Psychiatry and Clinical Psychopharmacology

An anorexia nervosa case presented with a complaint of glass eating

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S248-S249
Read: 627 Published: 17 February 2021

Anorexia nervosa (AN) is characterized by excessive weight loss resulting in body weight below healthy norms, refusal to reach appropriate weight during ongoing growth process, intensive fear of gaining weight or being obese despite being underweight, and distorted self-perception in terms of body image and body-shape. Lifetime prevalence of anorexia nervosa is 1%. It begins between the ages of 12 to 18. Anorexia nervosa is associated with numerous major medical complications secondary to starvation. In this case report, we will discuss an anorexia case presented with a complaint of glass eating. A 15-year-old schoolgirl (grade 9) was referred to our outpatient clinic for consultation by pediatrics department, as she ate glass to avoid eating food. The patient was referred to pediatrics outpatient clinic with a complaint of glass eating. Laboratory evaluations revealed that there was no abnormal finding other than decreased vitamin B12 level. ECG was found to be normal. A foreign body image considered as glass was observed on the abdominal radiography. The patient was referred to child psychiatry outpatient clinic, as she cited that she ate glass to be filled during examination. In the interview with the patient and her parents, it was found out that she started a diet with thought of being overweight 3 months ago; that she had weight loss of 20 kilograms at this period; that she refused to eat despite all efforts of the parents; that she continued to consider herself as overweight and began to eat glass for being filled; that she used anti-diabetic drugs of her father for the same purpose; that she had menstrual irregularity over 2 months; and that she had complaints of malaise, unwillingness and insomnia. In the psychiatric examination, she appeared exhausted and weak. She was dysphoric. The patient cited that she felt overweight and she was thinking that she had no abnormality. It was found that there was disrupted body-perception and no insight. Body weight, height, and BMI were 36 kg, 165 cm and 13.22, respectively. The patient was diagnosed as anorexia nervosa and major depressive disorder and şuoxetine (20 mg/day) and olanzapine (5 mg/day) were initiated to the patient. In the follow-up, it was seen that there was improvement in body-perception and depressive mood and that she began to gain weight. Patients with anorexia nervosa can make calorie calculations and develop excessive fear against some nutrients by fear of weight gain. Patients can perform excessive exercise. In addition, there may be drug abuse including laxatives, diuretics, those suppressing appetite, thyroid hormone preparations for the purpose of weigh lost. Similarly, there may be abuse of anti-diabetic agents as seen in our case. In addition, our patient preferred glass eating, a rarely encountered method, for weight loss. Rapid weight loss cause many disorder in human body; in addition, methods used to lose weight can also result in severe problems. Thus, clinicians should be careful when assessing cases with anorexia nervosa.

EISSN 2475-0581