How to treat anorexia nervosa? – case report

Abstract

Anorexia nervosa is an eating disorder characterized by low body weight and body image distortion with obsessive fear of gaining weight. It is a complex condition involving psychological, neuroendocrine, hormonal and metabolic components. The following is a case report of a young patient diagnosed as anorexia nervosa and primary amenorrhea, without the development of secondary female characteristics. Hormonal examination confirmed hypothalamic origin of the described disorders. There was an important impairment in the mood sphere (Beck's Depression Inventory and Hamilton Depression Rating Scale) of this young woman. Densitometry of lumbar spine revealed significant bone loss (diagnozed as osteoporosis) in this patient. All of the abovementioned examinations were repeated after one and a half years of hormonal treatment (estrogen-progestins). A return of normal menstrual cycle (with ovulation function) and normal hormonal profile have been observed. After one and a half years of treatment the patient had regular feeding patterns and none of the anorexia nervosa symptons have been found. A significant improvement in Beck's Depression Inventory and Hamilton Depression Rating Scale was found after one and a half years of hormonal treatment. The patient was also characterized by important increase of bone mass density – osteopenia was described by the densitometry of the lumbar spine.