Rehabilitation from Anorexia

Rehabilitation from Anorexia Nervosa

A literature review was compiled from research founded in PubMed.  In the case of Anorexia Nervosa there are two sub-types, one is restricting-type anorexics and binge-eating/purging type anorexics who restrict eating and exercise, but occasionally binge and purge.  AN patients are in a state of denial about their condition, “Individuals are emotionally shut down. Food restriction, food rituals, and obsessional thinking are coping tools for life.  As the body is nourished, and individual will be more prepared to deal with feelings that emerge “(Intuitive Eating).  Approaches to re-feeding, the restoration of weight, and weight maintenance, have not received enough research. The review revealed common factors in those in rehabilitation. AN patients typically consume a low-calorie diet with a lack of variety, making it hard to reach nutritional needs. Patients must have a higher caloric intake than healthy individual in order to gain weight, because in is during re-feeding that the Thermic Effect of Food for this population is very high. AN patients need 60-100 kcal/kg/day with slow increases overtime in order to maintain at 1-1.5 kg /week weight gain during rehabilitation. Anorexics who have had a history of obesity may gain weight more quickly, but typically Anorexics appear hypermetabolic during re-feeding and require a high amount of calories for weight gain. To avoid re-feeding syndrome, levels of phosphorus, magnesium, potassium and calcium should be closely monitored for several weeks. Consequences of the re-feeding syndrome include cardiac arrhythmias, congestive heart failure, metabolic acidosis, respiratory failure, and more. Due to anxiety toward eating in AN patients, maintaining is seen in only about 50% of individuals after in-patient care, because increased food intake can be overwhelming to maintain. It is important after patient release for ANs to stay focused on their needs for nutrition and reduce obsessive/rigid thinking about food. Behavior modification and positive coping-mechanism with transition is essential.

Helpful Healing Steps

Ø  Healing body-image distortion.

Ø  Wearing less tight clothing,

Ø  Staying away from the mirror,

Ø  Weighing oneself should be limited.

Ø  During rehabilitation one should limit exercise;

Ø  Rigidity in view of nutrition needs to change. Individuals should focus on the body’s needs and food as fuel.

Ø  Getting rest

Ø  Creative stimulation

Ø  Expressing feelings/ sit-down with feelings and experience them

Ø  Being heard, understood, and accepted  (support system)