The Relationship Between Weight Recovery And Anorexia Treatment
Sadly, it is rare for a patient with an eating disorder to go to an office quickly. It is a pathology that those who suffer from it tend to have a low awareness of the disease. Their insight—that is, the ability to understand and become aware of their problem and its possible solution—is usually very low as well. Despite being psychological disorders, the root of these particularities in patients seems to be biological.
Thanks to advances in neuropsychology and the possibility of evaluating these cases through imaging studies, it has been possible to determine that these psychological phenomena are determined by prolonged malnutrition, which causes a high cerebral impact. Weight recovery, therefore, cannot be relegated to the background in treating disorders such as anorexia nervosa. In fact, as we will develop in this article, it is closely related to the initiation and adherence of treatment for this pathology.
Anorexia nervosa, according to the ICD-11 diagnostic manual, is an eating disorder (ED) that is characterized by a distortion of the body image and the search for thinness, which could lead to restriction of intake. It is not a minor disorder or one that does not require urgent treatment, since this dietary restriction could ultimately lead to starvation. Fortunately, it is possible to recover from anorexia nervosa. To determine whether or not someone suffers from anorexia nervosa, there are a series of criteria that the person must meet and which are found in diagnostic manuals. This task should be carried out by a doctor or mental health professional.
According to the MSD manual for professionals, two types of anorexia nervosa are usually distinguished.
Causes of an eating disorder
Anorexia nervosa, like other eating disorders, is multifactorially determined. This means that they do not have a possible cause to determine in a univocal and irrefutable manner. However, there are different areas that predispose to an eating disorder, and from which the etiopathogenesis can be conceived.
First of all, there is an undeniable sociocultural dimension that frames EDs. In our Western societies we have developed “diet cultures” in which we tend to value and validate thin bodies over other bodies; to categorize “good” foods and, on the contrary, “bad” ones. On the other hand, EDs can be determined by family factors. The research recognizes that there are no “archetypes” of families that favor a disorder of this type, but there are There are certain dynamics in family functioning that can hinder or promote recovery. Finally, there are also individual factors, in which certain personality types are distinguished, as well as genetic and neurobiological factors that predispose to an ED.
Beyond this, the factors that precipitate the appearance of an eating disorder are fundamentally two. On the one hand, the diet.
A person or adolescent may be predisposed to one of these disorders – due to their context and individual characteristics – but they will rarely develop an eating disorder if they have not carried out or been suggested a restrictive diet. On the other hand, the other phenomenon that could trigger an eating disorder if these predisposing factors are present is stress.
Regarding the treatment of anorexia nervosa, it has been shown that this must be carried out by an interdisciplinary team, which includes psychiatrists, psychologists and nutritionists, who are capable of addressing the different layers that make up this disorder. First, these treatments tend to target the patient’s nutrition. Only in this way will it be possible to address the problems linked to mental health in a second moment. As we mentioned at the beginning of this article, anorexia nervosa generates neurobiological abnormalities, altering the neurochemical circulation of the brain, which could affect treatment.
Prolonged malnutrition is what produces this cerebral impact. It has been shown that patients with a BMI below 19—a value that should not be interpreted by the general population but rather by the professional team—tend to have the low insight that we mentioned before. Low weight sows greater possibilities of the appearance of other psychiatric pathologies ; It is also related to relapses and generates serious psychological symptoms that, however, usually disappear when weight is regained.
Therefore, weight regain is key to enabling treatment. Without attending to the “bio” dimension it is impossible to attend to the “psi” dimension. It is essential that patients reach the point of receiving psychological treatment with the aim of unraveling what behaviors and/or cognitions sustain this pathology. But, to do this, they must first be nourished. In line with this, as Lenoir and Silber forcefully point out: “psychotherapy is not compatible with a hungry brain.”
The therapeutic process is fundamental, but there must be a biological aspect that sustains it, that acts as a soil. Only in this way will the patient understand that what is happening to him is valid, that it is having a negative impact on his life and that, to improve, it requires his commitment to the treatment. It is the nutrition professional who will be in charge of promoting weight gain. Although medication is less common in anorexia nervosa than in other EDs, a psychiatrist can also intervene in this first instance of treatment, given that some eating disorders give rise to certain comorbidities such as anxiety disorders or depression.
Lastly, we highlight the crucial role of interventions on the family of the person with the eating disorder, since they will be the allies of the interdisciplinary team. Family and friends are the ones who will seal adherence to treatment. All of these pillars allow psychotherapy to be carried out and the psychologist to determine to what extent the connection that the patient has with food expresses its relationship with what happens at the level of emotions and thought.
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