{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:55:40Z","timestamp":1779206140174,"version":"3.51.4"},"reference-count":81,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T00:00:00Z","timestamp":1671580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Avicenna J Med"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Anorexia nervosa (AN) is a type of eating disorder that has been increasing in incidence and has been encountered more commonly by physicians in their daily practice. Both environmental and genetic risk factors paired along with a more susceptible neurobiology are at play in the emerging resistance to treatment in AN. Preoccupations with intense fear of weight gain, dietary restrictions, excessive exercise, and how the individual is perceived by society mixed with underlying psychopathology all further add to the issue. Many patients who fall into this cycle of obsessive and restrictive patterns refuse to get treatment. As clinicians, it is essential we recognize the early signs of both eating disorders during the initial primary care appointments.<\/jats:p><jats:p>To review the literature on the etiology of AN, possible misdiagnosis leading to inappropriate management of this condition, and understand the treatment-resistant AN and its management. Additionally, it will explore possible reasons that contribute to the resistance to treatment, the underlying psychopathology of anorexics, its genetic predisposition, psychiatric comorbidities, identification of the early signs and symptoms, and timely prevention.<\/jats:p><jats:p>Early recognition by a physician includes a thorough history and physical examination, pertinent laboratory, and electrolyte studies, and identifying comorbid psychiatric conditions. The treatment of AN is intricate and requires a holistic approach. Treatment includes multiple modalities such as nutritional rehabilitation and psychosocial and pharmacological therapies. An interdisciplinary team of medical professionals for managing chronic AN is recommended.<\/jats:p>","DOI":"10.1055\/s-0042-1758859","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T23:59:40Z","timestamp":1671667180000},"page":"003-014","source":"Crossref","is-referenced-by-count":17,"title":["A Clinical Overview of Anorexia Nervosa and Overcoming Treatment Resistance"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9589-1333","authenticated-orcid":false,"given":"Hassan","family":"Nagy","sequence":"additional","affiliation":[{"name":"Division of Research & Academic Affairs, Larkin Health System, South, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2532-0196","authenticated-orcid":false,"given":"Tanya","family":"Paul","sequence":"additional","affiliation":[{"name":"Division of Research & Academic Affairs, Larkin Health System, South, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6618-8187","authenticated-orcid":false,"given":"Esha","family":"Jain","sequence":"additional","affiliation":[{"name":"Division of Research & Academic Affairs, Larkin Health System, South, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9085-8582","authenticated-orcid":false,"given":"Hanyou","family":"Loh","sequence":"additional","affiliation":[{"name":"Division of Research & Academic Affairs, Larkin Health System, South, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0007-124X","authenticated-orcid":false,"given":"Syeda Hafsa","family":"Kazmi","sequence":"additional","affiliation":[{"name":"Division of Research & Academic Affairs, Larkin Health System, South, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7758-775X","authenticated-orcid":false,"given":"Rishbha","family":"Dua","sequence":"additional","affiliation":[{"name":"Division of Research & Academic Affairs, Larkin Health System, South, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2216-0975","authenticated-orcid":false,"given":"Ricardo","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Division of Research & Academic Affairs, Larkin Health System, South, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4254-6565","authenticated-orcid":false,"given":"Syed Ali Abbas","family":"Naqvi","sequence":"additional","affiliation":[{"name":"Division of Research & Academic Affairs, Larkin Health System, South, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6721-6752","authenticated-orcid":false,"given":"Metu Chiamaka","family":"U.","sequence":"additional","affiliation":[{"name":"Division of Research & Academic Affairs, Larkin Health System, South, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5630-4642","authenticated-orcid":false,"given":"Erjola","family":"Bidika","sequence":"additional","affiliation":[{"name":"Division of Research & Academic Affairs, Larkin Health System, South, Miami, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,12,21]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1097\/01.yco.0000228759.95237.78","article-title":"Incidence, prevalence and mortality of anorexia nervosa and other eating disorders","volume":"19","author":"H W Hoek","year":"2006","journal-title":"Curr Opin Psychiatry"},{"issue":"10","key":"ref2","doi-asserted-by":"publisher","first-page":"e027339","DOI":"10.1136\/bmjopen-2018-027339","article-title":"Incidence of anorexia nervosa in young people in the UK and Ireland: a national surveillance study","volume":"9","author":"H Petkova","year":"2019","journal-title":"BMJ Open"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1001\/archgenpsychiatry.2011.74","article-title":"Mortality rates in patients with anorexia nervosa and other eating disorders. 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