ANOREXIA NERVOSA

What Is Anorexia Nervosa? Anorexia nervosa is an eating disorder that affects mainly young women who have an abnormal concept of body shape and weight, and an intense fear of becoming overweight. This preoccupation with their body image leads those suffering from anorexia to refuse to eat enough food to maintain a healthy and normal body weight. Patients with anorexia nervosa do not lose their appetite and so at times can revert to binge eating followed by vomiting and use of laxatives and/or diuretics to rid themselves of calories. This behaviour describes another eating disorder known as bulimia nervosa. In fact fifty percent of anorexics also have traits of bulimia.

What Causes Anorexia Nervosa? There is no known single cause of anorexia, although it is thought that many factors play a role. Some believe that family dynamics and up-bringing contribute to the development of anorexia and other eating disorders such as bulimia. Families that are highly motivated, goal oriented and super-achievers tend to encourage a personality that is prone to anorexia. These families have been described also as having problems in interpersonal communication. It has been observed that many people who develop eating disorders are often perfectionists who are intelligent and meticulous. Some researchers have indicated that sexual abuse may also play a role, but this is controversial and not uniformly accepted. A genetic component has been proposed to be involved, since there is an increased incidence of eating disorders in first degree relatives of these patients. However, this is currently considered only a minor contribution to the illness. One of the strongest influences remains the media and society's view of thinness. Today's concept of beauty is still pervaded by super-thin actresses and supermodels who often look anorexic. Yet the media transmit and help perpetuate these unhealthy body images to everyday people, without considering the consequences when we associate beauty with starvation.

What Are The Signs And Symptoms Of Anorexia Nervosa? Signs and symptoms of anorexia can vary from being minor and short-lived to severe and irreversible. Some of the early signs include an excessive concern about weight and a decrease in the amount of food eaten during meals. Strangely enough, most patients are already thin to begin with. Many patients are constantly thinking about food, studying diets, collecting recipes and counting calories. Most patients deny their illness and are usually taken to a doctor against their will when families become concerned about significant weight loss, inadequate growth (especially in teens), or other complaints such as abdominal pain, constipation, or bloating. It is important to realize that patients suffering from anorexia can be very manipulative. They can lie about how much food they eat, hide or throw away food, and even prepare large and fancy meals for their friends and family. Physical findings include a loss of menstruation, decreased interest in sex, an abnormally low heart rate and blood pressure, sensitivity to cold and hair loss. These changes are related to the constant state of malnutrition these patients are in. In a severely malnourished patient, almost every major organ (e.g. the kidneys and the heart) can fail and there is a significant risk of sudden death. One of the major causes of sudden death is the occurrence of fast, abnormal heart rhythms, known as ventricular tachyarrhythmias, which can result in a fatal heart attack. Suicide is another major cause of death, since other psychiatric illnesses such as depression also accompany anorexia.

With What Can Anorexia Nervosa Be Confused? Anorexia is often confused with other eating disorders, in particular, bulimia nervosa. While both disorders involve distorted body images and extreme fear of weight gain, anorexic patients restrict their diet while bulimic patients binge on food and purge the food through methods such as self-induced vomiting, laxative and diuretic use, and excessive exercise. Unlike patients with anorexia, who can become extremely thin and sick looking, bulimic patients usually have normal weight. Among young women, bulimia is more common than anorexia.

What Are The Long-Term Complications Of Anorexia? If anorexia is not treated early, it can lead to serious, even life-threatening medical complications due to the prolonged state of malnutrition. Heart disease can develop since during starvation, and levels of cholesterol tend to rise. Another long-term complication of starvation is abnormally low levels of hormones in the body. These low levels can result in irregular or absent menstruation, frequent miscarriages, higher rate of birth defects and even sterility. Loss of minerals important for bone growth due to low levels of estrogens can lead to osteoporosis later in life. The longer the eating disorder persists, the more permanent the bone loss. Growth retardation is a serious complication for children and young teens, and can lead to permanent short stature if anorexia is not treated immediately. People with anorexia may also experience nerve damage, seizures, loss of concentration and apathy. Anemia is another common complication which results in weakness and fatigue. A serious type of anemia can develop, called megaloblastic anemia, resulting from deficiency of vitamin B12. Although some of these complications may disappear with the return to a healthy, well balanced diet, there is evidence that some may be permanent.

How Is Anorexia Nervosa Treated? Anorexia is treated in two stages. The first stage is to stabilize the patient medically, since a prolonged state of starvation can destabilize delicate fluid, electrolyte (such as potassium and sodium) and nutritional balances. This is done by providing nutritional and fluid replacement. This is extremely difficult for an anorexic patient, since such measures would result in feared weight gain. It may be necessary to hospitalize the patient if weight loss is extreme or weight has fallen very quickly. The second stage is long-term treatment of the underlying psychiatric illness. This is approached through the development of trusting relationships with those involved in caring for the patient, such as nurses, the family doctor, a psychiatrist or a psycho-therapist. Individual and group therapy are recommended in order to prevent relapse. For younger patients, family therapy can also be helpful, since family support plays a major role in helping patients recover. Sometimes antidepressants such as Prozac (fluoxetine) are prescribed. These medications have been proven effective even in patients without clinical depression.