Background: Reduced bone mineral density (BMD) is an established complication of anorexia nervosa (AN). There is inconclusive evidence as to whether this reduction in bone mass is permanent or can be reversed with recovery from AN. The objectives of this study were to: i. determine the extent of reversal of skeletal deficits with recovery from AN, and the duration of recovery required for complete reversal, if this occurred; and, ii. evaluate the effect of key illness characteristics on BMD. Methods: Women (aged 17-40 years) who had previously received inpatient treatment for AN at one of two hospital-based programs were selected for this cross-sectional study; 514 healthy premenopausal women recruited from the community served as a control group. A detailed lifetime illness history was obtained by a Life History Calendar interview. BMD was measured by dual-energy X-ray absorptiometry (DXA) at the spine, hip and total body. Low BMD was defined as a weight and age-matched standard deviation (Z-score) of ≤ -1.5 at one or more skeletal sites. Participants were considered recovered if they had maintained a body mass index ≥ 18.5 kg/m2 and resumed regular menstruation for ≥ 1 year. Results: Of 190 AN participants, 77 were considered recovered and 113 were ill. The prevalence of low BMD was 11.7% in the recovered group, 47.3% in the ill group and 6.8% in the control group. The odds of low BMD in the recovered participants was significantly lower than in the ill participants (odds ratio [OR] = 0.17, 95% CI 0.07, 0.36, p<0.0001) and was not significantly different from the controls (OR = 1.81, 95% CI 0.79, 3.78, p=0.15). Duration of illness was associated with low BMD (OR = 1.16, 95% CI 1.08, 1.25, p<0.0001) and was negatively associated with the odds of AN recovery. Normal mean BMD values at each skeletal site were observed in women recovered ≥ 3 years. Conclusion: The results emphasize the importance of early and sustained AN recovery for the prevention and treatment of low bone mass in this population and may offer motivation for AN patients to make positive behavioural changes leading to successful, long-term recovery.

Background: Reduced bone mineral density (BMD) is an established complication of anorexia nervosa (AN). There is inconclusive evidence as to whether this reduction in bone mass is permanent or can be reversed with recovery from AN. The objectives of this study were to: i. determine the extent of reversal of skeletal deficits with recovery from AN, and the duration of recovery required for complete reversal, if this occurred; and, ii. evaluate the effect of key illness characteristics on BMD. Methods: Women (aged 17-40 years) who had previously received inpatient treatment for AN at one of two hospital-based programs were selected for this cross-sectional study; 514 healthy premenopausal women recruited from the community served as a control group. A detailed lifetime illness history was obtained by a Life History Calendar interview. BMD was measured by dual-energy X-ray absorptiometry (DXA) at the spine, hip and total body. Low BMD was defined as a weight and age-matched standard deviation (Z-score) of ≤ -1.5 at one or more skeletal sites. Participants were considered recovered if they had maintained a body mass index ≥ 18.5 kg/m2 and resumed regular menstruation for ≥ 1 year. Results: Of 190 AN participants, 77 were considered recovered and 113 were ill. The prevalence of low BMD was 11.7% in the recovered group, 47.3% in the ill group and 6.8% in the control group. The odds of low BMD in the recovered participants was significantly lower than in the ill participants (odds ratio [OR] = 0.17, 95% CI 0.07, 0.36, p<0.0001) and was not significantly different from the controls (OR = 1.81, 95% CI 0.79, 3.78, p=0.15). Duration of illness was associated with low BMD (OR = 1.16, 95% CI 1.08, 1.25, p<0.0001) and was negatively associated with the odds of AN recovery. Normal mean BMD values at each skeletal site were observed in women recovered ≥ 3 years. Conclusion: The results emphasize the importance of early and sustained AN recovery for the prevention and treatment of low bone mass in this population and may offer motivation for AN patients to make positive behavioural changes leading to successful, long-term recovery.

Bakgrund: Sjukdomen Anorexia Nervosa är en ätstörning som drabbar främst flickor och unga kvinnor. Anorexia Nervosa påverkar personen både fysiskt och psykiskt och anses som ett allvarlig, livshotande sjukdom. Närstående involveras i denna sjukdom och åsidosättas ibland i vårdsammanhang. Syfte: Syftet var att beskriva närståendes erfarenhet av att leva med en vuxen person med fastställd diagnos av Anorexia Nervosa. Metod: Systematisk litteraturstudie med 9 inkluderade artiklar som analyserades medinnehållsanalys enligt Forsberg och Wengström (2013). Resultat: Analysen av artiklarna resulterade i 5 underkategorier och utifrån dessa framkom två huvudkategorier. De huvudkategorier som bli tydliga är: Påfrestning för närstående och närståendes upplevelse av vården. Många av de närstående som ingick i studierna upplevde stor påfrestning av att vårda en person med Anorexia Nervosa. Denna påfrestning ledde till ångest, oro, skuld och hjälplöshet. Upplevelsen av vården i detta sammanhang uppfattades olika och inte alla kände att de fick tillräckligt med stöd. Slutsats: Många av de närstående upplevde att sjukdomen Anorexia Nervosa drabbade hela familjen och berörde allas liv i familjesammanhanget. Denna påfrestning resulterade i psykiska och fysiska problem. Relationer sinsemellan och med omgivningen förändrades. Närstående orkar inte med ett socialt liv och upplever bristande empati från samhället.

Background Anorexia nervosa is a growing problem in society and it is most common among women. It is a complex disease that affects both the mental and the physical health. The disease expresses itself differently from person to person, therefore, treatment should be individualized. Nurses need to gain insight into how patients feel about the treatment in order to understand their experience. Previous studies use statistical research to evaluate treatment. This study focuses on describing patients' concrete experiences during care and treatment for anorexia nervosa. Aim The aim is to highlight women's experiences of care and treatment for anorexia nervosa at hospital wards. Method The study was based on qualitative articles containing interviews. Nine articles were analysed according to Friberg's (2012) qualitative content analyse for literature-based studies. Results Four themes and twelve subthemes emerged from the analyse. The findings of the results are characterized by feeling isolated, not being seen, feeling trust and taking one step at the time. The quality of care affects the outcome of the treatment. Conclusion Nursing patients with anorexia nervosa is a complex task and skilled staff is required. The whole patient should be treated, both physically and mentally. When treating only the physical the underlying problem still exist and relapse is inevitable. Every individual is different and everyone has different problems. Individualized care is therefore required for the best treatment results.

This thesis examines the development of an anorexic discourse in Goethe's Die Wahlverwandtschaften. Chapter 1 investigates anorexia as a cultural signifier and its relationship to non-clinical and non-medical disciplines. I then submit that female self-starvation serves a structural and a thematic function in WV. In Chapter 2, I argue that Ottilie's arrested female development illustrates the central, concept (elective affinities) of the novel. Chapter 3 examines food as a non-verbal system of communication in the narrative. Here, I demonstrate that Ottilie's eating disorder denies her subjectivity while it signifies and affirms the dominant social institutions depicted in the novel. Chapter 4 examines Ottilie's oscillation between corporeality and bodilessness. Her physicality is always associated with instability. The disappearance of her flesh allows for the passive reflection of masculine identity. In Chapter 5, I analyze the representation of Otttilie's death and demonstrate that her corpse allegorizes the construction of subjectivity in the narrative. In closing, I argue that Ottilie is an empty signifier in the novel, onto which the plot is imposed. Her anorexia functions as a sign for the process of narration and is a condition of the novel itself.

Public view removed at the authors request. 16/07/2006 / The daily experience of anorexia nervosa sufferers has not previously been studied and yet it is fundamental to understanding anorexia nervosa. This study examined and compared the daily experiences of anorexia nervosa patients and control participants in terms of sense of self, mood states and flow states. Flow is characterised by undivided concentration and interest in an activity for intrinsic benefits. Flow is not always desirable, as some ways of experiencing it may be harmful to the individual and society. Anorexia nervosa participants were recruited from hospitals and private practices of clinicians specialising in the treatment of anorexia nervosa. Exclusion criteria included male gender, chronic anorexia nervosa, drug abuse, and current participation in an inpatient program. Anorexia nervosa participants completed a series of questionnaires at baseline, 3-6 month follow-up and 7-12 month follow-up (stage one, two and three respectively). The questionnaires were designed to measure the severity of their eating disorder. Anorexia nervosa and control group participants completed Experience Sampling Forms (ESF) and a Repertory Grid at baseline and 3-6 months. The ESFs were completed each time a pager was activated. The pager was activated seven times a day, for four days at random times between 8.00am and 10.00pm. The pager signals were a minimum of two hours apart. The Repertory Grid consisted of 23 constructs and 13 elements provided to the participant. Thirty-one anorexia nervosa sufferers and thirty-two control participants completed stage one and eighteen anorexia nervosa sufferers and twenty-seven control group participants completed stage two of the study. Eighteen anorexia nervosa sufferers completed stage three of the study. Control participants were not required to participate in stage three. There was no difference in the severity of anorexia nervosa between completers and drop-outs The analysis of the ESFs at stage one indicated that the anorexia nervosa group participants did not spend more time alone at home or more time alone in any situation than the control group. For both groups, being alone had a negative influence on mood state, but had no effect on sense of self. The anorexia nervosa group felt lonelier and less sociable than the control group. The mood state and sense of self for the anorexia nervosa group was significantly lower over all the ESFs when compared to the control group. They were also more self-critical, experienced higher levels of guilt, were less able to live up to their own expectations, and were less satisfied with their performance in the activity they were doing. The anorexia nervosa group experienced less flow states than the control group at stage one. There was an improvement in mood state, sense of self and self-criticism for the anorexia nervosa group when they were in a flow state compared to when they were not in a flow state. There was an improvement in mood state, sense of self, guilt and self-criticism for the control group when they experienced flow, however these differences were not significant. The anorexia nervosa group had a more positive mood state and sense of self at stage two when compared to stage one. Correspondingly, there was a trend towards a reduced severity of the disorder indicated by a significant improvement on some of the psychological tests (EAT, REDS, BDI, DT). There was also a significant improvement in BMI. However, there was a significant decline in the amount of flow of anorexia nervosa participants experienced at stage two when compared to stage one. This result may be attributed to the significant decline in the response rate on ESFs in the second stage of the study for both the anorexia nervosa and control groups. Anorexia nervosa non-responders at stage two reported more severe symptoms of anorexia nervosa than anorexia nervosa responders, although this was a trend and reached significance only on minor indicators of eating disorder severity. The identification of a factor that predicted severity over a six-month period was not possible. The repertory grid analysis showed that the construct system of the anorexia nervosa participants was tighter and less complex than that of the control group. The anorexia nervosa group construed themselves as dissimilar from the way they would like to be in any context. The control group construed themselves as similar to the way they would like to be when they were alone, but as dissimilar from the way they would like to be when they were with other people. While the most salient element for both the anorexia nervosa and control groups was 'alone at home', it appears that the controls use this time for goal-directed activities. In contrast, this time was dominated by fear of losing control for the anorexia nervosa group. Although there was a trend towards a decrease in the amount of variance accounted for by the first component for the anorexia nervosa group at stage two compared to stage one, the interpretation of this result was complicated by mixed result of the control group. The anorexia nervosa groups' daily experience of life was bleak when compared to the daily experience of the control group, except for periods when the anorexia nervosa participants experienced a flow state. DeVries (1992) has documented the success of therapeutic interventions that involve the identification and replication of activities that resulted in a flow state. This investigation suggests that a similar result may be possible in the treatment of anorexia nervosa.

Dissertation (Ph.D.) -- University of Texas Southwestern Medical Center at Dallas, 2006. / Vita. Bibliography: pp. 101-116.

Thesis (Ph. D.)--University of Toronto, 2004. / Adviser: Michele Peterson-Badali.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2009. / Includes bibliographical references (p. 92-96).

Thesis (Ph. D.)--Auburn University, 2007. / Abstract. Vita. Includes bibliographical references.