1. Nikki Nies
Midterm Paper
11/29/12
255--Meal Design and Management
ANOREXIA NERVOSA
WORD COUNT:
FLESCH READING EASE: 32.6
FLESCH-KINKAID READING LEVEL: 12.0
NIKKI NIES
11/29/12
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2. Nikki Nies
Midterm Paper
11/29/12
255--Meal Design and Management
Background/Introduction:
With the constant pressures received from friends, family and social media, it is understandable
people may fall prey of the certain beliefs. Anorexia nervosa may not be the first condition that
comes to mind of one of the many eating conditions, but it is one that sparks
Intense fear of gaining weight; limits food intake and constantly thinks about food even though
already at a health weight. There are psychological factors, a way to get a sense of control back
in one’s life. It is often an outlet for anger, tension and anxiety, with many battling the disorder
described as anxious, emotionally reactive and sensitive (Ravin, n.d.).
An imbalance between ventral brain circuits, which regulate reward and emotion and dorsal
circuits, which are associated with consequences and planning ahead (Ravin, n.d.). Disturbances
in the serotonergic system contribute to the vulnerability to restricted eating, behavioral
inhibition and excessive concern about the negative consequences of eating and gaining weight.
One exposed to misperceived hunger, little pleasure from food and the calm and mood elevating
effects of food restriction can create a strong predisposition towards developing anorexia nervosa
(Anorexia Nervosa Fact Sheet, 2009).
The combination of very high-energy requirement and dietary restriction can easily stimulate
AN.
An anorexia often has low body weight for his or her own height, resists keeping a normal body
weight; has an intense fear of gaining weight; thinks she or he is fat when in actuality he or she is
thin; misses three or more menstrual periods in a row.
Predominantly, young women in adolescence and women are mostly impacted by anorexia.
Stress of assimilating to the American concept of “thin” can cause many minorities to develop an
eating disorder.
The criteria to be considered anorexic, is, but not limited to: culture, families, life changes or
stressful events, personality traits and genetics. In America, there is a consistent amount of what
constitutes as beautiful and what “mold” one needs to fit into to be accepted in society. Many
role models and super models today are not the normal everyday body type, but have been air
brushed and digitally altered to make the “perfect” woman. Many women are afflicted with the
battle of embracing their own skin and limiting themselves to culture’s skewed standards.
The likelihood of anorexia increases when a mother or sister has already suffered from the
disorder. Many times, parent’s views are passed down to their children, so if they have a
negative body image, value looks highly and criticize their children’s body often, it can have a
negative impact on children in the future.
Traumatic events and stressful situations can alter one’s eating habits, feeling that they are able
to control one aspect of his or her life, if an uncontrollable event occurs.
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3. Nikki Nies
Midterm Paper
11/29/12
255--Meal Design and Management
Often one that is a perfectionist, sets impossible standards and has an insatiable attitude, can fall
into the trap of anorexia nervosa.
Sometimes, anorexia is unavoidable as one can receive a gene, hormone or chemical imbalance
in the brain that encourages the development of anorexia.
Characteristics/Diet Concerns and treatment of condition:
Anorexia limits the amount of nutrients consumed, which limits the body’s ability to maintain its
regular functions.
Anemia can occur from a lack of iron. Limiting one’s bodily fluids, there can be subpar amounts
of potassium, magnesium and sodium intake. Also, a permanent loss of bone calcium can lead to
fractures and lifelong problems of osteoporosis. Imbalance of electrolytes
With medical care, one can get better with a support group including doctors, nutritionists and
therapists. A team of specialists can help guide someone return to a healthy weight, treat any
associated psychological issues in regards to anorexia, help the person eliminate any negative
thoughts that instigate the anorexic behavior. In addition, medicines such as mood stabilizers,
antidepressants and antipsychotics can be used to maintain a healthy perspective of one’s weight.
Family therapy is an encouraged part of treatment. Usually it starts with motivational
psychotherapy and once weight is restored, can go on to cognitive behavioral therapy, which
cements positive thinking and reduces chances of relapse.
The psychological issues can include irrational thinking, mood swings, easily irritated, bad
memory, fainting and changes in brain chemistry. The contrast in feelings when one avoids
eating is feelings of alertness, energetic and calm when fasting, as opposed to those that do not
suffer with the disorder, who feel tired, irritable and sluggish when under eating occurs (Ravin).
A weight gain goal of 2-3 pounds a week for hospitalized patients and 0.5-1 pound a week for
outpatients. Patients usually start with 1000-1600 calories a day, leading up to 2000-3500 a day.
Fluid retention is common in the healing process, as it is a response to weight gain.
Often times, in addition to therapy and weight gain, calcium, zinc and vitamin D supplements are
advised ("Anorexia Nervosa," 2012, p. [Page #]). Even if one is not zinc deficient, it has
been found that it can improve one’s overall weight gain. Studies have shown
consumption of DHA and EPA has provided rapid improvement in severe cases.
Summary/Conclusion (word count:
Anorexia stems from Hellenistic times of fasting. Early sufferers include Mary, Queen of Scots
and Catherine of Siena. However, anorexia nervosa was not accepted as a medical condition
until the 19th century and limited to the medical profession until late 20th century. Once
anorexia nervosa was included in the Diagnostic and Statistical Manual of Mental Disorders,
more information was opened to the public and more exposure to the disorder allowed more
treatments to become available. Hilde Bruch’s The Golden cage: the Enigma of Anorexia
Nervosa is credited with given anorexia a broader range of exposure, beyond the medical
profession. Karen Carpenter, an American vocalist and drummer, died suddenly from heart
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4. Nikki Nies
Midterm Paper
11/29/12
255--Meal Design and Management
failure, related to anorexia nervosa. Extended media coverage on her sudden death gave more
public attention to the cause and spurred other celebrities, such as Jane Fonda and Lynn
Redgrave to share their hardships with the disorder.
References
Anorexia nervosa. (2012, February 8). New York Times, Health. Retrieved from
http://health.nytimes.com/health/guides/disease/anorexia-nervosa/treatment-for-anorexia.html
Anorexia Nervosa Fact Sheet [Fact sheet]. (2009, June 15). Retrieved October 31, 2012, from Women’s
Health website: http://womenshealth.gov/publications/our-publications/fact-sheet/anorexia-
nervosa.cfm#a
Ravin, S. K., Dr. (n.d.). The Functional Role of Nutrition and Anorexia Nervosa: Food is
Medicine. Retrieved October 31, 2012, from F.E.A.S.T. website: http://feast-
ed.org/TheFunctionalRoleofNutritionandAnorexiaNerv.aspx
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