Review Article
Year: 2018 | Month: November | Volume: 8 | Issue: 11 | Pages: 279-291
Anorexia Nervosa: A Multi-Faceted Approach for Treatment
Malhotra S R1, Malhotra A2
1Professor (Retd.) Food Science & Nutrition, COHS, CSKHPKV, Palampur, H.P-176061, India;
2Student Researcher, Department of Psychology, Faculty of Arts, University of Delhi-110007, India;
Corresponding Author: Malhotra S R
ABSTRACT
Anorexia Nervosa is an eating disorder which involves self-restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory and physical health due to intense fear of gaining weight or of becoming fat. Effective and evidence based intervention in Anorexia Nervosa is quintessential due to the increasing prevalence, complications and mortality rate. This may include extensive therapy based on the need and medical status of the patient which may or may not require nutritional, pharmacological and psychosocial intervention. A critical review was undertaken on therapeutic treatment and complications of Anorexia Nervosa by understanding the underlying biochemical imbalances and psychosocial stressors. This review sheds light on evidence based research on nutrient intake for weight gain and maintenance along with careful management of refeeding syndrome and hormonal reactions. The outcomes of pharmacological treatments have been discussed. Modified and customized forms of psychological therapies including but not limited to family based therapy, enhanced cognitive therapy and psychodynamic therapy have been highlighted. Treatment methods in this manuscript have been widely used in various societies and yet require research and replicability. Vital access to treatment and recovery can also be hampered by a limited availability of care or lack of care in remote areas, by stigma, poor professional skills and poor understanding of the pathways to care. People with eating disorders can recover but they're at increased risk of relapse during periods of high stress or triggering situations. A holistic, longstanding and evidence based approach would prove to be effective in the treatment of the vulnerable population. Suggestions have been made for future research involving cultural perspectives, body perceptions according to gender and technological advancements.
Key words: anorexia nervosa, nutritional therapy, psychological therapy, stress, nutrient deficiency, weight maintenance