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Last update : 04/03/2024

Anorexia nervosa: Symptoms, causes and treatment options in Türkiye

Anorexia nervosa is a serious eating disorder characterized by severe food restriction and altered body image. People with anorexia nervosa often have unrealistic perceptions of their weight and appearance. They may believe they are overweight even when they are dangerously thin.

Anorexia nervosa treatments in Turkey offer specialized resources and thorough therapy that addresses the psychological and physical components of this difficult disorder.

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What is Anorexia Nervosa?

Anorexia nervosa is an eating disorder that primarily affects women. It is characterized by a gradual and increasing reduction in caloric intake, often accompanied by excessive and compulsive exercise, leading to progressive loss of body weight.

Weight loss is relentlessly pursued by patients with little or no concern for the damage it does to their health. They also have an intense fear of gaining weight and an unwillingness to maintain a healthy body weight (typically between 18.5 and 25 BMI points).

Causes of anorexia nervosa

The causes of Anorexia Nervosa (AN) are unclear, although most of our specialists in Turkey believe that it results from a combination of several factors.

Psychological factors

Individuals with childhood anxiety disorders or obsessive-compulsive tendencies have an increased risk of developing this form of anorexia. Many AN patients share other behavioral characteristics that predispose them to the disorder, including

  • Difficulty coping with stress.
  • Excessive worry and doubt about the future.
  • Extreme self-perfectionism.
  • Excessive emotional control.

Environmental Factors

The link between anorexia nervosa and cultures that glorify thinness is remarkable. Puberty, marked by hormonal changes and increased stress, can trigger the disorder in predisposed individuals.

Western culture, with its abundant exposure of young girls, and to a lesser extent boys, to media messages extolling thinness, also appears to have an influence.

Genetic and physiological factors

Family history increases the risk of anorexia. Cerebral and hormonal changes may influence the onset of this disorder, although it is unclear whether these changes are causes or consequences of malnutrition. These changes may affect hunger regulation or increase anxiety and guilt about eating.

Signs and symptoms of AN

The signs and symptoms of anorexia nervosa can be divided into physical and behavioral symptoms.

Physical symptoms

Most of the symptoms presented by people with anorexia are related to severe malnutrition. These include:

  • Amenorrhea (absence of a menstrual period for at least 3 consecutive cycles)
  • Hypothermia (<35 °C) with cold intolerance
  • Bradycardia (heart rate <60 beats/minute)
  • Hypotension (pressure <70 mmHg).
  • Dryness of the skin, which tends to be covered with a kind of fine hair and yellowish color (due to an increase in beta-carotene).
  • Generalized skin itching.
  • Abdominal pain and constipation.

Behavioral symptoms

Psychological aspects associated with anorexia nervosa include:

  • Altered perception of body weight and self-image
  • More restrictive eating patterns associated with fear of weight gain
  • Withdrawal from social relationships
  • Increased physical activity

Anorexia nervosa treatment in Turkey

Ideally, anorexia nervosa should be treated on an outpatient basis. However, this is not always possible for all patients.

In some cases, specialized hospital care in Turkey may be appropriate. This would allow for more intensive and appropriate follow-up for patients who require a higher level of care.

Psychotherapy for anorexia nervosa

Effective treatments for anorexia nervosa are exclusively psychological. According to our research in Turkey, cognitive behavioral therapy (CBT) is the optimal choice for the treatment of eating disorders.

CBT-E (cognitive-behavioral therapy for emetophobia) is a specific form of CBT that focuses on the psychopathology of eating disorders. It aims to modify the problematic behaviors associated with the obsession with thinness using specific strategies.

The process of psychological treatment of anorexia in our partner clinics in Turkey includes three stages:

  • The initial stage involves promoting individuals to proactively recognize and address their eating concerns—an essential precursor to initiating transformative actions.

  • In the subsequent phase, there are two primary objectives of utmost importance. Firstly, striving towards attaining an ideal and healthy weight range, specifically a Body Mass Index (BMI) between 19 and 20. Secondly, placing significant emphasis on addressing psychopathology, particularly body image concerns. During this phase, we also work on identifying problematic mental states to prevent regression.

  • The final phase aims to address concerns related to the end of treatment and to prevent the risk of relapse.

Pharmacological treatment of anorexia

According to pharmacological studies conducted in Turkey, the administration of medication does not show any positive impact on the disorder. It is generally recommended to avoid medication during the critical phase of weight loss. Interestingly, depressive symptoms and obsessive-compulsive behaviors tend to improve when weight is regained.

However, if depression persists even after achieving a suitable body weight, the use of antidepressants can be taken into consideration. In some cases, anxiolytics like benzodiazepines, taken before meals, may be an option, although their effectiveness seems to be limited. Antipsychotics are only reserved for the most intricate and challenging cases.

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