Managing Anorexia in Asperger's Syndrome: Seeking Specialized Care

Asperger's syndrome Anorexia nervosa

Doctor, I would like to ask about my cousin (a high school freshman) who has Asperger's syndrome.
She tends to be very stubborn and recently became fixated on losing weight, which has led to severe bodily dysfunction.
She hasn't had her period for six months, and her stomach's absorption capacity is almost nonexistent; she feels no difference whether she eats a lot or a little.
After researching online, it seems she has developed anorexia nervosa due to her dietary issues.
She is currently hospitalized at Tamsui Mackay Memorial Hospital for treatment, but the psychiatric ward has a mix of patients, and she is having a hard time adapting.
In fact, she is becoming more resistant and is still fixated on the fear of gaining weight again.
I would like to know if there are any specialized doctors or relevant institutions that focus on treating such cases.
We hope she can avoid being in that kind of environment for treatment, as it only increases her fear.
Are there any methods that could help her? Our family is very concerned, and we would appreciate your advice.
Thank you.

Lin Yu-ru, 10~19 year old female. Ask Date: 2016/01/08

Dr. Liang Sunyuan reply Psychiatry

Hello, when anorexia reaches the point of requiring hospitalization, it usually indicates that the body has already encountered significant issues, and without hospitalization, improvement may be unlikely.
While some individuals may feel uncomfortable or resistant to being in a psychiatric ward, hospitalization for the treatment of anorexia is typically a temporary crisis intervention, and the duration of hospitalization is usually not very long.
It is recommended that family and friends provide ample support, as it is believed that once her physical and mental health improves, she should be able to transition to outpatient treatment.

Reply Date: 2016/01/08

More Info

Managing anorexia in individuals with Asperger's Syndrome can be particularly challenging due to the unique characteristics associated with both conditions. Your concern for your cousin's well-being is commendable, and it's essential to approach this situation with a comprehensive understanding of her needs.

Firstly, it's crucial to recognize that anorexia nervosa is a serious eating disorder characterized by an intense fear of gaining weight and a distorted body image, leading to self-imposed starvation and excessive weight loss. In individuals with Asperger's Syndrome, which is part of the autism spectrum, there may be heightened rigidity in thinking and behavior, making it difficult for them to adapt to changes, including those related to eating and body image.

Given that your cousin has been hospitalized at a psychiatric facility, it's important to ensure that she is receiving appropriate care tailored to her specific needs. Here are some suggestions and considerations for managing her condition:
1. Specialized Care: Look for treatment centers or professionals who specialize in eating disorders and have experience working with individuals on the autism spectrum. Facilities that focus on dual diagnosis (both eating disorders and autism) can provide a more supportive environment. You may want to reach out to local hospitals, clinics, or mental health organizations to find specialists who have expertise in this area.

2. Therapeutic Approaches: Cognitive Behavioral Therapy (CBT) is often effective for treating anorexia. However, adaptations may be necessary for individuals with Asperger's. Therapists who understand the cognitive styles of those with autism can help address the rigid thought patterns that contribute to her eating disorder. Family-based therapy (FBT) can also be beneficial, as it involves the family in the treatment process, helping to create a supportive home environment.

3. Nutritional Support: A registered dietitian specializing in eating disorders can work with your cousin to develop a meal plan that addresses her nutritional needs while also considering her fears and anxieties about food. This professional can help her understand the importance of nutrition in a way that resonates with her.

4. Creating a Supportive Environment: Since your cousin is struggling in a mixed psychiatric ward, consider advocating for her needs. Speak with the treatment team about her specific challenges and the possibility of a more structured environment that caters to her needs. If possible, explore outpatient programs that focus on eating disorders, which may provide a more suitable setting for her recovery.

5. Family Involvement: Engage family members in her treatment process. Educating the family about anorexia and Asperger's can foster understanding and support. Family therapy sessions can also help address any dynamics that may contribute to her condition.

6. Monitoring and Follow-Up: Regular follow-ups with healthcare providers are essential to monitor her progress and make necessary adjustments to her treatment plan. This includes monitoring her physical health, mental health, and nutritional status.

7. Encouraging Open Communication: Encourage your cousin to express her feelings and fears about food and body image. Open communication can help her feel supported and understood, reducing her anxiety about treatment.

8. Alternative Therapies: Some individuals find relief through alternative therapies such as art therapy, music therapy, or mindfulness practices. These can provide additional outlets for expression and coping.

In conclusion, managing anorexia in someone with Asperger's Syndrome requires a tailored approach that considers both the eating disorder and the unique characteristics of autism. Seeking specialized care, involving family, and creating a supportive environment are critical steps in helping your cousin on her path to recovery. It's essential to remain patient and supportive as she navigates this challenging journey.

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