Anorexia nervosa is an eating disorder characterised by the desperate pursuit of thinness, severe food restriction, an intense fear of weight gain and refusal to maintain a medically healthy body weight, and a distorted image of one's body and weight, wherein the patient sees herself as overweight no matter how underweight she may be. (1) Since the initial recognition of anorexia nervosa as an illness in the late 19th century, the treatment and assessment of such has grown and evolved. With incidence rates of anorexia nervosa peaking between the ages of 15 and 19 in young women, and with this condition among the psychiatric disorders with the highest rates of mortality (2), the importance of adolescent-focused treatment cannot be overstated.
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Criterion B refers to an intense fear of fatness and weight gain, and criterion C the body image disturbances causing people with anorexia nervosa to view themselves as overweight, to believe that body weight holds an overstated importance in their value, and to not recognise the severity of their low body weight if made aware of it. (5). In this assessment, the therapist must be gentle in introducing the topic and ascertaining the young person's thoughts, attitudes, and beliefs revolving around eating. An interview with the young person's parents, both if at all possible, will also aid in the diagnosis; parental concern will often lead to a much less positive picture of the young person's eating habits and self-esteem than will the young person, who may be inclined towards concealment, minimisation, or non-acknowledgement of their problem. (6) These interviews should discuss the history of the young person's illness, any comorbid conditions, any clinically relevant personality traits such as perfectionism or obsessiveness, and undertake a HEADSS assessment to determine the young person's background and any relevant risk factors for poor mental health outcomes. …show more content…
Given the different stages of development teenagers undergo, it may be difficult to determine where a teenager's weight should lie; with the Body Mass Index being unreliable for adolescents, and the adolescent's expected weight being difficult to determine given her stage of development, a young person with disordered eating patterns may not have reached a weight considered significantly low. This also does not allow for an early diagnosis of anorexia nervosa, as a young person who meets criteria B and C may not have lost enough weight to fulfil criterion A. pThis is particularly evident if the young person was overweight and her weight loss brings her to an average weight rather than a significantly low weight; when this is the case, but the patient meets criteria B and C, this is considered to be atypical anorexia nervosa (5). One criterion removed from the DSM-V is the physical symptom of amenorrhoea, the loss of menstrual periods for at least three months; the removal of this as a criterion reduces potential conflict in the assessment of adolescents, as it may not be relevant to males, premenarchal girls, and those taking hormonal contraceptives. With patients frequently hiding their illness and presenting as compliant perfectionists, they may not receive any kind of assessment or treatment until their weight becomes dangerously low; by this
Criterion B refers to an intense fear of fatness and weight gain, and criterion C the body image disturbances causing people with anorexia nervosa to view themselves as overweight, to believe that body weight holds an overstated importance in their value, and to not recognise the severity of their low body weight if made aware of it. (5). In this assessment, the therapist must be gentle in introducing the topic and ascertaining the young person's thoughts, attitudes, and beliefs revolving around eating. An interview with the young person's parents, both if at all possible, will also aid in the diagnosis; parental concern will often lead to a much less positive picture of the young person's eating habits and self-esteem than will the young person, who may be inclined towards concealment, minimisation, or non-acknowledgement of their problem. (6) These interviews should discuss the history of the young person's illness, any comorbid conditions, any clinically relevant personality traits such as perfectionism or obsessiveness, and undertake a HEADSS assessment to determine the young person's background and any relevant risk factors for poor mental health outcomes. …show more content…
Given the different stages of development teenagers undergo, it may be difficult to determine where a teenager's weight should lie; with the Body Mass Index being unreliable for adolescents, and the adolescent's expected weight being difficult to determine given her stage of development, a young person with disordered eating patterns may not have reached a weight considered significantly low. This also does not allow for an early diagnosis of anorexia nervosa, as a young person who meets criteria B and C may not have lost enough weight to fulfil criterion A. pThis is particularly evident if the young person was overweight and her weight loss brings her to an average weight rather than a significantly low weight; when this is the case, but the patient meets criteria B and C, this is considered to be atypical anorexia nervosa (5). One criterion removed from the DSM-V is the physical symptom of amenorrhoea, the loss of menstrual periods for at least three months; the removal of this as a criterion reduces potential conflict in the assessment of adolescents, as it may not be relevant to males, premenarchal girls, and those taking hormonal contraceptives. With patients frequently hiding their illness and presenting as compliant perfectionists, they may not receive any kind of assessment or treatment until their weight becomes dangerously low; by this