffering from anorexia is suffering from a self-esteem problem and the way
that the person perceives themselves is the main contributing factor to the
development of the anorexia disorder. In this theory the individual perceives
what society demands, such as society wanting thin girls, and then the person
will reflect that in order to bring happiness and success to themselves they
need to embody the thin perception as that is what they portray in movies,
media, and television. The person will
strive to fit the idea that was created that they need to be thin to be happy
and successful, the ideal person in society.
The person will strive for this look through the development of anorexia
as the individual is striving to be thin at any cost including not eating and
over exercising to make this ideal of perfection a reality.
Common Symptoms
Anorexia is a serious eating disorder that can
affect a person's psychological as well as physical health. A person that is
suffering from anorexia can become underweight severely which leads to problems
with depression, and the individual may begin to withdraw from their life and
society as a result of it. People with
anorexia disorder tend to be more irritable and prone to mood swings than
individuals that don't suffer from the disorder. According to Gentile (2010), these
individuals will be more overly sensitive, having more irritability, and find
it hard to interact with others. Other symptoms that individuals may include
insomnia that can impact a person's ability to function when awake as the
individual may be more tired during times awake, they may be unable to
concentrate, and they can experience problems with focusing their attentions. According
to Gentile (2010), the most common symptom felt by individuals that suffer from
anorexia is the obsession these people with have with food. People are consumed
with food, from thoughts about food to having specific habits with food such as
eating small pieces at a time, hoarding food, or they may cook large meals at a
time for other individuals but not touch a bite of the meal.
People with anorexia will obsess over looks
believing that no matter what they are always too fat and thus they have not to
eat or constantly over exercise to become thin. Gentile (2010), states that
people are overly compliant in life, and lack in adequate self-perception and
thus the people strive to achieve perfection and to please others in their
life. Individuals that suffer from anorexia tend to be overachievers that
exceed themselves through excelling at academics, signing up for a lot of
extracurricular activities, and in general overloading and working themselves. Gentile
(2010), states that since a person’s physical appearance is important to the
individual that has anorexia the person often is a very high achiever in a lot
of different areas and their family is often portrayed as perfect as well. The
delusions that a person holds about appearance will become evident as the
person will refuse to believe what anyone has to say regarding the individual's
weight and instead will choose to believe that their weight and appearance is
different than what they are being told.
A person that is suffering from anorexia will put off compliments about
their weight choosing to disagree outright or will simply not believe the
compliment and continue to strive to lose weight. In this disorder, denial is a
huge factor that helps the sufferer maintains their weight problem. Denial is at the root of the disorder causing
the individual never to be satisfied and to resort back to weight loss
behaviors that keep the disorder going.
Treatments
The treatment for anorexia nervosa can range from
therapy to medication and everything else in between it. One of the treatment
options for individuals with anorexia is a cognitive therapy that has shown a
lot of promise and success in treating individuals with anorexia. In treating
anorexia, it depends a lot on the patient's motivation in wanting to get better
which can cause a lot of frustration for a doctor that is trying to treat the
individual. For the person to get better, they have to be motivated and committed
to following through with the treatment that the doctor has set up, the plan
that has been created. Most people lack the
drive or motivation to keep up with treatment and thus tend not to follow the
plan set up. Denial again comes into play with the individual as the individual
does not believe that there is anything wrong with them thus they do not want
to follow through with a treatment plan. Sufferers of anorexia will rationalize
symptoms of the disorder and become deceivers to themselves to continue doing
what they can to continue with the weight loss.
The use of cognitive therapy to treat individuals
with anorexia has shown great strides in assisting individuals to overcome
anorexia symptoms. Riva, Bacchetta, Baruffi, Rinaldj, and Molinari (1999),
state that the use of virtual reality or VR in studies has shown to be very
effective in treating anorexia. People can use the VR equipment to simulate
experiences in the real world exposing patients to encounters and situations
that will over time desensitize them and thus lead to a decrease in behavioral
tendencies of anorexia. With the use of cognitive therapy, it is relatively
short term taking about eight weeks to complete and is a fully integrated
approach that focuses on the individual's discovery and self-perception. This
therapy will utilize the assistance of a clinical psychologist that works
together with a cognitive behaviorist just in case there is a need for
medication to be either administered or prescribed to the person. While going
through therapy the psychologist may work in a group or individual setting to
assist the individual in interaction with others that share similar experiences
so the person will realize the experiences they have been not specific to just
them (Gentile, 2010).
When participating in the individual therapy the
psychologist will create a plan that involves the individual meeting with a
nutritionist weekly so that individual can develop healthy skills with
eating. The psychologists will also work
in holding sessions weekly with the individual, using the VR equipment, holding
supportive talks, doing weekly assessments, psychometric tests, and completing
psychopharmacological assessments (Riva et. al., 1999). Using cognitive therapy
has shown a lot of improvement in individuals suffering from anorexia as the
individuals learn about not obsessing about food, the individuals learn about
not obsessing with looks, and they are taught coping skills that allow them to
strive for a healthy lifestyle. This treatment also benefits the doctors and
patients by being able to motivate the individual to participate and work
toward change as the skills being used and knowledge learned transfer directly
into a person’s life after they are done with treatment. With the use of the
virtual reality, people can experience real life situations that can directly
impact the person's disorder. Additionally, the use of the virtual reality
allows it to be programmed to each person in order to fit their specific needs
and supports the feeling of the person being in control as it is highly
immersive (Riva et. al., 1999). The therapist is also with the patient
throughout the whole session with the VR, so they can assist them the entire
time with the experiences that they have or if a problem comes up.
This treatment supports both advantages as well
as disadvantages. First the treatment is
able to minimize distortion with the findings being more conclusive, and allows
the person to experience as well as remember everything experienced while
taking out the struggle of interaction with other individuals in the
experiences. The downside however, is that the treatment can run around $10,000
or more and thus is expensive to afford for individuals. Additionally, the treatment has not be run in
other areas of psychology so there has been no comparison created in different
approaches or the results of follow-up presented in order to display the long
term efficacy of the virtual reality treatment (Riva et. al., 1999). In the
studies that have been run the treatment when compared individually or with the
use of medication has shown great strides in altering symptoms of people with
anorexia nervosa. The treatment allows the person to face their perceptions and
discuss them with a therapist, helping to improve the perceptions especially
the one's concerning their body image and can help with changing the habits the
patient has with food (Riva, et. al., 1999).
Pharmacological Treatments
Anorexia nervosa is a difficult disorder that can
result in the relapse of a person many times because of the denial and
combative nature that goes with the disorder. Kotler and Walsh (2000), state
that anti-depressants have been used in cases of people suffering from Bulimia,
which has been effective and may be a possible alternative treatment for people
dealing with anorexia. In studies that have been done, double blinds with
placebos and antidepressants, there had been no noticeable changes or results
when it came to controlling a person's anorexia. In studies done with
individuals that have relapsed though the results have shown great promise. One
of the major symptoms of relapse is depression that the anti-depressants have
been able to help control and thus present more favorable results for helping
with anorexia in that stage of treatment (Kotler & Walsh, 2000). The
anti-depressants can help control the person's depression and allow the
individual to work through therapy to learn coping skills. There is a drawback
to the medication in that it is still no cure, it only helps with the
depression, and it has only been shown to help in the relapse phase of the
disorder. The medicine can assist in helping the individual once they enter the
relapse phase but still needs to be used in combination with other therapy
methods and can't be used as a stand-alone method.
Alternative Therapeutic Treatment
Anorexia disorder is severe affecting a person
both physically as well as mentally and can end up having a high rate of death
in the individuals that suffer from it. Psychologists that have been treating
individuals with anorexia have discovered that the use of replacing hormones to
treat a psychiatric disturbance has been beneficial in the treatment of
individuals with anorexia. During anorexia, the starvation the individual is doing
becomes visible on their body outside, but the inside of the body is also
damaged. Wheatland (2002), states that in the blood of a person with anorexia
an endocrine feature is higher significantly than cortisol levels in the person
as a result of the serve dieting, the purging of food, the excessive
exercising, and the self-injury that the individual will do to themselves
daily. In the research that was done, cortisol was given to sufferers of
anorexia and was found to show significant improvement in the person suffering.
While the cortisol levels may already be higher than normal and it seems weird
to give more cortisol to a person Wheatland (2002), states that giving the
additional cortisol allows the person to satisfy the cortisol requirement lowering
the need to maintain the starving state that the person perceives they need to
maintain and helps to treat the disorder.
An individual that doesn’t get treatment for the
disorder continues to starve themselves then will break down and eat, this
causes the person to feel guilty as their cortisol levels fall. Using the extra
cortisol allows the individual to maintain the high need for cortisol while
being able to satisfy their hunger without the guilt or need to purge the food
(Wheatland, 2002). The extra cortisol also counteracts the behavioral issues
associated with the disorder. Cortisol is a natural hormone that is in place in
all individuals and associated with stress in people at higher levels. Anorexia
produces high stress and low self-esteem increasing the levels of cortisol in
the person as they push toward becoming the perfect person (Wheatland, 2002).
Replacement therapy with this hormone allows for stress to be alleviated and
reduction in the need to be perfect.
Conclusion
The eating disorder anorexia nervosa is
classified as individuals that have a fear of weight gain and thus will over
exercise or starves themselves or both to prevent them from gaining any weight.
The disorder is typically seen as coming on in adolescence and doesn't really
have a lot to do with food, but rather the person dealing with problems that
are difficult in their life or emotions that are difficult so they deal with
them in unhealthy ways. Anorexia is a serious eating disorder that can affect a
person's psychological as well as physical health. The treatment for anorexia
nervosa can range from therapy to medication and everything else in between it.
One of the treatment options for individuals with anorexia is a cognitive
therapy that has shown a lot of promise and success in treating individuals
with anorexia. The use of cognitive therapy to treat individuals with anorexia
has shown great strides in assisting individuals to overcome anorexia symptoms.
Riva, Bacchetta, Baruffi, Rinaldj, and Molinari (1999), state that the use of
virtual reality or VR in studies has shown to be very effective in treating
anorexia. People can use the VR equipment to simulate experiences in the real
world exposing patients to encounters and situations that will over time
desensitize them and thus lead to a decrease in behavioral tendencies of
anorexia. Anorexia nervosa is a difficult disorder that can result in the
relapse of a person many times because of the denial and combative nature that
goes with the disorder.
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Forman,
S. (2011). Eating disorders: Treatment and outcome. Retrieved from http://www.uptodate.com/home/index.html.
Grave, R. (2011). Eating disorders: Progress and challenges. European Journal of Internal Medicine 22(3). 153.
Gentile,
M.G. (2010). Anorexia Nervosa: Identification, Main Characteristics and
Treatment. Nutritional Therapy & Metabolism.
Riva, G., Bacchetta, M., Baruffi, M., Rinaldj,
S., & Molinari, E. (1999). Virtual Reality Based.
Experimental Cognitive Treatment of Anorexia Nervosa. P. 221-230. Retrieve
from: http://www.vepsy.com/atnplab/flash_site/inglese/riva_anorexia_nervosa.pdf
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