Effect of symptoms
Some features of AN can be difficult to assess meaningfully
in that they decrease in ‘severity’ as illness severity
increases. For example, fear of fatness can decrease as
the individual’s weight drops and they are no longer
confronted with fat on their own body. Similarly, drive
for thinness and body image dissatisfaction can also
decrease as weight decreases. To generalist clinicians,
this could result in a failure to diagnose individuals with
potentially severe AN, as they appear to lack either one
or both of the essential symptoms. Other clinicians may
misconstrue this as ‘denial’ and engage in confrontational
discussions with patients, which may be unhelpful.