Chapters authored
Patients’ and Carers’ Perspectives of Psychopharmacological Interventions Targeting Anorexia Nervosa Symptoms
In clinical practice, patients with anorexia nervosa (AN), their carers and clinicians often disagree about psychopharmacological treatment. We developed two corresponding questionnaires to survey the perspectives of patients with AN and their carers on psychopharmacological treatment. These questionnaires were distributed to 36 patients and 37 carers as a quality improvement project on a specialist unit for eating disorders at the South London and Maudsley NHS Foundation Trust. Although most patients did not believe that medication could help with AN, the majority thought that medication for AN should help with anxiety (61.1%), concentration (52.8%), sleep problems (52.8%) and anorexic thoughts (55.6%). Most of the carers shared the view that drug treatment for AN should help with anxiety (54%) and anorexic thoughts (64.8%). Most patients had concerns about potential weight gain, increased appetite, changes in body shape and metabolism during psychopharmacological treatment. By contrast, the majority of carers were not concerned about these specific side effects. Some of the concerns expressed by the patients seem to be AN-related. However, their desire for help with anxiety and anorexic thoughts, which is shared by their carers, should be taken seriously by clinicians when choosing a medication or planning psychopharmacological studies.
Part of the book: Anorexia and Bulimia Nervosa
A Collaborative and Therapeutic Approach for Measuring the Correct Body Weight in People with Anorexia Nervosa
Diagnostic criteria for anorexia nervosa (AN) include significantly low body weight, fear of weight gain, and body image disturbance. Being severely underweight is associated with physical health risks, for example, electrolyte disturbances, epileptic seizures, cardiac arrhythmias, organ failure, and sudden death. It is also a perpetuating factor of AN. Therefore, the correct measurement of body weight is necessary for safe clinical management of AN. In clinical practice, there may be a requirement to attain a certain target weight before discharge from inpatient treatment or to prevent hospital admission. Schools, universities, and employers sometimes require a minimum body weight depending on the physical demands of the tasks at hand. Understandably, people with AN are therefore tempted to falsify their weight, for example, by water loading or using weights, to circumvent these restrictions and avoid disadvantages resulting from their mental health condition. In this chapter, we consider how to obtain an accurate assessment of body weight in the best possible collaborative, therapeutic, and motivating way.
Part of the book: Weight Loss - A Multidisciplinary Perspective [Working title]