Nikki Nies Midterm Paper 11/29/12 255--Meal Design and Management

ANOREXIA NERVOSA

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NIKKI NIES

11/29/12

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Nikki Nies Midterm Paper 11/29/12 255--Meal Design and Management

Background/Introduction:

With the constant pressures received from friends, family and social media, it is understandable people may fall prey of the certain beliefs. Anorexia nervosa may not be the first condition that comes to mind of one of the many eating conditions, but it is one that sparks

Intense fear of gaining weight; limits food intake and constantly thinks about food even though already at a health weight. There are psychological factors, a way to get a sense of control back in one’s life. It is often an outlet for anger, tension and anxiety, with many battling the disorder described as anxious, emotionally reactive and sensitive (Ravin, n.d.).

An imbalance between ventral brain circuits, which regulate reward and emotion and dorsal circuits, which are associated with consequences and planning ahead (Ravin, n.d.). Disturbances in the serotonergic system contribute to the vulnerability to restricted eating, behavioral inhibition and excessive concern about the negative consequences of eating and gaining weight. One exposed to misperceived hunger, little pleasure from food and the calm and mood elevating effects of food restriction can create a strong predisposition towards developing anorexia nervosa (Anorexia Nervosa Fact Sheet, 2009).

The combination of very high-energy requirement and dietary restriction can easily stimulate AN.

An anorexia often has low body weight for his or her own height, resists keeping a normal body weight; has an intense fear of gaining weight; thinks she or he is fat when in actuality he or she is thin; misses three or more menstrual periods in a row.

Predominantly, young women in adolescence and women are mostly impacted by anorexia. Stress of assimilating to the American concept of “thin” can cause many minorities to develop an eating disorder.

The criteria to be considered anorexic, is, but not limited to: culture, families, life changes or stressful events, personality traits and genetics. In America, there is a consistent amount of what constitutes as beautiful and what “mold” one needs to fit into to be accepted in society. Many role models and super models today are not the normal everyday body type, but have been air brushed and digitally altered to make the “perfect” woman. Many women are afflicted with the battle of embracing their own skin and limiting themselves to culture’s skewed standards.

The likelihood of anorexia increases when a mother or sister has already suffered from the disorder. Many times, parent’s views are passed down to their children, so if they have a negative body image, value looks highly and criticize their children’s body often, it can have a negative impact on children in the future.

Traumatic events and stressful situations can alter one’s eating habits, feeling that they are able to control one aspect of his or her life, if an uncontrollable event occurs.

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Nikki Nies Midterm Paper 11/29/12 255--Meal Design and Management Often one that is a perfectionist, sets impossible standards and has an insatiable attitude, can fall into the trap of anorexia nervosa.

Sometimes, anorexia is unavoidable as one can receive a gene, hormone or chemical imbalance in the brain that encourages the development of anorexia.

Characteristics/Diet Concerns and treatment of condition:

Anorexia limits the amount of nutrients consumed, which limits the body’s ability to maintain its regular functions.

Anemia can occur from a lack of iron. Limiting one’s bodily fluids, there can be subpar amounts of potassium, magnesium and sodium intake. Also, a permanent loss of bone calcium can lead to fractures and lifelong problems of osteoporosis. Imbalance of electrolytes

With medical care, one can get better with a support group including doctors, nutritionists and therapists. A team of specialists can help guide someone return to a healthy weight, treat any associated psychological issues in regards to anorexia, help the person eliminate any negative thoughts that instigate the anorexic behavior. In addition, medicines such as mood stabilizers, antidepressants and antipsychotics can be used to maintain a healthy perspective of one’s weight. Family therapy is an encouraged part of treatment. Usually it starts with motivational psychotherapy and once weight is restored, can go on to cognitive behavioral therapy, which cements positive thinking and reduces chances of relapse.

The psychological issues can include irrational thinking, mood swings, easily irritated, bad memory, fainting and changes in brain chemistry. The contrast in feelings when one avoids eating is feelings of alertness, energetic and calm when fasting, as opposed to those that do not suffer with the disorder, who feel tired, irritable and sluggish when under eating occurs (Ravin).

A weight gain goal of 2-3 pounds a week for hospitalized patients and 0.5-1 pound a week for outpatients. Patients usually start with 1000-1600 calories a day, leading up to 2000-3500 a day. Fluid retention is common in the healing process, as it is a response to weight gain.

Often times, in addition to therapy and weight gain, calcium, zinc and vitamin D supplements are advised ("Anorexia Nervosa," 2012, p. [Page #]). Even if one is not zinc deficient, it has been found that it can improve one’s overall weight gain. Studies have shown consumption of DHA and EPA has provided rapid improvement in severe cases.

Summary/Conclusion (word count:

Anorexia stems from Hellenistic times of fasting. Early sufferers include Mary, Queen of Scots and Catherine of Siena. However, anorexia nervosa was not accepted as a medical condition until the 19th century and limited to the medical profession until late 20th century. Once anorexia nervosa was included in the Diagnostic and Statistical Manual of Mental Disorders, more information was opened to the public and more exposure to the disorder allowed more treatments to become available. Hilde Bruch’s The Golden cage: the Enigma of Anorexia Nervosa is credited with given anorexia a broader range of exposure, beyond the medical profession. Karen Carpenter, an American vocalist and drummer, died suddenly from heart failure, related to

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Nikki Nies Midterm Paper 11/29/12 255--Meal Design and Management anorexia nervosa. Extended media coverage on her sudden death gave more public attention to the cause and spurred other celebrities, such as Jane Fonda and Lynn Redgrave to share their hardships with the disorder.

References

Anorexia nervosa. (2012, February 8). New York Times, Health. Retrieved from

http://health.nytimes.com/health/guides/disease/anorexia-nervosa/treatment-for-anorexia.html

Anorexia Nervosa Fact Sheet [Fact sheet]. (2009, June 15). Retrieved October 31, 2012, from Women’s

Health website: http://womenshealth.gov/publications/our-publications/fact-sheet/anorexia-

nervosa.cfm#a

Ravin, S. K., Dr. (n.d.). The Functional Role of Nutrition and Anorexia Nervosa: Food is Medicine. Retrieved October 31, 2012, from F.E.A.S.T. website: http://feast-ed.org/TheFunctionalRoleofNutritionandAnorexiaNerv.aspx

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