L'anorexie mentale (AM) est un trouble du comportement alimentaire qui se caractérise par une recherche obsessionnelle de minceur, une forte réduction de la prise alimentaire et une distorsion de l'image de soi. Elle est associée à de multiples perturbations endocriniennes et métaboliques, et à une altération de la masse et de la microarchitecture osseuses. Les facteurs et les mécanismes qui interviennent dans cette maladie sont très mal connus ce qui limite les options thérapeutiques. Il est donc nécessaire de développer un modèle animal qui reproduise les perturbations physiologiques observées en AM et permette d'étudier les facteurs associés à l'altération osseuse. Dans ce but nous avons développé un modèle murin avec une restriction du temps d'accès à l'alimentation associée à un stress induit par la séparation (separation-based anorexia, SBA). Cette phase SBA de 10 semaines est suivie d'une phase de récupération en conditions standard (REC) de 10 semaines. Chez les souris femelles C57B1/6 en fin de croissance rapide, la phase SBA induit une perte rapide et importante du poids corporel. L'analyse de la composition corporelle par DEXA révèle une diminution rapide de près de 40% de la masse grasse ainsi qu'une baisse progressive de la masse maigre et un arrêt de l'acquisition de la masse osseuse. Au niveau des tibias, la densité minérale cortical et la microarchitecture trabéculaire sont altérées. L'observation des frottis vaginaux et la mesure des ovaires révèlent une perturbation importante des fonctions reproductrices. Les tests de tolérance au glucose ont montré que les souris SBA ont une capacité très élevée à corriger la glycémie. Ces animaux sont fortement hypoleptinémiques, et l'axe GH-IGF-1 est très perturbé. L'étude de l'expression génique de différents tissus adipeux a montré une augmentation du niveau des marqueurs de lipogénèse et de lipolyse, ainsi qu'une forte induction du phénotype "adipocyte brun" dans le tissu adipeux sous-cutané. Après deux semaines de REC, les souris SBA retrouvent très rapidement leur poids corporel, leurs masses maigre et grasse. La masse minérale toujours basse à ce stade est corrigée après 10 semaines de REC, ainsi que la microarchitecture osseuse (étude préliminaire). Tous les autres paramètres étudiés sont normalisés, sauf l'hypoleptinémie qui étonnamment persiste même après 10 semaines de protocol REC et malgré la normalisation de la masse adipeuse. D'après ces résultats, on peut conclure que le modèle SBA reproduit de nombreuses perturbations physiologiques observées en AM. La phase de REC révèle que ces souris ont une importante capacité de récupération. L'hypoleptinémie persistante pourrait favoriser la récupération. L'identification des mécanismes impliqués pourrait fournir des pistes thérapeutiques afin de favoriser la reconstitution du capital osseux des patientes anorexiques. / Anorexia nervosa (AN) is an eating disorder mainly developed in adolescent girls and young women. It is characterized by an obsessive search for thinness, a profound undernutrition and a distorted self-image.It is associated with multiple endocrine and metabolic disturbances, decreased bone mass and microarchitectural alteration. Some of the developed adaptations are supposed to be involved in the blockade of the pathologic state. Unfortunately, these adaptations are poorly known and most of them cannot be studied on patients. So it is necessary to develop an animal model which mimics the main consequences observed in human pathology and allows studying the recovery process. For this purpose we adapted a murine model of time restricted feeding associated with chronic stress induced by separation-based anorexia (SBA). C57B1/6 female mice are submitted to a long term SBA protocol (10 weeks) and then a long term phase of recovery (10 weeks). At the beginning of the protocol mice are 8 weeks old, so their fast growth is finishing. SBA protocol induced a rapid and significant loss of body weight. Body composition analysis by DEXA showed a 40% decrease of the fat mass, a progressive loss of lean mass and a blockade of bone mass acquisition. Mice deveoped a high glucose tolerance. The observation of vaginal smears revealed a disruption of the estrous cycle and ovarian histology showed an atrophy of the ovaries. These two alterations suggest a major alteration of reproductive functions. These animals showed a very low leptinemia, and the GH/IGF-1 axis was disrupted. The study of bone alteration by microtomography indicated an alteration of bone microarchitecture and of cortical bone mass, mimicking osteoporosis often described in AN patients. Body weight, lean and fat masses were normalized quickly during the REC protocol. Bone mineral content still low after 2 weeks of REC protocol was fully corrected after 10 weeks. The estrous cycle ovarian size and the GH/IGF-I were normalized. Surprisingly, hypoleptinemia persisted even after 10 weeks of REC and despite the normalization of the fat mass. This result has been confirmed by the low level of leptin gene expression in various adipose tissues. Finally, the SBA protocol is valuable model of AN because numerous physiological alterations described in AN are mimicked in this model. The recovery phase revealed the high capacity of mice to normalize the long term alterations. Persitent hypoleptinemia could contribute to the normalization of body composition. However, the balance between central and peripheral effects of the uncorrected hypoleptinemia remains to be determined. This persisting hypoleptinemia could be used for the revision of the therapeutic strategies aiming to correct AN-induced osteoporosis.

Este estudo tem por objetivos identificar as representações sociais da equipe de enfermagem acerca da anorexia e bulimia nervosa e dos indivíduos portadores desses transtornos, bem como correlacionar essas representações com as intervenções realizadas no cotidiano do trabalho desses profissionais em um hospital psiquiátrico. Para realizá-lo, foram feitas entrevistas semi-estruturadas, individuais, junto a 12 componentes da equipe de enfermagem de um hospital universitário. A teoria moscoviciana de representação social foi adotada como referencial teórico-metodológico e os dados submetidos à análise de conteúdo segundo Bardin. Dessa análise emergiram temas como sintomas físicos e psíquicos além dos fatores psicossociais, que constituíram a categoria “A Construção do conhecimento”. A construção desse conhecimento mostrou-se ancorada essencialmente em um discurso médico – científico veiculado na instituição, numa interface com o conhecimento prático que a vivência cotidiana possibilita. Já a outra categoria delineou-se a partir do “Campo das Ações/ Sentimentos”, constituída por temas como controle/limite, onde o sofrimento psíquico do trabalhador é mais evidente, principalmente na iminência do suicídio. Por outro lado, é por meio de temas como a escuta, o vínculo de confiança e o cuidar individualizado que os profissionais conseguem expressar o prazer no trabalho / This study intends to identify the social representations of nursing staff about anorexia and bulimia nervosa and about carries of these eating disorders as long as to correlate these representations with the interventions made in the se professionals daily life, inside of a psychiatric hospital. Semi-structured, and individuals interviews were made with twelve members of the nursing staff of a university hospital. The moscovician theory of social representation was adopted as referential-methodological referential and the data were submitted for content analysis in Bardin’ s point of view. From this analysis emerged themes as physical and psychic symptoms, besides psychosocial factors, which constituted the category “knowledge Construction”. The construction of knowledge seemed to be anchored essentially on a medical-scientific lecture diffused in the institution, in a interface with the pratic knowledge which the daily life provides. On the other side, the other category was outlined from “Actions / Feelings Field”, constituted by themes as control / limit, where the worker’ s psychic suffering is more evident, mostly in imminence of suicide. By other way, is by themes as the listening, confidence link and individually care that professionals care express their pleasure on work

BIGHETTI, F. Tradução e validação do Eating Attitudes Test (EAT-26) em adolescentes do sexo feminino na cidade de Ribeirão Preto - SP. 2003. (número de páginas) Dissertação de Mestrado – Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto - SP. Os distúrbios da conduta alimentar, entre eles, a anorexia e bulimia nervosas, são síndromes psicossomáticas consideradas graves e de prognóstico ruim, caracterizadas pelo medo mórbido de engordar, levando à redução voluntária da ingestão alimentar com perda progressiva de peso, ingestão maciça de alimentos seguida de vômitos e uso abusivo de laxantes e/ou diuréticos. Desta forma, é de suma importância que o diagnóstico dessas doenças seja realizado precocemente, sendo que um dos instrumentos que auxiliam na triagem de possíveis doentes é o Eating Attitudes Test (EAT-26). O objetivo dessa pesquisa foi traduzir e validar o EAT-26 para a língua portuguesa em adolescentes do sexo feminino de nível sócio-econômico alto e, para tanto, o teste foi aplicado em 365 estudantes com idade entre 12 e 18 anos de duas escolas particulares de Ribeirão Preto-SP onde essas doenças ocorrem com maior incidência. Para desenvolver esta investigação, foram utilizados o referencial metodológico da tradução e retro-tradução do instrumento e métodos de análise estatística para avaliar a consistência interna dos itens do teste, isto é, a intensidade da concordância entre as versões traduzidas e sua confiabilidade. Além disso, caracterizou-se a amostra sob o ponto de vista nutricional e socioeconômico. Como resultados, a idade média das meninas foi de 14,2 anos com desvio-padrão de 1,7 anos e a maioria (81,7%) se mostrou eutrófica pelo índice de massa corporal. A avaliação socioeconômica revelou que praticamente todas as adolescentes recebem desconto na mensalidade escolar, moram em bairros de estrato socioeconômico médio-baixo e médio-alto, cujas famílias têm renda mensal entre 5 e 10 salários mínimos (28,8%) e 10 e 15 salários mínimos (7,5%). A contagem total média do EAT-26 foi de 19,8 pontos. A validação e confiabilidade de consistência interna do teste, representadas pelo alfa de Crombach 0,80, foram consideradas estatisticamente bastante satisfatórias por este valor estar próximo de 1,00. Concluímos assim, que o EAT-26 encontra-se em ótimas condições para ser aplicado em adolescentes, auxiliando no pré-diagnóstico de possíveis casos de transtornos alimentares. Além disso, políticas públicas devem reconhecer e valorizar a elaboração de programas informativos para adolescentes e outros grupos de risco para conhecimento mais amplo desses quadros, possibilitando a precocidade do tratamento e favorecendo o seu prognóstico. / The disturbances of eating conduct, among them, anorexia and nervous bulimia, are psychosomatical syndrome considered serious and of a bad prognostic, characterized by the morbid fear of getting fat, taking to a volunteer reduction of the food ingestion with a losing of weight, solid food ingestion followed by vomit and abusive use of laxatives and/or diuretics. This way, it is very important to obtain the diagnostic for these diseases precociously, and one of the instruments that helps the triagem of possible sick people is the Eating Attitude Test (EAT-26). The objective of this research was translating EAT-26 into Portuguese and validating it in female adolescents and so, the test was applied in 365 students from two private schools from Ribeirão Preto, ages between 12 and 18, the ages where these diseases most frequently occur. To develop this investigation, the metodological referencial of translation and retro-translation of the instrument were used, and statistical analysis method, to evaluate the internal consistence of the items of the test, this is, the intensity of the concordance between the translated versions and their confiability. Besides that, the sample was characterized under the nutritional and socioeconomical point of view. As results, the girls’ average age was 14,2 years old and most of them looked eutrofic by the body mass index. The socioeconomical evaluation revelead that practically all the adolescents receive a discount in their school payment, they live in neighborhoods of middle-low and middle-high socioeconomical standard of living, whose families have a month income between 5 and 15 minimum wages. The total average count of EAT-26 was 19,8 points. The validation and confiability of internal consistence of the test, represented by alfa of 0,80, were considered statistically satisfactory, because this value is next to 1,00. We can conclude that, the EAT-26 is in great conditions for being applied in adolescents helping the pre-diagnostic of possible cases of these diseases. Besides that, public policies must recognize and value the elaboration of informative programs for adolescents and other risk groups so that they can have more knowledge about these diseases, allowing the precocity of the treatment and favoring its prognostic.

A anorexia nervosa (AN) é um dos principais tipos de transtornos alimentares, caracterizado por uma limitação dietética auto-imposta pelo paciente, com temor intenso de engordar, recusa em manter o peso na faixa normal mínima e alteração na percepção da forma e do tamanho corporais. Geralmente apresenta graves complicações de saúde devido a seu estado nutricional e comorbidades psiquiátricas que dificultam o tratamento. Por esses aspectos, pacientes com AN tendem a apresentar dificuldades na vida cotidiana e no desempenho dos papéis ocupacionais, os quais são responsáveis por auxiliar na organização do comportamento do indivíduo e na construção de sua identidade envolvendo- o em contextos e posições sociais. O objetivo desta pesquisa é entender como se configuram os papéis ocupacionais dos sujeitos com AN. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do HCFMRP-USP (processo nº 9109/2008). A casuística foi composta por 11 sujeitos diagnosticados com AN (GE), todos adultos do sexo feminino, que estavam em tratamento no Grupo de Assistência em Transtornos Alimentares (GRATA) do Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP-USP). Um grupo controle (GC) foi formado com 11 mulheres adultas. A metodologia desenvolvida é quali-quantitativa; os dados foram coletados pela aplicação da \"Lista de Identificação de Papéis Ocupacionais\" e de uma entrevista semiestruturada audiogravada com 3 mulheres do GE. Os dados quantitativos foram analisados pelo Teste Exato de Fisher e os dados qualitativos pelo método de análise de conteúdo temática. Os resultados obtidos mostraram que de modo geral, houve mudança, com perda de papéis no desempenho ocupacional devido à AN. Na comparação entre os grupos, os papéis que tiveram resultados estatisticamente significativos em relação ao padrão de desempenho foram o de trabalhador, voluntário, amigo, e passatempo amador. Pela análise dos dados qualitativos, quatro temas emergiram das entrevistas: Percepções anteriores ao diagnóstico de AN, Percepções frente ao diagnóstico de AN, Percepção da interferência da AN no desempenho de papéis ocupacionais e Desejos para o futuro. Embora todos os papéis ocupacionais tenham sido influenciados pelo transtorno, as pacientes não percebem as perdas trazidas pela AN. Elas mostraram-se ambivalentes em relação ao adquirir papéis esperados para o adulto em relação ao que se espera para o adolescente, época do início do transtorno. Além disso, apresentavam dificuldade no relacionamento social e familiar, com prejuízo em relação às atividades e participação social o que sugere que o isolamento social, a preocupação com o outro e a diminuição destas atividades poderiam ter iniciado em fases mais precoces, anteriormente à doença. Esses resultados demonstraram a importância de avaliar questões ocupacionais no tratamento da AN, com vistas a diminuir os possíveis prejuízos psicossociais. Ainda, outros estudos tornam-se necessários para compreender essas dificuldades sociais iniciadas na infância e pré adolescência como um possível fator precipitante do transtorno. / The anorexia nervosa (AN) is one of the main types of eating disorders, characterized by a self-imposed dietary restriction by the patient, with intense fear of gaining weight, refusal to maintain weight in the normal range and change in the perception of body shape. The patient usually presents serious health complications due to his nutritional status and psychiatric comorbidities, which complicate the disease\'s treatment. Because of that the patient usually has difficulties in daily life and performance of occupational roles, which are responsible for assisting in the organization of individual behavior and get his identity besides involve him in social contexts and positions. The objective of this research is to understand how to configure the occupational roles of the subjects with AN. The study was approved by Ethics Committee in Research of HCFMRP-USP (process n º 9109/2008). The specific case included a research group with eleven diagnosed subjects with AN (GE - in portuguese Grupo Experimental), adult women, who were under treatment at the Assistance Group on Eating Disorders (GRATA - in portuguese Grupo de Assistência em Transtornos Alimentares ) of Hospital das Clínicas de Ribeirão Preto belonging to Medicine College (USP-HCFMRP) . A control group (CG) was created with eleven adult women. The methodology is qualitative and quantitative; the data was collected by applying the \"Identification List of Occupational Roles\" and through a semi structured interview audio recorded with three GP women. Quantitative data were analyzed by Fisher\'s Exact Test and the qualitative one by the Thematic Analysis of Content. The results show that there is usually loss of occupational performance roles due to the AN. Comparing the groups, the roles that had significant results regarding the standard of performance were the worker, volunteer, friend and hobby. Through the qualitative data analysis four themes emerged from the interviews: Perceptions before to the Diagnosis of AN, Perceptions With the Diagnosis of AN, Perception of AN Interference in the Occupational Roles Performance and Wishes to the future. Although all occupational roles have been influenced by the disorder, patients do not realize the losses caused by the AN. They had present themselves ambivalent about getting adult expected roles to what is expected for the adolescent, age of onset of the disorder. Moreover, they present social and familiar relationships difficulties, with loss in activities and social participation which suggests the social isolation, but the lack of concern with others and reduction of these activities may have started in a previous stage of the disease. These results demonstrate the importance of occupational activities in the treatment of AN, to reduce the possible psychosocial damage. Still other studies are needed to understand these social difficulties started in childhood or adolescence as a factor that may indicate the development of this disorder.

La capacité de juger ses propres actions se trouve être perturbée dans l'anorexie mentale (AM). Les patientes souffrant d’anorexie mentale surestime notamment le seuil de passabilité d’une ouverture (par rapport à un groupe témoin) lors d’une simulation ou d’un franchissement d’ouverture réelle. Ces données sont en accord avec les plaintes des patientes qui se sentent plus grosses qu’elles ne le sont en réalité. Le jugement des patientes est perturbé lorsqu’elles adoptent une perspective en première personne (j’effectue l’action), mais reste préservé lorsque la perspective est en troisième personne (je regarde un sujet effectuer l’action). Ces résultats suggèrent une atteinte spécifique du schéma corporel et non d’une perturbation globale des jugements perceptifs.Cette surestimation du schéma corporel dans l'AM pourrait être liée à l'existence d'un trouble de l'intégration multisensorielle, l’élaboration d’un schéma corporel harmonieux résultant de l'intégration des afférences visuelles, tactiles, proprioceptives et vestibulaires. Une corrélation existe entre la baisse des performances comportementales et l’intensité des troubles de l'alimentation, qu’il s’agisse de la recherche de minceur, des préoccupations corporelles et de l’insatisfaction générée. Les perturbations corporelles ainsi que les répercussions comportementales engendrées pourraient induire un renforcement des comportements alimentaires restrictifs.Les performances des patientes sont liées à la fois à leur perte de poids au cours des mois précédents et à leur poids avant la décompensation. Ce résultat pourrait appuyer l’hypothèse d’un défaut d’actualisation du schéma corporel, les modifications morphologiques engendrées par une perte de poids rapide et massive n’étant pas prises en compte par le système nerveux central. L'AM touche essentiellement les jeunes femmes entre 15 et 19 ans. De véritables bouleversements physiologiques et psychologiques se produisent lors de la puberté, ayant un impact sur le schéma corporel. Les variations de poids induites par les troubles du comportement alimentaire pourraient venir renforcer ces perturbations. L'étude des phénomènes neurologiques, tel que le syndrome du membre fantôme, pourraient faire la lumière sur ce point. En effet, de nombreuses personnes amputées continuent à ressentir la présence d'un membre fantôme après amputation. Beaucoup de modèles explicatifs ont émergé ces dernières années. L'un d'eux postule une certaine inadéquation entre la rétroaction sensorielle du fantôme et les régions corticales représentant le membre. Dans l’AM, un conflit similaire pourrait se produire entre un schéma corporel antérieur n’ayant pas pris en compte les variations pondérales et la rétroaction sensori-motrice. Ainsi, les patientes se trouveraient enfermés dans un corps plus gros. / The everyday human ability to make judgments about one’s own and other people’s body-scaled actions is disrupted in anorexia nervosa (AN). AN patients significantly overestimated their own passability (relative to a control group) in a simulated body-scaled action. These data were concordant with the patients' clinical complaints that they feel larger than they really are. Judgments in AN patients were significantly affected in the first-person-perspective condition (1PP) but not in the third-person-perspective condition (3PP; see Figure). These overall results suggest that the overestimation of the passability ratios in AN are likely to be caused by an overestimation of their own body schema. They are not symptomatic of a general impairment in perceptual judgments.This overestimation of the body schema in AN can be related to the existence of disturbance in multisensory integration in AN, since the body schema is the product of multisensory integration of visual, tactile, proprioceptive and vestibular inputs. A significant relationship exist between the behavioural performances and the severity of eating disorders by revealing a significant, positive correlation between the patient’s own body action on one hand and body concern, body dissatisfaction and drive for thinness on the other. This disruption causes restrictive eating behaviours to persist.The patients\\\\\\\' performances were related to their body weight loss over the previous months and to their pre-AN body weight. This finding provides a possible explanation for the disruption of body-scaled actions in anorexic people: the body schema modified by the rapid weight loss may not have been updated by the central nervous system. Anorexia nervosa mainly affects young women in the 15-19 age group. However, many of the neurological, morphological and psychological changes occur during puberty and they will have an impact on the body schema. Weight changes induced by eating disorders could reinforce these disturbances. The knowledge gained by studying neurological phenomena such as phantom limbs might shed light on this topic. In fact, many amputees continue to feel the presence of a phantom limb after amputation. Many explanatory models of phantom limb syndrome have emerged in recent years. One of these postulates a degree of mismatch between the sensory feedback from the phantom and the cortical regions representing the limb. In anorexic patients, there could be a conflict between the previous body schema (i.e. before the weight change) and the current sensorimotor feedback. Thus, patients would find themselves locked into a larger body.

Bibliographic identification: ULRICHOVÁ, Michaela. Kineziotherapy And Postural Changes At Very Young Patients With Anorexia Nervosa. Prague: Charles University. 2nd Faculty of Medicine. Department of Rehabilitation and Sports Medicine, 2017. 82 p. Supervisor doc. MUDr. Jiří Radvanský, CSc. Author's first name and surname: Michaela Ulrichová Title of the diploma thesis: Kineziotherapy And Postural Changes At Very Young Patients With Anorexia Nervosa Department: Department of physiotherapy Supervisor: Doc. MUDr. Jiří Radvanský CSc. The year of presentation: 2017 Abstract: There is a number of studies demonstrating the positive effects of supervised exercise therapy on patients with anorexia nervosa. Recent literature suggests that an appropriate physical activity may improve the quality of life during inpatient treatment, increase weekly weight gain, reduce eating pathology and lower relapse rates. The objective of this diploma thesis was to design an exercise program for hospitalised child patients with anorexia nervosa. A sample of 25 female patients was used to prove that this program has no adverse effect on the re-feeding program. The initial kineziological analysis of those patients showed significant patological postural changes which are much more frequent for patients with anorexia nervosa than for...

Background: Family members of people with eating disorders are often involved in caregiving. To better understand the impact on them, outcomes such as burden, distress, and less frequently quality of life (QoL) are taken into consideration. Despite advancements in the knowledge base surrounding the experiences of adult and parental caregivers of individuals with eating disorders, particularly Anorexia Nervosa, there is a scarcity of qualitative exploration from the sibling perspective, particularly that of adolescent siblings. Objectives: The systematic review aimed to identify research and synthesise findings relating to informal caregivers’ quantitative ratings of quality of life in the context of eating disorders. The primary study aimed to explore in detail the lived experience of adolescent siblings with a brother or sister with Bulimia Nervosa or Eating-Disorder-Not-Otherwise-Specified. Method: Applying a priori inclusion and exclusion criteria to papers identified from a combination of systematic searches of electronic databases and hand searches of other pertinent literature, revealed eight studies to be included for review. Within the qualitative study, eight semi-structured interviews were carried out with siblings (aged 12-19-years) who had a brother or sister with an eating disorder. An interpretative phenomenological analysis approach was utilised to analyse interview data. Results: The review highlighted low ratings for aspects of quality of life for informal caregivers of individuals with eating disorders, and some emerging comparative and subgroup differences. Three super-ordinate themes emerged from the qualitative exploration: Sibling Identity, The Vulnerable Social ‘Self’, and Intra- and Inter-Personal Coping. Discussion: Overall the findings provide particular insight into the quality life of informal caregivers and the unique experiences, feelings and various roles of adolescent siblings of people with eating disorders. Implications regarding caregiver support and the needs of siblings specifically are considered. Strengths and limitations, as well as future research possibilities are outlined for both the systematic review and empirical study.

This study explored the possibility that some individuals with alcohol and amphetamine addictions are initially motivated to use alcohol and amphetamines because of underlying issues involving body dissatisfaction and weight reduction associated with Anorexia and Bilimia Nervosa. Current literature reveals similarities among chemical dependencies and eating disorders.

Bakgrund: Anorexi betyder aptitlöshet och är ett missvisande namn på en sjukdom som handlar om avsiktlig självsvält. Sjukdomen är dödlig, personer med AN löper sexfaldigt ökad risk att dö jämfört med den allmänna befolkningen. Svår och långvarig AN är ett av psykiatrins mest utmanande tillstånd att behandla. Det saknas fortfarande studier på vuxna med AN, då det övervägande finns forskning rörande tonåringar med AN. Syfte: Syftet med denna studie var att belysa vilka faktorer personer med egen erfarenhet av Anorexia Nervosa ansåg vara främjande och/eller försvårande i återhämtningen från sjukdomen. Metod: Litteraturstudien baserades på systematiska databassökningar i databaserna Pubmed, Cinahl och PsycINFO. Resultatet baserades på 13 artiklar med kvalitativ metoddesign med utgångspunkt i patienters upplevelser. Resultatet presenterades utefter identifierade andra- och tredje nivåns teman. Resultat: Litteraturstudien resulterade i negativa och positiva faktorer till återhämtning uppdelat i ett tredje nivåns tema om faktorer relaterade till individen, och ett tredje nivåns tema om faktorer relaterade till omgivningen- och omvårdnad. Litteraturstudien mynnade ut i ett konstaterande om att AN handlade om så mycket mer än mat och vikt, och visade på viktiga steg för individen och omvårdnaden som tillsammans ledde till återhämtning från AN. Diskussion: Gemensamt för resultatets båda tredje nivåns teman var individens önskan om att vårdarna skulle se bakom sjukdomen och arbeta tillsammans med patienten. Personcentrerad omvårdnad som kärnkompetens och salutogenes som teori var därför viktiga och användbara utgångspunkter i vården för återhämtning. Konklusion: Fokus i behandling borde vara på individ istället för på sjukdom för att uppnå återhämtning. / Background: Anorexia means loss of appetite and is misleading for a disease that is about self-starvation. The disease is deadly, people with AN have a sixth increased risk of dying compared to the general population. Severe AN is one of psychiatry's most challenging conditions to treat. There is still a lack of studies on adults with AN, most research is on teenagers with AN. Aim: The aim with this study was to highlight which factors people with a personal history of Anorexia Nervosa considered to be positive and/or negative for their recovery. Method: Literature review based on systematic database searches in the databases Pubmed, Cinahl and PsycINFO. The result was based on 13 articles with qualitative method design based on patients' experiences. The result was presented according to identified third-level themes and second-level themes. Results: The study resulted in negative and positive factors regarding recovery divided into one third-level theme of factors related to the individual, and one third-level theme of factors related to the environment and nursing care. The literature study culminated in a finding that AN is about so much more than food and weight and shows important steps for the individual and the administered care, which together lead to recovery from AN. Discussion: Common to the two third-level themes of the result was the individual's desire for the caregivers to look behind the disease and work with the patient. Person-centered nursing such as core competence and salutogenic theory where therefore important and useful starting points in the care for recovery. Conclusion: The focus of treatment should be on the individual instead of the disease in order to attain sustainable recovery.

Inom omvårdnad av personer med ätstörningar är relationen mellan vårdare, familjer och patient viktig. Det är viktigt att se till personens psykiska och fysiska behov samt kunna motivera till återhämtning hos den sjuka. Syftet med det här examensarbetet var att beskriva personers upplevelser av att leva med en ätstörning. Nio vetenskapliga studier analyserades med en kvalitativ innehållsanalys med manifest ansats. Analysen av artiklarna resulterade i fem kategorier: att känna sig övergiven av omgivningen; att känna sig styrd av sjukdomen; att förstå att man är sjuk och vilja bli av med sjukdomen; att känna ilska, skam och ångest samt att inte se sin rätta kroppsbild. Upplevelser som personerna hade var bland annat att de kände sig isolerad, hade svårt att bilda relationer utanför familjen, kände skam, ångest och hade en vilja att självskada sig. Att skapa kunskap är viktigt i omvårdnaden av personer med ätstörningar för att sjuksköterskor ska kunna skapa en trygghet, tillit och kunna främja en hälsosam livsstil för återhämtning från sjukdomen. Denna litteraturstudie kan användas till att öka förståelsen för personer som lever med en ätstörning vilket kan bidra till en förbättrad omvårdnad för dessa personer och familjer.