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Anorexia nervosa is an eating disorder where excess weight loss and lack of inappropriate weight gain as the indicators. Anorexic patients usually restrict the amount of calorie intake and have a narrow range of food preferences. Other than that, excessive and compulsive exercise, as well as purging or vomiting and use of laxatives is usually associates to anorexic behaviour in order for them to lose weight. In normal people, they will easily gain weight if they increase their food intake, but not for anorexic patients. Marzola et. al (2013) explains that anorexic patients tend to become hypermetabolic where they are resistance to gain weight. Hence, a large amount of food is needed for anorexia nervosa patients to gain weight.
They are many nutrition intervention and strategies for treating anorexia nervosa patients. Marzola et. al. also suggests that in order to treat anorexic patients, the caloric restoration can be improved by increasing the variety of foods that are prescribed for the patients. This is because usually, they have a limited preference for food. In addition, this is important to replenish the essential micronutrients and macronutrients loss during the restriction period. During the restoration period, it is important to emphasize on meeting the required nutrients. This can be achieved through improved food intake. Improved food intake is said to help to reduce the anxiety and resistance to re-feeding.
For example, food containing protein with high biological value like whey, casein and egg whites are recommended in order to treat anorexic patients. This is because this kind of foods has a higher concentration of amino acid per gram. Other than that, protein food sources like fish and poultry are also recommended. Next, anorexic patients usually avoid consuming energy-dense foods which mainly contains fat in it. Thus, they will have a lower level of fats in their body which can alter their bodily function from functioning properly. In order to replenish those fats, lipids-rich foods which mainly found in fish, meat eggs are recommended during treatment. Complex carbohydrates like bread, rice and potatoes as well as fruits, fruit juices and vegetables also being recommended to the anorexic patients. Lastly, for vitamin and minerals, the amount of it recommended by the RDA can be met by the supplement in liquid or tablet form. Other than anorexia nervosa, there are also other intervention and strategies for treating other eating disorders like bulimia nervosa and binge eating in terms of behavioural modification. For example, Cognitive Behavioral Therapy (CBT) helps in cognitive restructuring of the eating disorder patients.
Faulty beliefs about the relationship between eating patterns and physical symptoms are replaced with more accurate perceptions and interpretations. CBT has been proven to be effective at lessening the binge eating behavior and helps in normalizing cognitions in individuals with bulimia nervosa (Varchol, L. and Cooper, H. ,2009) Besides CBT, other behavioural modification strategies like Dialectical Behavior Therapy (DBT) has also become increasingly popular as an eating disorder treatment. DBT helps in correct emotional dysregulation which is one of the factors and behavior for individuals with eating disorder. During DBT, new coping skills are taught and practiced. The aim for this DBT is to replace the eating disorder behavior with more constructive ones and reducing high risk behavior as well as increase respect for self. Varchol, L. and Cooper, H. (2009) suggests that DBT can reduce binge eating and purging symptoms in selected population.
Other strategies for psychotherapy in adults like interpersonal therapy, psychodynamic therapy, family and group therapy as well as self-esteem enhancement may also be helpful To conclude, the restoration of nutrient status for anorexia nervosa patients should start slowly and the increment in weight should be gradual. We have to focus on the nutrient intake for eating disorders patients rather than caloric intake. Psychotherapy also is needed to encourage them to change their behaviour.
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