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Anorexia Nervosa Assessment

Anorexic-rex and Assess-man
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Anorexia nervosa is an extreme eating disorder characterized by fear of gaining weight, excessive dieting, distorted body image, decreased bone density, lanugo, amenorrhea, and anemia. Generally, patients with anorexia nervosa will have a low body mass index (BMI). Adolescent girls are at a high risk of developing anorexia.
10 KEY FACTS
Adolescent Girls
Teen Girls

Adolescent girls are one of the populations most affected by anorexia nervosa. Adolescent girls should be assessed for signs of distorted body image and extreme weight loss.

Fear of Gaining Weight
Fear of Up-arrow Weight-scale

Anorexia nervosa involves a highly distorted body image and a severe fear of gaining weight. Those suffering from the disease go through great lengths to lose weight such as excessive dieting, purging, and excessive exercise.

ASSESSMENT
Excessive Dieting
Excessively-small Amount of Food on Nutrition-plate

Those with anorexia nervosa engage in excessive dieting practices due to a distorted body image and fear of gaining weight. These excessive dieting habits include, purging, use of laxatives and diuretics, and excessive exercising. Those with anorexia nervosa may be seen cutting their food into tiny bites and moving it around their plates without eating much. If a patient loses 30% of their weight within six months, it is important to consider hospital admission.

Distorted Body Image
Distorted Body Mirror-image

Anorexia nervosa stems from a heavily distorted body image. Generally, patients with this disorder will weigh less than 75% of their necessary body weight.

Decreased Bone Density
Down-arrow Bones

Anorexia nervosa may lead to decreased bone density due to decreased estrogen levels and reduced calcium intake.

Stress Fractures
Stressed-bones with Fractures

Due to decreased bone density and strength, bones are at increased risk for fracture when stress is applied. This occurs as a result of decreased nutritional intake and hormonal imbalances.

Lanugo
Lamb-new-coat

When anorexia nervosa becomes severe, weight loss is so extreme that the body is no longer able to insulate itself. The body produces tiny white hairs called lanugo all over in an attempt to compensate for insulation.

Amenorrhea
Amen-tampon

Anorexia nervosa, when severe, may cause amenorrhea. This occurs because the body is not receiving adequate nutrition and therefore estrogen production decreases, increasing the risk of osteoporosis and fractures. This symptom is not required for diagnosis.

Anemia
Anemone

Decreased nutritional intake that occurs with anorexia nervosa often results in anemia because the necessary requirements of proteins, vitamin B, and iron are not being met with the extreme dieting.

DIAGNOSTIC CRITERIA
BMI < 18.5
Body on Index-card with (18) ID and (5) Hand

In order to diagnose a patient with anorexia nervosa, he or she must have a low body weight compared to age-related norms, in addition to the above symptoms and signs.

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