Research and examine the biomedical, individual, and group approaches to treatment.

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Anorexia Nervosa

The biggest obstacle in treating anorexia nervosa is allowing the patient to recognize that they have a disorder. Most people who have anorexia nervosa deny that they have an eating disorder. Individuals often only enter treatment when the condition of the disorder becomes more serious. Anorexia may seem like a simple disorder to treat, but in reality it is very difficult because it requires the patients and any people involved to work extra hard. Many different therapies may be tried on each individual, but not all of them may necessarily be effective enough to cure, so having many different ways of treatment benefits not only one individual, but the entire population. (“New York Times”)


Treatments:

Biomedical

For the biomedical approach to treating anorexia nervosa, one possible form of treatment to cure this type of disorder is through hospitalization. However, hospitalization has proved to not be as reliable as compared to the other ways of treatment. Besides it being one of the more ineffective ways of treatment, there are positives to hospitalization. Patients who are hospitalized would be carefully monitored through staff members, thus preventing any attempts at binge eating and vomiting. (Slowik) Different settings are available in which hospitalization can happen, including general hospitals, psychiatric hospitals, and specialized eating disorders programs. Although there are the positive and negative sides of each of these settings, treatments can be successful within all of them. In severe cases of anorexia, subjects may be required to be fed through a tube that is placed in their nose and goes to the stomach. (“Mayo Clinic Staff”) Medication is another form of treatment as there are antidepressants, antipsychotics, and mood stabilizers that are able to help anorexic patients. Some of these include antidepressants (amitriptyline), olanzapine, and selective serotonin reuptake inhibitors (SSRIs). (“Medline Plus”) Although these drugs do present a change, there is not a specific medication that has been proven to be able to decrease the weight of an individual. An example could be an individual who takes Prozac, and the symptoms that he receives from taking it could lead to depression or stress. Through the use of medication, it will not necessarily cure anorexia nervosa, but it would definitely reduce the likelihoods of showing any symptoms of this disorder.


Individual

There are many different ways to approach treatment in the individual sense for anorexia nervosa. One approach of treating this disorder is through individual psychotherapy. This approach is considered one of the “cornerstones of treatment for anorexia nervosa, especially for people who are beyond adolescence and who are not living at home.” (Slowik) This form of therapy allows individuals a safe place to learn how to identify concerns, come up with solutions to problems, overcome fears, and test out new skills. The first goal for treatment is to restore the subjects’ body weight back to a healthy one. It is impossible to recover from an eating disorder without being restored to a proper weight and learning about proper nutrition. A psychologist can provide strategies to improve one’s behavior so that they can return to a healthy weight. A dietitian can provide advice towards a healthy diet, and even provide specific meal plans that have calorie requirements that will help one reach their weight goals. Through individual therapy, one can gain a higher self-esteem and learn to better cope with other feelings. One type of talk therapy called cognitive behavioral therapy is used commonly to treat anorexia nervosa. (“Mayo Clinic Staff”) Cognitive behavioral therapy is “a type of mental health counseling (psychotherapy).” (“Mayo Clinic”) Within the therapy, one works with a health counselor (psychotherapist) in a structured way, attending a number of sessions that are limited. By helping one to rid their minds of negative or inaccurate thinking, CBT allows one to view challenging situations more clearer and respond in a more positive and effective manner. (“Mayo Clinic”) Such examples of cognitive-oriented therapies focus on issues such as self-image and self-evaluation which would be beneficial to the subject. Because most people think they have a distorted body image, which is considered one of the most common amongst people, the CBT is a good form of treatment for anorexic individuals.

One research study conducted by Tiffany Rain Carei et. al aimed to assess the effect of individualized yoga treatment on eating disorder outcomes among the adolescents receiving outpatient care for diagnosed eating disorders such as anorexia nervosa, bulimia nervosa, etc. Participants included 50 girls and 4 boys, aged 11-21 years. They were randomized to an 8 week trial of standard care and individualized yoga plus standard care. 27 were chosen to be under standard care and 26 to yoga plus standard care. The standard care was required to meet ethical guidelines. The control group was offered the yoga care after the study was completed as an incentive to continue participation. The outcomes that were evaluated included Eating Disorder Examination (EDE), Body Mass Index (BMI), Beck Depression Inventory, State Trait Anxiety Inventory, and Food Preoccupation questionnaire. The results were that the yoga group demonstrated greater decreases in eating disordered symptoms. The EDE levels decreased over time in the yoga group, while the control group showed decrease but returned to baseline levels of EDE at week 12. Food preoccupation was measured and after each yoga session and significant drops occurred. The BMI levels were maintained by both groups anxiety and depression symptoms decreased over time. Conclusions that the researchers came up with were that individualized yoga treatment decreased the EDE levels at 12 weeks, and reduced food preoccupation immediately following the yoga sessions. (“Pub Med Central”)


Group

The group therapy allows an individual to interact and connect with other subjects who have the same disorder. Being in a group can also bring upon support amongst each other, giving each other tips on how to get rid of habits, etc. These support groups allow anorexic patients to interact with other patients who have the same disorder and share their experiences and thoughts. (“New York Times”) There is however limitations to this approach as groups that are formed solely within the individuals without guidance of any mental health professional may present problems. For some individuals who are anorexic, support groups can lead the individual to want to be the thinnest. (“Mayo Clinic Staff”) Group treatments are not only an appropriate method, but also it is well-known for its “chosen modality as well as its powerful effects.” (“Psych Central”) Some of these groups include may focus more on “task-oriented” topics such as food, eating, body image, interpersonal skills, and vocational training, whilst other groups may look at understanding the psychological factors that may have led to the development of the disorder. (“eHealthMD”)

A study done by Jennifer Couturier et al. wanted to examine the dissemination of Anorexia nervosa which includes its effectiveness, fidelity, and acceptability. Participants were fourteen adolescents with anorexia nervosa ranging in age from 12-17 years. The therapists were trained with a workshop, manual and weekly supervision. Each session was videotaped and rated for treatment fidelity. The pre- and post-treatment assessments were then compared. From this study, the weight of each individual significantly increased by an average of 7.8 kg. Dietary restraint showed significant improvement, as did interoceptive deficits and maturity fears. Out of 9 participants who had secondary amenorrhea, 8 had regained menstrual function. Treatment fidelity was rated at least 72% of the time in phase I of the treatment. This study indicates that this treatment is effective not only for weight restoration, but also in improving psychological symptoms that include dietary restraint, interoceptive deficits, and maturity fears. This form of treatment is considered acceptable to adolescents and parents. (“Pub Med Central”)

Works Cited:
Berger, Fred K. "Anorexia Nervosa: MedlinePlus Medical Encyclopedia." U.S National Library of Medicine. U.S. National Library of Medicine, 18 Apr. 2011. Web. 29 Feb. 2012. <http://www.nlm.nih.gov/medlineplus/ency/article/000362.htm>.

Carei, Tiffany R., Amber L. Johnson, Cora C. Breuner, and Margaret A. Marshall. "Randomized Controlled Clinical Trial of Yoga in the Treatment of Eating Disorders."Randomized Controlled Clinical Trial of Yoga in the Treatment of Eating Disorders. Pub Med Central. Web. 1 Mar. 2012. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844876/?tool=pmcentrez>.

Couturier, Jennifer, Leanna Isserlin, and James Lock. "Family-Based Treatment for Adolescents with Anorexia Nervosa: A Dissemination Study." Family-Based Treatment for Adolescents with Anorexia Nervosa: A Dissemination Study. Pub Med Central. Web. 1 Mar. 2012. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3012128/?tool=pmcentrez>.

Edwards, Roxanne D. "MedicineNet.com." MedicineNet. MedicineNet, Inc., 1996. Web. 29 Feb. 2012. <http://www.medicinenet.com/anorexia_nervosa/page5.htm>.
"Health Guide." Anorexia Nervosa. The New York Times. Web. 29 Feb. 2012. <http://health.nytimes.com/health/guides/disease/anorexia-nervosa/overview.html>.

"Psych Central: Anorexia Nervosa Treatment." Psych Central. Psych Central, 1992. Web. 29 Feb. 2012. <http://psychcentral.com/disorders/sx2t.htm>.

Slowik, Guy. "What Are The Treatments For Anorexia Nervosa?" EhealthMD. 28 June 2011. Web. 29 Feb. 2012. <http://ehealthmd.com/content/what-are-treatments-anorexia-nervosa>.

Staff, Mayo Clinic. "Definition." Mayo Clinic. Mayo Foundation for Medical Education and Research, 05 Jan. 2012. Web. 29 Feb. 2012. <http://www.mayoclinic.com/health/anorexia/DS00606/DSECTION=treatments-and-drugs>.

Staff, Mayo Clinic. "Definition." Mayo Clinic. Mayo Foundation for Medical Education and Research, 16 Sept. 2010. Web. 29 Feb. 2012. <http://www.mayoclinic.com/health/cognitive-behavioral-therapy/MY00194>.