Anorexia Nervosa
What is it?
Anorexia nervosa is an eating disorder often marked by
an unnatural fear of weight gain, compulsive exercising,
self-starvation, a distorted body image, and amenorrhea,
or absence of at least three consecutive menstrual cycles.
There are two sub-types of anorexia nervosa – restricting
and binge-purge. Restricting anorexia nervosa is
characterized by strict diet and exercise. Binge-purge is
marked by periods of compulsive eating with or without
self-induced vomiting and the use of laxatives or enemas.
Although many diagnosed with anorexia nervosa recover, the
disorder can lead to death.
Who gets it?
About 90 percent of those with anorexia nervosa are
young women ages 14 to 18. But men and women through their
40s are also at risk. Anorexia nervosa was once considered
a disorder of the upper and middle classes. But, more
recent studies show that cases of anorexia are becoming
more common among young women of all races and social
classes in the United States. Adolescents who aspire to be
models, professional athletes or performers appear to be
at higher risk for developing anorexia nervosa. Anorexia
nervosa may be found in people also suffering with
depression, anxiety disorders and obsessive-compulsive
disorder.
What causes it?
The precise cause of anorexia is not known but is
probably the result of a combination of psychological
factors, social influences and occupational goals. The
changes caused by puberty appear to be a strong influence.
Some girls may have difficulty accepting the changes in
their bodies in adolescence, especially fat accumulation.
This may be coupled with teasing by peers. Other
psychological contributors may include reactions to sexual
abuse, a desire to appear weak and fragile to the opposite
sex, family dysfunction, and an overemphasis on control
and independence.
Socially, young women from an early age are conditioned
by the media and other sources to believe that only very
thin women are considered beautiful.
Many of the risk factors for women are the same for
men, a group in which the number of cases is rising
especially among homosexuals.
What are the symptoms?
One important sign that someone may be suffering from
anorexia nervosa is grossly distorted body image, meaning
that the person feels they are overweight and, in fact,
appear thin. Other symptoms may include unnatural fear of
weight gain, compulsive exercising, self-starvation, loss
of energy, and, in girls who have started menstruating,
amenorrhea, or absence of at least three consecutive
menstrual cycles. Those with anorexia nervosa may begin to
appear emaciated.
Over time, the disorder may cause serious health
problems including sudden death, congestive heart failure,
dental problems, growth retardation, stomach rupture,
swelling of the salivary glands, anemia, abnormalities of
the blood, loss of kidney function and osteoporosis.
Diagnosis
Many anorexics deny that they have a problem and are
usually brought for treatment by a family member.
A physician may look for the following signs that a
patient has anorexia nervosa: emaciated body, dry or
yellowish skin, abnormally low blood pressure, history of
amenorrhea, abdominal pin, constipation and lack of
energy. The patient may also have developed lanugo, a
soft, downy hair that grows on the arms and chest. If a
patient has been vomiting, she may have eroded tooth
enamel and Russell’s sign, or scars on the back of the
hand. The physician will also assess whether a patient’s
weight loss is less than 85 percent of ideal body weight.
Other health concerns that present similar symptoms
will need to be ruled out through a series of tests. Those
other health conditions may include metabolic disorders,
brain tumors, diseases of the digestive tract and
mesenteric artery syndrome.
Treatment
The disorder has different levels of severity. The most
critical cases may require hospitalization with group and
individual therapy and, in some cases, force-feeding.
Those with less severe cases may require outpatient
psychotherapy and nutrition counseling. Family counseling
may also be recommended. Although treatment with
medications is debated among physicians, medications
including antidepressants, anti-anxiety drugs or others
may be recommended.
The majority of anorexics will recover. However, some
studies report that about one in 10 may die from
complications of anorexia nervosa. Those causes of death
include starvation, electrolyte imbalance, heart failure
and suicide.
Self care tips
Families should encourage healthy attitudes towards
food, body image and exercise and be mindful of the
symptoms of anorexia nervosa.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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