Anorexia Nervosa

Who Is at Risk for Anorexia Nervosa?

Anorexia Nervosa may affect many different populations including women and men, as well as people from all racial and ethnic backgrounds. While many different types of people may have anorexia nervosa, approximately 90% of those afflicted are women. Most individuals with the disorder develop it in late adolescence or early adulthood, though onset may occur earlier or later.

Risk Factors for Anorexia Nervosa

Anorexia Nervosa is a multi-determined illness. A variety of environmental and genetic factors may play a role in increasing the risk of developing this disorder. Several of these risk factors include:

• Gender
  Anorexia Nervosa predominantly affects women, with clinical populations generally reflecting approximately a 10:1 female-to-male ratio
• Dieting
  Studies among adolescents have found that engaging in dieting is a predictor of later eating disturbances as well as fear of weight gain, negative body image, and body dissatisfaction
• Temperament
  Individuals who develop anxiety disorders or display obsessional traits in childhood are at increased risk of developing anorexia nervosa
• Environmental
  Historical and cross-cultural variability in the prevalence of anorexia nervosa supports its association with cultures and settings in which thinness is valued. Occupations and avocations that encourage thinness, such as modeling and elite athletics, are also associated with increased risk
• Genetics
  Twin studies suggest that genetic factors may contribute to developing anorexia nervosa

Diagnostic Criteria

• Restriction of energy intake relative to requirements, leading to significantly low body weight in the context of age, sex, developmental trajectory and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than minimally expected.
• Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
• Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight

Subtypes

• Restricting type: During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior (i.e. self-induced vomiting or the misuse of laxatives, diuretics or enemas). This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting and/or excessive exercise.
• Binge-eating/purging subtype: During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e. self-induced vomiting or the misuse of laxatives, diuretics or enemas).

What Treatments are Available for Anorexia Nervosa?

• Inpatient/Outpatient Treatment
  Inpatient treatment is helpful for patients who are in need of weight restoration and have difficulty doing so outside of a structured setting. Typically, these programs have a multidisciplinary team approach that incorporates individual, family and group psychotherapy. The EDRU provides both inpatient and outpatient treatment for patients interested and eligible in the ongoing research studies.
  Day Treatment is available at Columbia University's Eating Disorders Program at 51 W. 51 Street, New York, NY.
• Post-Hospitalization Psychotherapy
  Research has found outpatient Cognitive-Behavioral Therapy (CBT) to be useful in the prevention of relapse following completion of an inpatient program. CBT is a structured psychotherapy that aims to help patients develop a regular pattern of eating and challenge dysfunctional thoughts regarding eating, body shape and weight.
• Family-Based Therapy (FBT)
  Outpatient family-based therapy has been shown to be effective in treating adolescent patients with a recent onset of the disorder.
• Medication
  Currently, there is little evidence that the psychiatric medications that have been studied are helpful for patients with anorexia nervosa, but research on novel medication approaches is ongoing at our clinic and elsewhere.

For additional information, please call (646) 774-8066.