Treatment of Anorexia Nervosa in an Ultra-Orthodox Adolescent Male
Abstract
Objective: This unique case presents an opportunity to deepen the understanding of the etiology of anorexia nervosa in an ultra-orthodox 14-year-old adolescent. The boy arrived at our countryside clinic after a 1.5-year history of severe self imposed diet restrictions to control his weight and appearance, and a year of partial and full hospitalizations in psychiatric wards. The main objectives of the intervention were: to achieve nutritional rehabilitation, develop normal eating and self-care habits, eliminate bed-wetting, as well as challenge developmental issues and cultural discourses. Method: 12-months of comprehensive intervention, which included: a weekly dietetic session, parental guidance or family therapy, interpersonal and narrative psychotherapy twice a week, and a clinical mentorship (two days per week). The boy’s progress was assessed via interview, using EDEQ-17 for the assessment of eating disorder symptoms, DASS-21 for the assessment of self-regulation, and the Rosenberg scale for the assessment of selfesteem. Results: After a year in our outpatient clinic, the boy regained normal eating habits and normal weight status. His EDEQ global score decreased from 4.1 to 0.9. His global DASS-21 score decreased from 38 (severe) to 7 (normal) indicating improvements in self-regulation and impulsiveness. Self-care and self-esteem were also significantly improved. Bed-wetting disappeared. He is currently fully functional in his community and attends a school that better…
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