Lecture 13: Anorexia Nervosa

Question 1

Diagnosis for AN

Answer 1

• persistent restriction of energy intake–> sig low body weight (in context of what is expected for age, sex)
• intense fear of gaining weight (even though rly low weight)
• disturbance in ways one’s body weight is experienced, rly think about body shape and weight, don’t know seriousness of their condition
• specify whether:
  
  • restricting type: during last 3 months= not eating
  • bing-eating / purging type: last 3 months= binge
    eating or vomiting

Question 2

Alternative conceptualisations: Embodiment

Answer 2

Malecki + Rhodes

• including range of embodied experiences
• not cartesian-body dualistic impression of human functioning–> more to explain mind, body, yourself within social structure
• embodiment theory= externally driven–> subjective experience of “body-subject”– connected to feelings
• traditional way of looking at AN= body image disturbance
• but try to see it from a subjective lense: whats it like to be in a body of AN? what is your body experiencing? whats it like to look at your body in this society?
• DSM= observing AN from the outside
• Embodiment= looking at it from inside out

Question 3

Alternative conceptualisations: Feminism

Answer 3

• ED in relation to wider social expectations: western femininity, gender diff in appetite, sexuality, economic power to social roles
• AN= seen as culture-bound syndrome–> cultural metaphor– so ask socio-cultural stuff
• our body isn’t owned by us, its owned by the society
• the society tell us how we should look at our body
• not just media, but much more deeply rooted

Question 4

Medical risks

Answer 4

• neurological (pseudoatrophy of brain)
• metabolic (hypothermia, dehydration)
• cardiovascular (hypotension)
• haematological (iron defiiciency)
• renal
• endocrine
• musculosketal (osteopenia)
• immunological (bacterial infections)

Question 5

Indications for hospitalisations in AN

Answer 5

1. Physiological instability
   a. slow heart rate
   b. hypotension
   c. hypothermia
   d. orthostatic chanegs in pulse
2. cardiac
3. electrolyte disturbances
4. severe malnutrition

Question 6

Prognosis

Answer 6

risk of suicide– 32x higher than expected, compared to MD (which is 21x)
- average duration: 7 yrs

Question 7

problems in AN treatment

Answer 7

• not enough sample sizes
• recruitment difficulties
• placebo controls
• poor compliance

Question 8

good treatment for adolescent patients?

Answer 8

• fam based treatments
• most get better w/ this
• giving love, eating with them during dinner, making sure they’re ok
• have to save life first– rly life threatening, so try to increase weight first, and then tackle what went wrong (cbt therapy)
• around 1 yr
• 6 months: fam
• 3 months: on your own
• 3 months: therapy at end

Question 9

what is tipping point

Answer 9

• when you change your view about your body image, your behaviours to lose weight
• becoming aware of your actions and views= change