Individuals with anorexia nervosa are usually people of normal or slightly abovenormal weight who start on an "innocent" diet and eventually begin suppressing hunger sensations to the point of self-starvation, according to the California Medical Association's July/August 1989 Health Tips. They may subsist on as few as 250 calories a day. The causes of anorexia nervosa are primarily psychological, although some people with the disorder may have a genetic predisposition which can be triggered by psychological factors. Psychological factors are suspected because the vast majority of anorexics are Caucasian, North American women between the ages of 13 and 22. Many of these women are starting to menstruate or have just graduated from high school. The widespread pressure on these women to diet and stay thin just as they enter society may contribute to anorexia.

Treatments for Anorexia Nervosa

Treatment for anorexia typically involves reducing patients' fears of a normal body weight by encouraging them to gradually regain their natural body weight. Group support and medication play an important role in subsequently reducing their anxiety about eating. Some nutrient supplements and nasogastric or intravenous feeding also have proven successful. Nutritional supplements alone are usually insufficient, however, because the underlying psychological causes must be treated as well.

The diet for an anorexic prescribed by a physician should reflect nutrient needs and identify energy allowances that take into account the degree of starvation. For these patients, relatively small, gradual increases are usually made in caloric level of the diet during treatment. It is very important, however, that meal plans always consider individual needs.

Weight Gain Diet Guidelines for Anorexics

1. Restore satisfactory nutritional state, preferably through the patient's own efforts.

2. Restore adequate weight and normal eating patterns.

3. If necessary, give patients intravenous feedings to restore fluids and electrolytes.

4. Immediately set goal weights, individualized on their understanding of their growth patterns and growth need.

5. Make sure not to reinforce compulsive rituals and preoccupation with food that often cause anorexia in the first place.

Kenneth Burns

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