100 Questions & Answers About Anorexia Nervosa

Title......Page 5
Copyright......Page 6
Contents......Page 9
Foreword......Page 13
Preface......Page 17
Acknowledgments......Page 19
Introduction......Page 21
Patient Biographies......Page 23
Part One: Overview of Anorexia Nervosa......Page 25
1. What is anorexia nervosa?......Page 26
2. How is the diagnosis of anorexia determined?......Page 27
3. My doctor said I have “atypical anorexia.” What does that mean?......Page 29
5. What are the prevalence rates of anorexia nervosa?......Page 33
6. What is the history of anorexia nervosa?......Page 35
7. Does anorexia occur in males as well? Are there any differences in symptoms between males and females?......Page 37
8. Does anorexia only occur among teenagers?......Page 39
9. Is anorexia dangerous? What are the risks associated with anorexia?......Page 43
10. Can you help me to understand the thoughts and feelings associated with my loved one’s illness?......Page 48
11. Do people with anorexia get better?......Page 51
Part Two: Weight Loss and Other Warning Signs......Page 53
12. I am concerned that my roommate may have anorexia, but I am not certain. Are there any behaviors or warning signs that I should be watching for?......Page 54
13. What is “starvation syndrome”?......Page 58
14. When my doctor weighs me during checkups, she refers to my body mass index instead of my weight. What is the difference?......Page 60
15. What is the “set-point theory” of weight regulation?......Page 61
16. Before my son developed anorexia, I thought it was only a problem for girls. What are some other myths about anorexia?......Page 62
17. It seems like there are many reasons why a person might lose appetite and not eat for a period of time. How can one know if anorexia is the cause?......Page 66
18. I recently read about the misuse of laxatives and other medications to promote weight loss. What should I know about this weight-loss practice?......Page 68
19. What are some of the normal physical and weight changes associated with puberty?......Page 73
20. My daughter recently said she just wants to lose “a little weight” in order to feel better about herself. Should I be concerned?......Page 76
21. I read somewhere that restricting calories is good for you and may even be associated with better health and a longer life. So what is wrong with trying a calorie-restricted diet for health-related purposes?......Page 79
Part Three: Risk Factors......Page 81
22. What causes anorexia nervosa?......Page 82
23. Is it true that most people with anorexia have experienced sexual abuse?......Page 92
24. How does the mass media influence ideas about anorexia and eating disorders?......Page 93
25. What about information on the Internet? Are Web sites about anorexia helpful or harmful?......Page 99
26. Does substance abuse commonly co-occur with eating disorders such as anorexia?......Page 102
27. Sometimes I have an extremely difficult time communicating my emotions. Could this problem be related to my anorexia?......Page 103
Part Four: Special Considerations......Page 107
28. I recently noticed that my sister has scars on her arms and wrists. I am concerned that she may be intentionally hurting herself. Why would she do this?......Page 108
29. What ethnic groups are affected by anorexia?......Page 110
30. I really want to become pregnant, but I’m afraid to because I’m just beginning my journey of recovery. What are some of the effects of pregnancy on women with anorexia?......Page 111
31. I have read that people with anorexia have low self-esteem. Is this true?......Page 112
32. I am a real perfectionist. People tell me I am too “hard on myself,” but I just like to do things well. I also have certain ideas about what my body should look like and specific goals about my weight. Will this interfere with my treatment?......Page 114
33. One thing that I notice about myself is that I have an aversion to sex. This can’t be from the anorexia, can it?......Page 118
34. My daughter has been recovered for a couple of years and is doing well. I am concerned because she has made friends with a couple girls who look really underweight and unhealthy. Should I worry that her friendships could lead to a relapse?......Page 119
35. I think I may have an eating disorder, but I’m not ready to get help for it. I don’t want my family to be concerned, so I’m hiding my weight loss from them. I also usually eat alone and hide how much I exercise from them. I don’t know how much longer I can keep this up. What should I do?......Page 120
36. What effect does anorexia have on relationships?......Page 123
Part Five: Exercise and Athletes......Page 127
37. How much exercise is “too much” exercise?......Page 128
38. How is exercise approached in the treatment of anorexia nervosa?......Page 134
39. Are athletes at greater risk for developing anorexia and eating disorders?......Page 136
40. I thought lower body fat percentage makes you a better athlete, but now I know this is not true. What are some other misconceptions about weight and sports performance?......Page 138
41. What is the “female athlete triad”?......Page 140
42. How can coaches be involved in screening for and preventing eating disorders?......Page 141
Part Six: Body Image Concerns......Page 143
43. What is body image?......Page 144
44. How do I know if I have a healthy body image?......Page 146
46. What is Body Dysmorphic Disorder?......Page 148
47. How does a healthcare professional assess for and treat body image disturbance?......Page 150
48. What are some practical ways to improve body image?......Page 153
49. What can I do to enhance my child’s body image?......Page 155
Part Seven: Support for Loved Ones......Page 157
50. My daughter was recently diagnosed with anorexia, and, needless to say, I am overwhelmed. My life feels like it has been turned upside down. I am scared and tired, but at the same time, I desperately want to be there for her. How can I get through this?......Page 158
51. I know caring for my child will be a challenge, but I’m not sure what to expect. What type of difficulties might I face?......Page 159
52. What do you hear most often from the parents of anorexia patients regarding their experiences? What can I learn from other parents who are facing the same struggles?......Page 160
53. I feel ashamed to tell any of my friends about my child’s eating disorder. I’m not sure I would know what to say even if I tried. What should I do?......Page 164
54. Lately it feels like our lives revolve around our son’s anorexia. Our household rules have nearly dissolved to the point of confusion and chaos. We’re unsure how much we should adhere to his demands with regard to mealtimes and the type of food we serve. Can you give us some help that might take us in the right direction?......Page 165
55. My wife has become more irritable and withdrawn since she became ill with anorexia, and I have difficulty communicating with her. Her eating disorder symptoms seem to compound this problem so that when we do talk, it’s often about her weight concerns. How do I talk comfortably with her?......Page 167
56. What about eating out? My family used to do this regularly, but now my son doesn’t want to go with us because of his eating disorder. Should I insist he go?......Page 169
57. I’m concerned about my college roommate. I really think she has an eating disorder, but I’m scared to approach her. What should I do?......Page 170
58. Our family therapist said my child needs to gain weight, but should I be weighing her at home to track her progress?......Page 172
59. Our daughter has been in recovery for 2 years now and is doing well. She wants to go away to college in the fall, but we’re not sure it is a good idea yet. What should we consider when making this decision?......Page 173
60. What are some practical suggestions for families of loved ones dealing with anorexia nervosa?......Page 174
Part Eight: Weight Restoration, Nutrition, and Healthy Eating......Page 177
62. It has been so long that I need to be reminded—what does “healthy eating” look like?......Page 178
63. What types of foods are included in a healthy, balanced approach to nutrition?......Page 180
64. When my daughter was hospitalized with anorexia, her doctor cautioned us about “refeeding syndrome edema.” What is this condition?......Page 181
65. How is weight restoration achieved, and why is it important?......Page 182
66. When I was struggling with my anorexia, I had a limited number of foods I would “allow” myself to eat. Can nutritional counseling help me learn to expand my food choices?......Page 185
67. How will my treatment team determine my healthy weight range?......Page 187
68. What changes should I expect in my body as I start to return to a healthy weight?......Page 188
69. What is the Maudsley approach to weight restoration?......Page 189
70. Should I take a vitamin supplement when I am in recovery?......Page 190
72. What is orthorexia nervosa?......Page 192
73. A friend of mine was encouraged to keep a food diary when she was in treatment, but I find this worsens my tendency to obsess about food. Should I stop using the food diary?......Page 193
74. I have always thought eating starchy foods would make me gain weight, but my dietitian says this is actually a “food myth.” What are some other food myths?......Page 194
Part Nine: Treatment and Recovery......Page 197
75. How does a healthcare professional evaluate for anorexia?......Page 198
76. What kinds of questions will I be asked during my assessment?......Page 199
77. What kinds of laboratory tests will my physician conduct during assessment?......Page 200
78. How do I choose a treatment team?......Page 201
79. What kinds of professionals are included in a treatment team?......Page 205
80. What is meant by “level of care,” and how does it affect my treatment options?......Page 207
81. What does treatment involve?......Page 210
82. How long does recovery take?......Page 213
83. How will I know when I am getting better?......Page 214
84. What is “transition care,” and how important is it to eating disorder treatment?......Page 217
86. What are some of the psychological treatments currently used for treating anorexia?......Page 218
87. What is “motivational interviewing,” and how can it help with recovery?......Page 222
88. My therapist and my dietitian both use the term “cognitive distortions” when they talk about my eating disorder symptoms. Can you explain what these are and how they may be affecting me?......Page 223
89. How can assertiveness training help with recovery?......Page 225
90. Are there any medications that help with anorexia?......Page 227
91. What should I know about the confidentiality of my child’s discussions in psychotherapy?......Page 228
92. What should I know about insurance and payment for treatment?......Page 229
93. What about self-help for anorexia? Can’t I just try to recover on my own?......Page 231
94. My whole life has been wrapped up in this eating disorder. How can I begin to rebuild a healthy view of myself after so long?......Page 234
95. What are some practical things I can do to make the most of my recovery process?......Page 235
96. How can I prevent a relapse of my symptoms?......Page 237
Part Ten: Prevention and Advocacy......Page 239
98. What are some examples of successful prevention programs?......Page 240
99. What can individuals and families do to help with prevention efforts?......Page 243
100. What is eating disorders advocacy, and how do I become involved?......Page 244
Appendix A......Page 247
Appendix B......Page 251
Bibliography......Page 259
Glossary......Page 261
Index......Page 269