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Anorexia Nervosa

DHYG 122

What is Anorexia?
Anorexia is an eating disorder characterized

Immoderate food restriction
Inappropriate eating habits
Having an obsession with being thin
Irrational fear of weight gain
Distorted body self perception

Anorexia nervosa (AN) is a life-threatening

eating disorder characterized by self-imposed

starvation and excessive weight loss.
Denied the essential nutrients it needs to
function, the starving body dramatically slows
virtually all metabolic processes, causing
significant physiologic damage.
AN is the mental health disorder with the
highest mortality rate.
(Frozena & Schub, 2004)

Subtypes of anorexia
Restricting type: severe limitation of food

intake is the primary strategy for weight loss.

Binge eating/purging type: the patient
regularly engages in binge eating and
subsequent purging.
(Frozena & Schub, 2004)

The exact cause is unknown
Eating problems during infancy or early

Trying to be perfect or overly focused on rules
Many factors can be involved:
Social attitudes
Family conflict

General Characteristics
Many exhibit:
Depressive symptoms
Excessive exercise
Approximately 15 to 20% will starve to death
Eating disorders in America is an obsession with 90

million people attempting to reach their ideal weight.

Extremely thin (15% below expected or original body

Early Symptoms
Low self-esteem
Feeling of lack of control in life
Distorted body image
Misperception of hunger

Middle Stage Symptoms

Compulsive exercise
Menstrual cycle stops
Increased facial and body hair
Fights with family members about eating
Thin, dry scalp

Crucial Stage Symptoms

Denial of problem
Mood swings
Electrolyte imbalance (weakness)
Lassitude cardiac arrest

There are a few tests that can be done to find

the cause of the weight loss and to also see

how much damage the disease has cost.
Bone density tests
Complete blood work up
Organ function tests
Urine tests

Recovering is possible, but they will struggle with fluctuating

weight and the resulting deterioration of their health for

many years.
Once treated, it is common for the disease to return.
Cognitive behavioral therapy is a treatment option.
There are support groups where other individuals who have
this disease can also bring their family members and friends
for help.
Theyre often encouraged to talk to a dietitian for
counseling, where an eating schedule can be made as an
Treatment should include health care professionals which
includes the dental hygienist.

Dental Considerations
Signs of malnutrition
Weight changes

Very low caloric intake
Obsession with diet
and weight
High carbohydrate diet

Increased caries rate

due to high
carbohydrate intake
and xerostomia
Fluoride therapy
Meticulous oral

Professional Interview
Michelle K. BSN
How do you approach people with anorexia

You approach them with open communication,

not forcing them to say it, but telling them that

you are available to talk. It is easier when you
are taking the patients initial information and
asking them if they have currently lost weight,
then you can elaborate.

How often do you see people with anorexia?

For me, I only see maybe one patient a month.
When I didnt work in the cardiac unit, it was maybe
two or three times a month.
What advice/help do you give them?
If they tell you that they have a problem, ask them if
they would like help. If they arent interested in help,
your information will not be used. You can try to
encourage them to get treatment, making sure that
you never accuse them or judge them, but explain
how harmful it can be for their health.

What age group do you see it the most in?

A young woman, probably 15 to 25 years old.
What do you think we should know about

anorexia nervosa?
I would say the most important thing to know

is that its not a choice, it is a disease. They are

not doing it for attention, they cannot just quit,
it will be a constant battle throughout their life.
When people do choose to get treatment, in
therapy they refer to their disorder as ED.
Sometimes they will say ED told me not to eat.



Daniel, S. J., Harfst, S. A., & Wilder, R. S. (2008).

Mosby's Dental Hygiene Concepts, Cases,

Competencies (2nd ed., pp. 848-849). St. Louis, MO:
Frozena, C., & Schub, T. (2004, December 23).
Ebscohost. Retrieved from Anorexia Nervosa:
Stegeman, C. A., & Ratliff Davis, J. (2010). The Dental
Hygienist's Guide to Nutritional Care (3rd ed., pp.
332-335). St. Louis, MO: Elsevier.