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Defining Longstanding Anorexia
Anorexia Nervosa (AN) has become a well-known disorder, with most people generally understanding that it is an eating disorder, that it involves self-imposed restriction of food, and that it is incredibly dangerous.
What is lesser known, yet equally important, is the fact that not all diagnoses of AN are created equal. The disorder can manifest with varying symptoms, numerous contributing factors, and fluctuating timespans.
Recovery from Longstanding Anorexia is absolutely possible. However, some individuals will struggle with these disorders for years. Some of what you need to know about Longstanding Anorexia are addressed.
Defined
The best definitional terms used for Longstanding Anorexia in the mental health field are “severe and/or enduring.” These terms are often used to refer to those individuals mentioned above, that may struggle with severe or chronic anorexia symptoms for long-term or much of their lives.
There is a current lack of definitional clarity regarding longstanding AN. However, a recent study attempted to create a foundational definition and specified three components of severe and enduring anorexia: “persistent, unremitting symptoms, of long duration, and treatment resistance [1].”
With no universal definition, there is also no agreement as to a specific time span that constitutes as “enduring” or longstanding.” However, it seems there is at least agreement that the lower limit of what is considered “longstanding” would be three years [1].
Finally, a word on the term “treatment resistance.” It is not uncommon for an individual battling anorexia to undergo numerous treatment attempts in various settings. No two individuals are alike. Therefore, no two eating disorders are alike; therefore, no single treatment will work for everyone.
The term “treatment resistant” does not mean one foray into treatment did not work for an individual, and it does not imply that the individual themselves is resisting treatment or that it is somehow their own fault treatment is unsuccessful.
One study provided a clear understanding that “Only after establishing that the (diagnostic) formulation is accurate, and the person has been offered and received all appropriate first-line, evidence-based therapy is the term ‘treatment resistant’ to be applied [1].”
Risks
The risks associated with longstanding anorexia nervosa are high, as enduring symptoms over time are associated with poorer treatment, health, and morbidity outcomes [1].
Essentially, as harmful and dangerous AN behaviors continue to occur over time, these behaviors and ideologies become more embedded in the individual, the physical impacts and consequences worsen, and the risk of death increases.
Moving Forward
More research needs to be conducted regarding the impacts of longstanding AN and if, indeed, the distinction between longstanding and shorter duration AN makes any difference in regard to treatment or treatment outcomes.
Providing definitional clarity throughout the mental health field will allow for this research to be conducted and compared.
References:
[1] Hay, P., Touyz, S. (2018). Classification challenges in the field of eating disorders: can severe and enduring anorexia be better defined? Journal of Eating Disorders, 6:41.
About the Author:
Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.
As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published on March 22, 2019.
Reviewed & Approved on March 22, 2019, by Jacquelyn Ekern MS, LPC
Published on EatingDisorderHope.com
The EatingDisorderHope.com editorial team comprises experienced writers, editors, and medical reviewers specializing in eating disorders, treatment, and mental and behavioral health.
