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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