Anorexia Nervosa: Clinical Course, Comorbidities, and Current Treatment Approaches

Öz

Eating disorders are serious conditions with significant physical and psychological effects during childhood and adolescence, posing a potential threat to life. According to the DSM-5, Anorexia Nervosa (AN) is characterized by an intense fear of gaining weight and restrictive eating behaviors. The etiology of AN remains unclear, and the course of the illness is variable; while 46% of patients achieve full recovery, 20% develop a chronic course. AN is frequently associated with psychiatric comorbidities such as anxiety disorders and depression and may lead to severe medical complications, particularly affecting the cardiovascular, endocrine, gastrointestinal, and neurological systems. Treatment requires a multidisciplinary approach, with nutritional rehabilitation, psychotherapy, and pharmacotherapy being the most crucial components. Cognitive Behavioral Therapy (CBT) is a widely used treatment method for AN. Antipsychotics like olanzapine have been shown to aid in weight gain, though the efficacy of other medications remains controversial. Antidepressants may be beneficial in managing anxiety and depressive symptoms, but evidence supporting their direct effect on eating behaviors is limited. Due to the risk of refeeding syndrome, the refeeding process must be carefully planned. Long-term follow-up and patient adherence remain among the most challenging aspects of treatment. This review addresses the clinical course, comorbidities, medical complications, and current treatment approaches for anorexia nervosa.

Anahtar Kelimeler

• Anorexia nervosa
• eating disorders
• cognitive behavioral therapy
• pharmacotherapy

ANOREKSİYA NERVOZA: ETİYOLOJİ, KLİNİK SEYİR, KOMORBİDİTELER VE GÜNCEL TEDAVİ YAKLAŞIMLARI

Öz

Yeme bozuklukları, çocukluk ve ergenlik döneminde önemli fiziksel ve psikolojik etkileri olan, yaşamı tehdit edebilen ciddi hastalıklardır. DSM-5’e göre Anoreksiya Nervoza (AN), kilo alma korkusu ve yiyecek kısıtlaması ile karakterizedir. AN’nin etiyolojisi kesin olarak belirlenmemiş olup, hastalığın seyri değişkendir; tam iyileşme oranı %46 iken, %20’sinde hastalık kronikleşmektedir. AN, anksiyete bozuklukları ve depresyon gibi psikiyatrik komorbiditelerle sık görülür ve ciddi tıbbi komplikasyonlara yol açabilir. Özellikle kardiyovasküler, endokrin, gastrointestinal ve nörolojik sistemler bu hastalıktan etkilenir. Tedavi multidisipliner bir yaklaşım gerektirir; beslenme rehabilitasyonu, psikoterapi ve farmakoterapi en önemli bileşenlerdir. Bilişsel Davranışçı Terapi (BDT), Anoreksiya Nervoza yaygın kullanılan bir tedavi yöntemidir. Olanzapin gibi antipsikotiklerin kilo alımına yardımcı olabileceği gösterilmiştir. Antidepresanlar, anksiyete ve depresyon belirtilerinde faydalı olabilir ancak yeme davranışını doğrudan iyileştirdiğine dair kanıtlar sınırlıdır. Yeniden beslenme sendromu riski nedeniyle beslenme süreci dikkatli planlanmalıdır. Uzun vadeli takip ve hasta uyumu tedavi sürecinin en zorlu aşamalarından biridir. Bu derlemede; anoreksiya nervoza klinik seyri, komorbiditeleri, tıbbi komplikasyonları ve güncel tedavi yaklaşımları ele alınmıştır.

Anahtar Kelimeler

• Anoreksiya nervoza
• yeme bozuklukları
• bilişsel davranışçı terapi
• farmakoterapi

Kaynakça

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