EARLY RECOGNITION AND PREVENTION OF ANOREXIA IN ADOLESCENT AGE
Keywords:
anorexia, amenorrhea, adolescenceAbstract
Introduction: Anorexia nervosa is an eating disorder that manifests itself when a person refuses to eat an adequate amount of food or is unable to maintain a minimum body weight and a corresponding Body Mass Index (BMI). Anorexia is a mental disorder that is extremely serious because in 6-20% of cases it can be fatal.
Methodology: A female 23-year-old patient, with no previous medical history was examined in the Service for Students Health due to symptoms of fatigue and tiredness. Her physical finding was normal, and BMI was 19 at that stage. Due to lack of menstrual cycle the gynecologist was consulted and diagnoses polycistic ovaries was made. Further decline of BMI to 17.2 was detected.
Six months later, the patient had a BMI of 15.8, spontaneous tooth loss, and an irregular menstrual cycle despite hormone therapy. The patient was examined by hematologist, endocrinologist, gastroenterologist, nephrologists and infectologist. She continually gave the impression that she was interested in her health status, and she denied any diet problems.
Anorexia was suspected at the next check up when her BMI was 13 (TV 159cm, TM 33kg)..She was hospitalized at Psychiatry Unit with a value of BMI 11.5 (TM 29 kg). Antidepressant therapy and parenteral nutrition were administered.After 5 months of treatment, she gained her weight; TM was 42kg, with a BMI of 16.6.
Conclusion: Prevention of anorexia must be carried out before the onset of the disease. Education in schools about eating habits should be the first step in forming healthy lifestyles.
References
Van Eeden AE, van Hoeken D, Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021;34(6):515-524. doi:10.1097/YCO.0000000000000739
Murray S, Quintana DS, Loeb KL, Griffiths S, Le Grange D. Treatment outcomes for anorexia nervosa: a systematic review and meta-analysis of randomized controlled trials. Psychological medicine.2019;49(4),535-544.
Morawiecka-Pietrazak M, et al. The relationship of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with bone mineral density in adolescent girls suffering from anorexia nervosa. Endokrynologia Polska.2021;72(4):336-346. Pubmed: 34010435.DOI: 10.5603/EP.a2021.0036
van den Berg E, Houtzager L, de Vos J, et al. Meta-analysis on the efficacy of psychological treatments for anorexia nervosa. Eur Eat Disorders Rev. 2019; 27: 331– 351. https://doi.org/10.1002/erv.2683
Herpertz-Dahlman B. Intensive treatments in adolescent anorexia nervosa. Nutrients 2021, 13(4), 1265; https://doi.org/10.3390/nu13041265
Bulik CM, Carroll IM, Mehler P. Reframing anorexia nervosa as a metabo-psychiatric disorder,Trends in Endocrinology & Metabolism.2021;32(10):752-761. https://doi.org/10.1016/j.tem.2021.07.010.