Anorexia and Bulimia nervosa.
The person chooses not to eat.
Intense fear of becoming obese even under weight. Weight perception: feeling fat
when thin. Excessive exercise and induced vomiting. Abuse of laxatives, diuretics,
and appetite suppressants. Dieting and excessive importance to weight reduction.
Stages: binge eating, remorse, vomiting and concealment.
Amenorrhoea, when not on pill, more than 3 cycles absent.
Feeling self worth as being embodied in shape and weight. Depression and suicide attempts coexist.
View: struggle for identity and control.
Physical complications: sensitivity to cold, constipation, amenorrhoea, faints, weakness, fatigue, BP¯, glucose¯, K+¯.
Parental preoccupation with food may precipitate and sometimes leave the person without a sense of identity.
Management: if extremely weak - prompt admission to the hospital under the mental health act.
IV feeding and work on building a trusting relationship. Gaining weight: targets and aims.
Treat the medical complications of starvation. Help building relationships. On admission privileges are removed and restored as weight increases.
Cardiac complications are the commonest cause of death.