Anorexia Nervosa - Research Paper Example

Anorexia Nervosa Research Question This research aims at identifying whether the treatments of anorexia help to eliminate the symptoms and causes of the disease simultaneously. Background Anorexia nervosa is a disease that most teenagers and adolescent suffer because of poor eating behavior. The symptoms of the disease include depression, excessive loss of weight, extreme physical exercise, heart and kidney problems, dieting, anxiety, and withdrawal from social interaction. Methods The disorder is treated with family, group, and individual therapies, massage therapies, fish oil supplements, and antidepressants. These treatments reduce anxiety, depression, and unhealthy obsessions while they increase body weight and self-esteem that makes individuals to long for being healthy. Results The results indicate that the cures for anorexia eliminate symptoms of the disorder, but they do not deal with all the causes of the disease. The treatments do not address environmental and biological causes of the disease. The treatments of the disorder do not have side effects except fish oil that may cause the bodies of the victims to lose weight instead of increasing it. Discussion Clinical Trial The clinical trial under investigation is the one that is currently recruiting adolescents to find out their tolerability towards fish oil and the effect of massage therapy on the anxiety of the victims. Introduction Anorexia is a disorder of excessive loss of weight that is caused by a victim’s extreme passion of not gaining weight. The intense passion for losing weight causes a victim to eat fewer calories than the ones the body requires and perform intense exercises that then lead to the loss of weight (Wint, & Yu, 2012). Teenagers especially females are the ones who suffer from anorexia more frequently than the other age groups in the society. Literature Review Causes According to Hay and Sachdev (2011), researchers have not yet identified a specific cause of the disease, but there are numerous suggestions about various causes of anorexia (1). The first suggestion states that a gene that is found in Chromosome 1p causes anorexia (Hay & Sachdev, 2011). The gene is inheritable meaning that it may be passed from one person to another in a family lineage. The other proposition is that anorexia is caused by the destruction of the hypothalamus section of the brain (Hay & Sachdev, 2011). The psychological characteristic of observing strict diets and becoming thin also causes the disease especially in women (Mayo Clinic Staff, 2012). The last cause of the disease is the environment where a person lives; the use of women with thin bodies in the media persuades individuals to believe that being slender is more attractive than being fat (Mayo Clinic Staff, 2012). Signs and Symptoms There are numerous symptoms of anorexia and they include fear of gaining weight, social withdrawal, and intense exercise, and abnormal eating behavior, use of diet pills, excessive loss of weight, anxiety, depression, dieting, and regular illnesses (WebMd, 2014). Effects The main effects of anorexia when a person fails to get treatment include osteoporosis (thin bones), low blood pressure, hair loss, abnormal heartbeat and pulse rate, and destruction of the kidney, heart, and brain (WebMd, 2014). Diagnosis and Treatment of Anorexia Hay and Sachdev (2011) argue that it is difficult to diagnose individuals with anorexia directly because they deny their condition and think that they do not need any help (13). However, a criterion may be used to diagnose the disease with the help of family members of the victim. The criteria include excess loss of weight, fear of gaining weight, and obsession with dieting and acquiring a certain body shape (Hay & Sachdev, 2011). Individual, family, and group therapies are the major treatments for anorexia nervosa. These therapies aim at restoring the weight of the victim back to the normal level. Individual therapies help to change the psychological thinking of the victim by eliminating unhealthy thoughts (Wint, & Yu, 2012). Family therapy, on the other hand, helps the family members of the victim to support healthy lifestyles and eating behavior in the family unit. Mayo Clinic Staff (2012) argue that group therapies help victims of the disorder to connect with others who have the disease (6). The therapies are led by medical practitioners to ensure that the group focuses on positive health. WebMd (2014) argues that nutritional counseling and antidepressant medication may help to get rid of the disorder (4). Counseling helps to educate individuals about the usefulness of eating balanced diets and maintaining healthy weight. Antidepressants help to get rid of depression and anxiety that are common in individuals with the disease. Research Question Does the treatment of anorexia nervosa address the symptoms and causes of the disease or does it deal with only one of them? Methods Clinical Trial The clinical trial aims at determining whether fish oil supplements are safe, tolerable, and efficient in addressing anxiety in patients with anorexia nervosa. In addition, the trial also aims at determining the efficiency of a four weeks massage therapy in these patients (Bravender, 2014). The primary outcome that the trial will measure is how patients tolerate omega-3 fish oil supplement. The secondary results that will be measured include the efficiency of massage in reducing anxiety and its characteristics. Participants The clinical trial aims at examining 40 patients who are between 12 and 21 years old. The participants include both men and women, but it excludes individuals who are healthy. The clinical trial will divide the participants into two groups. The first group will be made of 20 patients whom will take fish oil supplement and undergo massage therapy at set times. The second group will also consist of 20 members, but they will take placebo pills and undergo massage therapies during a specified period (Bravender, 2014). Recruitment The recruitment of participants will take place within the Eating Disorders Program (EDP) of the United States. EDP nurses will identify possible participants when they arrive at a hospital and inform them about the clinical trial (Bravender, 2014). Those who will be interested in taking part will then be provided with a written guide and meet with the coordinator of the program for a formal agreement of participation. The clinical trial will be double-blind meaning that the participants and the researchers will not be able to identify who will take fish oil and who will take the placebo pill. The parties that will take part in the double blind trial include caregivers, outcome assessors, subjects, and investigators. The double blind clinical trial will help to ensure that results are valid and reliable because no one will be able to manipulate the expected results. Evaluation of the Risks and Benefits The clinical trial is in phase 11 whereby patients will receive massage therapy in addition to taking their fish oil and placebo pills. The massage therapy that will be conducted by experts will last for half an hour in three sessions per week for one month (Bravender, 2014). The therapies will take place in a designated room and they will involve stroking, touching, kneading, and mild friction. There are no risks involved in the clinical trial because the medication and massage therapies are fit. The benefits of the treatment is that it will lead to increased body weight and reduced anxiety in the patients. According to Bravender (2014), a clinical trial conducted on 19 patients to treat anorexia nervosa with massage therapies indicated that the therapies immediately reduced the level of anxiety and depression in the participants (6). The research also indicated that after the massage therapies, participant’s levels of eating disorders reduced significantly (Bravender, 2014). This means that massage therapies are beneficial in that they reduce depression and promote fine eating behavior. Consent Form A consent form is a document that a participant signs to agree to take part in a research (Lock, & DeGrange, 2012). In this case, the consent form will contain a summary of the clinical trial and it will ask participants to sign only if they agree to the conditions of the plan. The consent form also ensures that participants understand a study before agreeing to take part. Challenges The clinical trial has not mentioned any challenges that it may face, but the analysis of previous studies indicates that the trial may face various difficulties. According to Lock et al. (2013), the recruitment process may be slow because the safety of participants must be ensured (7). The trial indicates that patients with various characteristics will be excluded from taking part in the trial. The characteristics include those who are taking fish oil supplements, those who will not be able to take pills, those whose symptoms will have been observed for more than a year, those with co-morbid medical and psychiatric conditions, and those who will not be able to take part until the trial is over after twelve weeks (Bravender, 2014). These exclusion criteria may prohibit most of the potential participants from taking part and this will slow down the recruitment process, hence the clinical trial. Another challenge that the trial may face is that of participants withdrawing from the research before the end of twelve weeks. Some participants may opt out of the trial individually while friends and family members who have negative opinions about the clinical trial may advise others to opt out of the plan (Lock et al., 2012). This may delay the research from making valid and reliable conclusions. The ultimate challenge that the clinical trial may face is that of increase in the cost of conducting the program for the whole period. The increase in general prices in the economy may cause an increase in the expenses that the trial will consume (Lock et al., 2012). This may put pressure on the available funds for conducting the program and it may call for additional funds that may be difficult to acquire. Results Effect of Massage Therapy on Anxiety The use of massage therapy is expected to reduce anxiety and depression in the teenagers who will take part in the study. According to Vanderbilt (2003), the lack of touch leads to eating disorders while touch reduces these disorders (2). Vanderbilt (2003) concluded this when the Touch Research Institute conducted research and found out that those women who underwent massage therapies and had anorexia experienced low levels of anxiety after the remedy. The group of women who were massaged regularly for seven weeks exhibited long-term low levels of depression and stress and high levels of dopamine. The high levels of dopamine in the patients will increase their thoughts about health and well-being. This is because dopamine hormone produces feelings of happiness and appreciation for oneself. The massage also produced serotonin, which is a hormone that plays the same role as dopamine (National Eating Disorders Collaboration, 2014). When the patients feel happy, they will start accepting their body shape and size; this will eliminate the obsession of being excessively thin and increase the feeling of wanting a healthier body. Therefore, therapy will reduce stress and anxiety in patients who are treated with omega-3 and placebo pills; massage therapy does not have side effects. Effect of Omega-3 Fish Oil Supplement on Weight The fatty acids in Omega-3 tablets help to lower high blood pressure and increase the strength of bones. The fatty acids in these tablets help to expand blood vessels; the expansion of the vessels reduces high blood pressure. This means that omega-3 is expected to reduce the high blood pressure that participants with anorexia suffer because of depression (Hall-Flavin, 2012). Therefore, fish oil supplements will indirectly reduce depression in participants because it will lower their blood pressure. Another usefulness of omega-3 is that it reduces osteoporosis, which is a characteristic of the weakness of bones in the body. The supplement works by increasing the density of the femur bones that are located on the thighs (Hall-Flavin, 2012). The increase in the density of the thighbones will then lead to increase in the body weight of the participant. Therefore, the participants who will take omega-3 and undergo massage therapy will exhibit lower levels of stress and blood pressure, and higher levels of density of the femur than those who will take placebo pills. Participants and Rate of Participation The participation of females is likely to be more than that of males. This is because anorexia nervosa is common in women more than it is in men. A study conducted by Austin et al. (2008) found out that 58% of the participants who had anorexia were women while 43% of the respondents were men. 83% of the total participants were white were the other 17% were non-whites who include Latinos, African Americans, and Asians (Austin et al. 2008). This means that white people and especially women are more obsessed with slim bodies than non-whites are. This characteristic may manifest itself in the clinical trial leading to a higher participation of women compared to men. The clinical trial may face difficulties identifying participants because most victims of anorexia live in denial and do not like disclosing their eating disorders in hospitals. The victims hide their problem because they have low self-esteem and they think that their bodies are less attractive than those of others are (Mayo Clinic Staff, 2012). Furthermore, some victims may refrain from taking part in the clinical trial even if they do not hide their problem. Therefore, the slow identification of participants and their inability to take part in the research may drag the study and prevent it from achieving results within the set time. Withdrawal of Participants from the Trial Some participants may withdraw from the study when it is continuing and this may slow down the achievement of the objectives of the research. Participants may withdraw because of reasons that include severity of the disorder, side effects of the fish oil medication, personal decision to quit, and advice from family and friends (Lock et al., 2013). Elimination of the Causes of Anorexia Nervosa The causes of anorexia are psychological, environmental, and biological. The biological cause of the disease is a gene that is found on chromosome 1b (WebMd, 2014). Since scientists know little about this gene, it means that it may be impossible to alter the gene to prevent adolescents from acquiring the disorder. Therefore, the treatment of the disease using massage therapy and fish oil supplement may not eliminate the genetic cause of the disease. This means that patients who take part and suffer from anorexia caused by genes may not be cured completely after the clinical trial; because the genes will continue thriving in the bodies during and after the program. The fish oil supplement and the massage therapies may also not be able to change the whole environment where a person lives. Even if experts involve family members and friends in healing an anorexic patient, the trial may not be able to change an environment such as the media. Participants who continue watching media advertisements that are filled with slender people may continue showing appalling eating habits; because the media influences their actions (Wint, & Yu, 2012). Therefore, massage therapies and fish oil supplements may not be able to eliminate all the causes of anorexia nervosa. This means that there is need for further research to determine a specific medication for curing the disease and preventing all its causes. Discussion and Conclusion Anorexia is a disorder that individuals especially the young members of the society suffer because of poor eating habits. It is hard to identify the individuals who have the disorder by questioning them because they deny having the problem. However, the clinical trial may identify these individuals with the help of their families and other relatives (Mayo Clinic Staff, 2012). Anorexic individuals exhibit various symptoms that include strange eating habits, passion for being thin, admiration of thin people, depression, anxiety, low self-esteem, use of diet pills, and excess loss of weight within a short period (Wint, & Yu, 2012). The rate of participation in the clinical trial may be low because individuals with anorexia live in denial and they do not seek help unless when the condition becomes complicated. The exclusion of individuals with various characteristics; for example those who are already taking fish oil, and those whose symptoms are more than one year old may also make it difficult to find participants with the right qualities (Blavender, 2014). However, the nurses who will be in charge of the program may identify potential participants by interviewing their parents. There is no specific cure for anorexia nervosa, but various forms of help may assist victims to recover fully from the disease. Massage therapy is an efficient form of help that reduces the anxiety that individuals with anorexia normally have (Bravender, 2012). Massage therapy helps the bodies of the victims to produce dopamine hormone that produces the feeling of happiness (National Eating Disorders Collaboration, 2014). The feeling then helps the individuals to appreciate and love themselves and it increases the passion for being healthy. The therapies, however, need to be conducted by specialists who have excellent skills to ensure that they produce the desired results (Blavender, 2014) Fish oil supplements are efficient in lowering high blood pressure and increasing the strength of bones in the bodies of the victims (Vanderbilt, 2003). The increase in the strength of bones consequently increases the weight of the individuals gradually. This eliminates the symptom of rapid loss of weight among patients with the disorder. The treatment of the disease using individual, family, and group therapies is also an efficient cure for the disease: because it helps patients and their relatives to appreciate and exercise, healthy eating habits (WebMd, 2014). Conclusion Answer to Research Question Although the above treatment options help to cure the symptoms of anorexia, they may not be able to eliminate some of the causes of the disease. The genetic and environmental causes of the disease may not be cured by massage therapies and fish oil. This is because these cures do not have any effect of the genetic composition of an individual or on the environment especially the media. The media continues to use images of slim individuals in commercials and this may continue influencing victims of the disorder to long for thin bodies. Recommendation for Further Research The lack of sufficient data about anorexia indicates that researchers have not dwelt much on this topic. There is need for further research to identify specific causes and cures of the disorder. This will help to reduce the frequent cases of anorexia in the society especially among teenagers and adolescents. References Anorexia nervosa. WebMd. 2014. Retrieved from http://www.webmd.boots.com/mental-health/mental-health-anorexia-nervosa?page=2 Austin, S.B., Ziyadeh, N.J., Forman, S., Prokop, L.A., Keliher, A., & Jacobs, D. (2008). Screening high school students for eating disorders : results of a national initiative. CDC. Retrieved from http://www.cdc.gov/pcd/issues/2008/oct/07_0164.htm Bravender, T. (2014). Treatment of anxiety and anorexia nervosa in adolescents (TAANA). Clinicaltrials.gov. Retrieved from https://clinicaltrials.gov/ct2/show/study/NCT01933243?term=anorexia&rank=5&show_desc=Y#desc Complementary treating approaches. National eating disorders collaboration, 2014. Retrieved from http://www.nedc.com.au/complementary-treatment-approaches Hall-Flavin, D.K. (2012). Is there any benefit to taking fish oil supplements for depression? Mayoclinic. Retrieved from w.mayoclinic.org/diseases-conditions/depression/expert-answers/fish-oil-supplements/faq-20058143 Hay, P., & Sachdev, P. (2011). Brain dysfunction in anorexia nervosa: Cause or consequence of under-nutrition?. Current Opinion In Psychiatry, 24(3), 251-256. Lock, J., & Le, G. D. (2013). Treatment manual for anorexia nervosa: A family-based approach. New York: Guilford Press. Lock, J., Brandt, H., Woodside, B., Agras, S., Halmi, K., Johnson, C., Kaye, W., & Wilfley, D. (2013). Challenges in conducting a multi-site randomized clinical trial comparing treatments for adolescent anorexia nervosa. NCBI. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140589/ Mayo Clinic Staff (2012). Anorexia nervosa: treatment and drugs. Mayoclinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/anorexia/basics/treatment/con-20033002 Wint, C., & Yu, W. (2012). Anorexia nervosa. HealthlineI. Retrieved from http://www.healthline.com/health/anorexia-nervosa#Causes2 Read More