Teen Anorexia Nervosa Institution

Teen Anorexia Nervosa
Anorexia nervosa (AN) is an eating disorder, some kind of self
starvation characterized by amenorrhea, indistinct body image and low
body weight. There is no known cause of Anorexia nervosa. However, it is
deemed that the disorder is brought about by a complex interaction of
psychological, genetic, socio-cultural and biological factors. An
individual from a family with the eating disorder is not susceptible to
the disease. However, there is heightened interest in the probable role
of neurotransmitter abnormalities in the development of anorexia nervosa
(Eating Disorders Review, 2010). The teens suffering from Anorexia
nervosa also suffer mental health problems as effective or anxiety
disorders. In the near past, the disease has been prevalent among the
adolescents. In estimation, the disease affects at least one out of 100
females in between 16 and 18 years age bracket. Of all the teens
diagnosed with the eating disorder, 5% to 10 % are males. In the past,
the disease was common among the upper and middle class families.
Presently, Anorexia nervosa is common to all socioeconomic groups and a
number of racial and ethnic groups (Eating Disorders Review, 2010).
The identified gold treatment for Anorexia nervosa among teens is
Inpatient psychiatric treatment. In comparison to the outpatient
treatment, this approach has not been cost effective and successful. In
fact, the available interventions have not been comprehensively
researched to identify the best approach. In the near past, Dr. Gowers
and other researchers from British reported the results of a study
carried out on the three interventions available for the treatment of
the eating disorder among teens in the United Kingdom. The treatment
result for Child and Adolescent Anorexia Nervosa (TOuCAN) trial compared
the merits of inpatient psychiatric treatment and two forms of
outpatient management, Community Generic Child and Adolescent Mental
Health Services (CAMHS) and a specialist multimodal multidisciplinary
program developed just for the study (Gowers et al. 2007).
The study aimed at determining whether the teens treated in specialist
outpatient and inpatient services had any merits over those treated in
the general outpatient treatment services. Moreover, the study aimed at
evaluating if inpatient treatment had an advantage over outpatient
treatment. Finally, the study would examine the cost effectiveness and
the success of each of the treatment programs.
The study was randomized controlled, and it was carried out among 215
teens in the 12 to 18 age bracket. Inclusion criteria comprised food
restriction and/or minus compensatory behaviors, fear of weight gain,
less than 85 per cent of the expected weight on the basis of height and
age and secondary or primary amenorrhea. Around 35 centers participated
in the study (Gowers et al. 2007).
The participants were randomly placed on either usual treatment in the
mental health centers including personal cognitive behavior therapy,
parental counseling, self evaluation or dietary advice or the inpatient
management to a specialist. The outpatient treatment lasted for 6
months, while that of inpatient was withheld by the service providers.
From the study, out of the teens who participated, 67 per cent responded
to the treatment they were given. However, the groups allocated in
patient treatment indicated low adherence. A follow up of one to two
years followed each subject. The final result was at 94 per cent at 2
years (47% at 5 years). At all the stages, significant improvement in
all the groups was noted: 19 per cent attained a good outcome at 1 year,
33 per cent at 2 years, and 64 per cent at the 5-year point (Gowers et
al. 2007).
The teens allocated inpatient treatment indicated poor results. This
included the patients who never completed their outpatient management
and had to be referred to the inpatient management. For the first two
years, general treatment was expensive. This was due to the fact that a
good number of the teens were hospitalized after the management phase.
The specialist outpatient management was found to be cost effective.
The teens were satisfied with the treatment in the outpatient management
program. In addition, their parents also expressed positive feedback for
the outpatient management. In comparison, the parent seemed to be more
satisfied with the results than the young people. The young people were
more contended with the specialist than the general treatment. This was
due to their self-assurance in expertise as well as the capability to
create good relationships with their therapists in both the inpatient
and outpatient setting.
How Public School Systems Plays a Role in a Teenage Student Receiving
Schools should play a vital role in managing eating disorders. This is
based on the fact that teenagers spend most of their time there and
thus, tutors have a chance to interrelate with as well as observe the
learners in various ways including academic, social, and eating-linked
situations. This implies that, there is a high possibility of teachers
becoming aware of a specific problem affecting a student prior to the
With the intention of enabling schools to categorize and help students
with Teen Anorexia Nervosa, they should be informed on the current
evidence-based management and treatment. The teachers should be trained
on discovering such eating disorders and how they can deal with the
same. They should also be trained on how to address teenage students who
demonstrate signs related to eating disorders. Preferably, schools
should have a selected resource individual, for instance, a counselor
who should be given the responsibility of guiding interventions linked
with Anorexia Nervosa (Muhlheim, 2012). Besides, they should have
available resources where the identified students should be referred.
School nurses are usually distinctively prepared to evaluate and devise
a nursing care plan and diagnosis for a teenage student who has been
identified and receiving treatment for Teen Anorexia Nervosa. As
required, the nurse engages the student’s family for more
intervention. Through the use of health education, the school nurses are
able to categorize the teenage students early. The school nurse is given
the responsibility of carrying out periodical follow-ups and assessments
including blood pressure, pulse and weight check-ups. According to
studies, the nurses play essential responsibility in promoting superior
therapeutic success as well as improved school achievement in the
treatment and management of a teenage student with Anorexia Nervosa
(Muhlheim, 2012).
The public schools systems offer an environment that enhances and
features healthy behaviors and body image. This is achieved by ensuring
that, the school restaurant offers only nutritious foods whilst
discouraging the provision of unhealthy foods. Some schools also offer a
curriculum that is intended at promoting acceptance of one’s size and
healthy eating. The most remarkable one is written by Kathy Kater
(2005). Such a curriculum aims at discouraging dieting, creating
awareness, and educating the teenage student on matters pertaining to
eating disorders. Some schools have instituted Cognitive-behavioral
therapy (CBT) in order address the eating disorder, as it is deemed to
be more efficient than nutritional counseling (Lask and Bryant-Waugh,
Talking with the teenage student and his/her family member is a very
essential factor. The chosen staff (counselor) provides certain
information regarding the student, educates the family on matters
relating to the eating disorder, and the significance of early
intervention. Through this the family member is able to link with the
staff and offer a supportive association. By working with the
student’s family member, the school is able to jointly decide on the
necessary measures to take during the treatment process. Working hand in
hand with the teenage student receiving treatment is another role. This
is done via medical mentoring and counseling (Muhlheim, 2012). This is
achieved through communication with the team offering treatment. The
treatment team offers guidance to the schools concerning whether the
teenage student undergoing treatment should take part in field trips,
sports or PE. Limits on tiring activities such as extreme athletic for
the student obtaining treatment should be put. Schools also give
accommodations to such a student by reducing course load, providing
short school day, giving some days off for appointments and bed rest,
monitoring the student while taking his/her lunch at school. Together
with the treatment team, the school makes certain that the
psychological, medical, as well as academic requirements of the student
are considered.
It is apparent that Anorexia nervosa is a major health disorder among
the teenagers. The public school systems play a vital role in a teenage
student receiving treatment of Anorexia Nervosa. The majority of
teenagers with the disorder have misapprehension regarding what
comprises healthy eating. By instituting Cognitive-behavioral therapy
(CBT), schools are able to reform and break the wrong beliefs, and food
rules that the student may be having. According to studies, CBT is very
efficient as compared to nutritional counseling in enhancing results
(Lask and Bryant-Waugh, 1993).
Eating Disorders Review (2010). Books Inpatient vs. Outpatient Treatment
for Adolescents with AN. Volume 21, Number 4. Retrieved from
Gowers, SG. Clark, A. Roberts, C. Griffiths, A. Edwards, V. Bryan, C.
Smethurst. N. Byford. S Barrett, B. (2007). Clinical effectiveness of
treatments for anorexia nervosa in adolescents: randomized controlled
trial. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17978323
Lask, B. and Bryant-Waugh, R. (1993). Childhood Onset: Anorexia Nervosa
and Related Eating Disorders, (2nd Ed.). Psychology Press.
Muhlheim, L. (2012). Addressing Eating Disorders in Middle and High
Schools. Retrieved from