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Anorexia Nervosa

 

What is anorexia nervosa?

Anorexia nervosa is a disorder of weight that occurs when a person is extremely afraid of gaining weight and therefore eats as little as possible. Similarly, they may have intense and protracted exercise regimens in an attempt to keep the weight off. This condition is both a physical illness and a psychiatric illness. Patients have a distorted body image, seeing pockets of fat where there aren't any, or where there should be some. The person will develop severe nutritional deficiencies, and suffer the effects of them: poor growth, poor healing, bleeding disorders, gastrointestinal complications and a host of others. The massive decrease in weight can affect hormonal levels which are responsive to the amounts of body fat. In young women menstruation can stop. Anorexia nervosa can be a very severe illness. Death may occur from suicide, but usually occurs as a result of the starvation.

This illness occurs most often in young women. However, about 5% to 10% of people with anorexia are men, and this number may be significantly higher due to underreporting.

How does it occur?

The cause of anorexia nervosa isn't clear. The disease is believed to be genetic given its high co-morbidity in identical twins. A contributing factor in many cultures may be the emphasis on equating female beauty with thinness. Factors that increase the risk of developing anorexia nervosa include:

  • a family history of anorexia nervosa or other eating disorders
  • a family or personal history of mood disorders, such as major depression and bipolar disorder (manic depression).

What are the symptoms?

Symptoms may include:

  • weight loss, usually severe
  • binge eating (eating large amounts of food in a short time) and/or purging (using laxatives or making yourself throw up)
  • weakness
  • depressed or anxious mood
  • insomnia
  • Hormonal changes or complications.

How is it diagnosed?

Your health care provider does a physical exam and medical history. He or she will investigate eating and other behavior patterns, such as:

  • extreme selectiveness in choosing food that is low in calories
  • binge eating
  • purging, taking laxatives
  • ritualistic eating
  • over-exercising
  • denial of hunger and denial of any problem at all.

Anorexia needs to be differentiated from a similar disorder called bulimia nervosa, which is marked primarily by normal or even overeating, followed by vomiting or laxative use. The treatments for the two disorders may be very different.

How is it treated?

This can be a very difficult condition to treat. Individual psychotherapy and family therapy are usually necessary. Medication (especially medication effective in mood disorders) may be prescribed to help reduce the fear of becoming fat, reduce depression and anxiety, and aid in weight gain. You may need to be hospitalized if your condition is severe and life threatening. How long will the problem last?

Ordinarily, the first treatment issue revolves around weight: if the person is severely malnourished, they may need to be hospitalized to receive supplementation.

If they are stable, there are a number of different treatment strategies that have good success rates. One should consult with a doctor if they believe they or someone they know may suffer from anorexia.

If you have anorexia, you may have symptoms for many years and will probably need ongoing treatment. Any stressful situation can cause a relapse. After you have reached a normal weight, you may need to continue psychotherapy or medication for months or years.

What can be done to help prevent anorexia nervosa and maintain good physical health?

Acceptance of yourself and your body can help prevent this problem. In addition you can:

  • Keep appointments with your health care provider or therapist.
  • Avoid skipping meals.
  • Avoid using laxatives.
  • Avoid drinking alcohol.
  • Avoid smoking cigarettes.

You may also want to contact the National Mental Health Association (NMHA). NMHA's toll-free number is 1-800-969-NMHA. The website address is http://www.NMHA.org.