#NEJMClinicalPractice: Anorexia Nervosa
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Anorexia nervosa is a severe psychiatric disorder that is characterized by starvation and malnutrition, a high incidence of coexisting psychiatric conditions, treatment resistance, and a substantial risk of death from medical complications and suicide. Intense fear of weight gain is a central feature; however, patients often deny this, and it must be inferred from their behavior. An extreme focus on body weight and shape is integral to the disorder, combined with complete control over everything that is eaten, including the preparation of food.

The two designated subtypes of anorexia nervosa are the restricting subtype, which is characterized by dietary restriction, and the binge-eating and purging subtype, in which restriction is accompanied by binge eating, purging, or both; the condition may progress from one subtype to another. The restricting subtype is associated with an earlier age of onset, a better prognosis, and a greater likelihood of crossover to the other subtype. The onset of anorexia nervosa usually occurs in adolescence or young adulthood.

-Anorexia nervosa is a severe psychiatric disorder characterized by starvation and malnutrition, a high prevalence of coexisting psychiatric conditions, marked treatment resistance or no response to treatment, frequent medical complications, and a substantial risk of death.

-Anorexia nervosa has two subtypes: binge eating, purging, or both, and food restricting only. Anorexia nervosa often progresses from one subtype to another, particularly from the restricting subtype to the binging–purging subtype.

- Indications for hospitalization include profound hypotension or dehydration, severe electrolyte abnormalities, arrhythmias or severe bradycardia, suicide risk, and a body-mass index (the weight in kilograms divided by the square of the height in meters) of 15 or less.

- Several psychotherapeutic approaches are used in management. For children and adolescents, family-based treatments are commonly used.

- Psychotropic medications are generally ineffective in promoting weight gain, reducing depressive symptoms, or preventing relapse in patients with anorexia nervosa.

Source: https://www.nejm.org/doi/full/10.1056/NEJMcp1803175
Dr. S●●●●y M●●●●●●●●i and 2 other likes this
Like
Comment
Share