Medical history (history of illness) is an important component in the diagnosis of anorexia nervosa (anorexia). Family history Are there any mental illnesses (e.g., eating disorder, depression) in your family that are common? Social history What is your profession? Is there any evidence of psychosocial stress or strain due to your family situation? How can … Anorexia Nervosa: Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Diabetes mellitus (diabetes). Hyperthyroidism (hyperthyroidism) Cystic fibrosis (cystic fibrosis, ZF) – genetic disease with autosomal recessive inheritance, characterized by the production of secretions in various organs to be tamed. Mouth, esophagus (food pipe), stomach and intestines (K00-K67; K90-K93). Chronic inflammatory bowel disease such as ulcerative colitis or Crohn’s disease. … Anorexia Nervosa: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by anorexia nervosa (anorexia): Blood, blood-forming organs – Immune system (D50-D90). Anemia (anemia), usually iron deficiency anemia (anemia due to iron deficiency). Immunodeficiency (eg, leukopenia) – weakness of the immune defense. Endocrine, nutritional and metabolic diseases (E00-E90). Electrolyte imbalances (derailment of blood … Anorexia Nervosa: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes [accompanying symptom: dry scaly skin]. Oral cavity [accompanying symptoms: sialosis (enlargement of the salivary glands); dental caries] [due topossible sequelae: tooth damage up to the fall … Anorexia Nervosa: Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count [anemia Anemia): 40% of cases, usually iron deficiency anemia; leukocytopenia (decreased number of leukocytes (white blood cells) in the blood): 30% of cases, mostly granulopenia (decreased number of granulocytes, belong to the leukocyte group, in the blood); thrombocytopenia (decreased number of platelets … Anorexia Nervosa: Test and Diagnosis
Therapy goals Weight gain Avoidance of complications or secondary diseases Therapy recommendations Indications for inpatient treatment (hazard indicators): Underweight: BMI < 15 kg/m2 or below the third age percentile in children and adolescents. Bradycardia with heart rate < 40/min Blood pressure < 90 to 60 mmHg Fasting glucose (fasting blood sugar) < 60 mg/dl Potassium … Anorexia Nervosa: Drug Therapy
Obligatory medical device diagnostics. Electrical impedance analysis (measurement of body compartments/body composition) – to determine body fat, extracellular body mass (blood and tissue fluid), body cell mass (muscle and organ mass), and total body water including body mass index (BMI, body mass index) and waist-to-hip ratio (THV). Electrocardiogram (ECG; recording of the electrical activity of … Anorexia Nervosa: Diagnostic Tests
A deficiency symptom may indicate that there is an insufficient supply of vital nutrients (micronutrients). The complaint anorexia nervosa indicates a micronutrient (vital substance) deficiency for Vitamin B1 Zinc A risk group indicates the possibility that the disease may be associated with the risk of micronutrient deficiency (vital substances). The complaint anorexia nervosa indicates a … Anorexia Nervosa: Micronutrient Therapy
To prevent anorexia nervosa (anorexia), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Recurrent dieting behavior Restrained eating behavior Psycho-social situation Fear of obesity Fear of being overworked Emotional neglect Family factors such as overprotection and conflict avoidance. Lack of self-esteem Physical abuse in the past Psychiatric disorders such as … Anorexia Nervosa: Prevention
The following symptoms and complaints may occur together with anorexia nervosa (anorexia): Leading symptoms Fear of gaining weight Excessive weight checks several times a day Very greatly increased physical activity Avoidance of high-calorie food to almost complete abstention from food Eating slowly “Purging” behavior (i.e., self-induced vomiting or misuse of laxatives (purgatives), diuretics (dehydrators), or … Anorexia Nervosa: Symptoms, Complaints, Signs
Pathogenesis (development of disease) The origin of anorexia nervosa is not yet fully understood. Several factors play a role. Primarily, neurochemical, metabolic, and hormonal changes are discussed. In addition to genetic disorders (see “Genetic burden” below) of the serotonergic (affecting serotonin levels) system, psychosocial and social factors seem to play a major role: Psychosocial factors: … Anorexia Nervosa: Causes
Treatment of anorexia nervosa should be disorder-oriented and take into account the physical aspects of the disease. The healing process usually requires many months, usually several years. For indications for inpatient therapy, see “Drug therapy” below. In the context of inpatient treatment, the goal should be a weight gain of 500 g to a maximum … Anorexia Nervosa: Therapy
