Clinical experiences
Anorexia nervosa in a teenage Girl
In February 2023, we got a message from early teen girl’s parent as follows
“Good evening. From last couple of months my daughter is not eating properly and lost 18 kg weight (her weight was around 52 kg earlier and now 34 to 35 kg). She is 14 years 10 months old and her height is 5'4".
“Regular allopathic family doctor suspected this as a case of anorexia nervosa and asked us to consult both psychologist and psychiatrist. We consulted both and she is currently under medication, last week she improved a bit but this week she again went back to not eating properly. Kindly advise and give your appointment at the earliest, thank you”
“We forgot to inform one more point sir. Most of the time she is in standing position or walking here and there but not sitting in one place”
When we asked about any particular reason behind this change, they mentioned the following three points as the possible reasons -
1. Six months back, she got braces to align her teeth, she become more conscious about physical looks.
2. She also mentioned that she feels bad when someone comments her as chubby
3. Her sister moved out of the house for higher studies hence she felt disturbed.
We had the first consultation through video call, the teen girl was not at all corporative in the initial consultation. In fact she was more irritated. From the parents, we came to know currently she is under the medications like antidepressant, laxative, supplements like Vitamin B-complex, Vitamin D and calcium. She was eating very little foods, mostly some fruits. juice and salads. As she’s concerned of gaining weight.
Our ayurvedic perspective on her condition.
Her digestive capacity, Agni, is disturbed due to emotional disturbance. Due to this, her gut brain axis wasn’t working properly. The intake of laxative and anti-depressant, again reduce the natural intestinal serotonin production. Due to low digestive capacity, her body was unable to absorb the nutrient supplements which worsened the case.
Our line of approach –
First, we needed to win the confidence of the teen girl and make her believe eating right will not lead to overweight, as she is very particular not to gain any weight.
We did not start any medication, just asked her to eat as per her wish and drink Coriander and dry ginger water whenever she feel thirsty. Also asked her to stop the supplements and laxative. These steps will help her to stabilize the metabolism.
Preparation of herbal water: Take 1 teaspoon coriander seed , 1/4 teaspoon of dry ginger powder, put it in 1 lit of water and boil for 15 minutes,
To stabilize her emotions and nature being all around and hyper, which is considered as the increase Vata dosha, we asked her to apply Lakshadi kerathailam on head crown, ear lobes, palm and feet for 5 minutes every day between evening 4:00 PM to 5:00 pm.
In the second consultation after 2 weeks –
This time, she was much calmer and was ready to listen. Here we explained her how the body is working as per Ayurveda and give some information about sapthadhatu concept - 7 tissue functional units of body which are transformed or nourished in sequential manner.
We were able to convince her that the Ayurvedic medication which we are providing will help to correct her metabolism and form healthy blood tissue which is very essential to maintain healthy life. As per the dhathu concept, if raktha or blood is not formed properly she cannot sustain her life, and these medications will not make her obese. As per ayurvedic concept if all the seven dhathus are working efficiently there won’t be any over accumulation of any particular tissue in the body. So theoretically even the fat will also won’t be there.
Once she understood the concept, she agreed to take medications which are listed below.
Dosage: 1/4 teaspoon with warm rice starch water, morning, in empty stomach.
( Which will helps to increase metabolism, digestive capacity)
2. Dasamoolarishtam + Abhayarishtam
Dosage: take 5 ml from each, mix, 10ml at bedtime.
(Which will helps to regulate gut brain axis)
External applications: Continue the Lakshadi kera thailam application.
Diet: Continue coriander dry ginger water, Eat as she likes, avoid raw salads.
In the 3rd Consultation after 2 weeks
She was responding positively to the corrections. So continue the same medication and asked her to slowly increase the amount of food she is eating, as she was willing to took rice , roti and vegetable etc .
But after 1 week she develop fever and stomach pain , as she ate heavy foods and ice cream, so we stopped the above medications (Gritham and arishtam for 5 days) and oil application.
Asked her to take 1 Danwantharam guika tablet after lunch ( to enhance digestive movements and reduce stomach pain), Indukantham kwatham tablet after dinner (to reduce fever due to indigestion).
After 5 days, we restarted the above mentioned internal medications. We changed oil massage with podikizhi (Pouch/bundle massage with pulses) on alternate days to ‘open-up’ the channels of her body which will help her to correct her metabolism.
4th consultation: after 2 weeks
She was responding positively with internal and external medication, so continued the same for 1 more week.
5th consultation – After 1 week,
For Internal medication , -
Continue the indukantham grutham
Instead of abayarishta we prescribe Dasamoolarishta and Balarishta, 10 ml after dinner
External Treatment -
Instead of pouch massage, we asked her to do full body massage with Narayana thalian which helps her to stabilize her Vata in to proper direction.
Continued the Lakshadi kera thailam Application
Along with internal and external medication we asked her to start some loosening exercise, breathing exercise and classical dance practise .
By the end of the May her condition improved, she was feeling better. We didn’t encouraged her to check weight as it an trigger stress in her.
Her parents sent the following message on May 2023
“She has improved sir, she is listening to us and also her irritation instances have come down. She is going to the school regularly and also improved on studies”
Key observations
- It. Is very critical to manage the teenage brains during the their pre-frontal development phase. We need to be careful on what to feed, and how to handle the situations.
- When you treat symptomatically , it may not resolve what body is trying to solve.
- By appropriate day routine and simple dietary pattern, we can build normalcy in our body without going to complicated procedures. No need to medicalise life.
- Understanding once’s digestive capacity and what are the right nutrients s more important than taking or not taking nutrients by comparing what others need.
-Dr. Poornima Sreelal
(BAMS, M.Sc. CND)
Ayurvedic Physician & Clinical Nutritionist.
The author can be contacted over mail infoayurdiet.in@gmail.com or +91-9447762555.
No comments:
Post a Comment