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Treating Anorexia Nervosa

Treating eating disorders is a difficult task for many professionals, not only because many clients are hesitant and there are many barriers to treatment but also because eating disorders are complicated disorders requiring medical, psychological and social intervention from a multidisciplinary treatment team. Medical complications associated with eating disorders can be challenging to treat and can often be missed because many therapists are focused on the emotional and psychological signs, symptoms, and complications associated with disordered eating.

The medical complications associated with the eating disorder can be extensive and if left untreated, can be irreversible. Eating disorders affect every organ system in the body including the brain, heart, gastrointestinal system, endocrine system, musculoskeletal system, and reproductive system. If an individual is engaging in purging behaviors including self-induced vomiting and laxative abuse, then this can cause severe electrolyte disturbances, which can become lethal. As an eating disorder professional, it is imperative to collaborate with primary care physicians and other medical specialists when these complications arise. Regular and consistent weigh-ins, ongoing monitoring of vital signs and laboratory work, bone density scans, and regular dental appointments are crucial steps for your eating disorder client to take during his/her treatment. The following are complications associated with anorexia nervosa:

  • Bloating
  • Constipation
  • Indigestion
  • Malabsorption
  • Early satiety (fullness)
  • Decreased intestinal and gastric mobility
  • Delayed gastric emptying
  • Gastric dilation and rupture
  • Esophageal tears
  • Abnormal heart rhythm
  • Heart failure
  • Bone density loss
  • Infertility
  • Anxiety
  • Depression
  • Kidney failure
  • Electrolyte imbalances
  • Dehydration and malnutrition
  • Fine body hair (lanugo)
  • Hair loss
  • Dry skin
  • Dental cavities (secondary to self-induced vomiting)
  • Delayed puberty (secondary to estrogen deficiency)
  • Stunted growth
  • Osteoporosis (secondary to estrogen deficiency)
  • Amenorrhea (loss of menstrual cycles secondary to estrogen deficiency)
  • Infertility
  • Anemia
  • Seizures
  • Tremors
  • Altered mental status
  • Wernicke’s encephalopathy (delirium, abnormal eye movements, gait and balance problems)
  • Korsakoff’s syndrome (anterograde and retrograde memory loss accompanied sometimes incomprehensible speech)
  • Rhabdomyolysis (muscle breakdown resulting in renal failure)

Individuals who are classified in the binge/purge subtype can specifically develop submandibular/parotid gland swelling characterized by swelling around the jawline and poor dentition secondary to self-induced vomiting which erodes the dental enamel resulting in cavities. Additionally, it is common to find excoriations or scabs and scars on the back of the hands or knuckles in individuals who take part in self-induced vomiting via means of sticking their hands down their throat which causes these breaks in the skin.

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