Anorexia

Anorexia is an eating disorder characterized by refusal to maintain a minimally accepted body weight, intense fear of weight gain, and distorted body image. Inadequate calorie intake or excessive energy expenditure results in severe weight loss.

The exact cause of this disorder is not known, but social attitudes towards body appearance and family factors are believed to play a role in its development. The condition usually occurs in adolescence or young adulthood. It is more common in women, affecting 1-2% of the female population and only 0.1-0.2% of males.

Anorexia is seen mainly in Caucasian women who are high academic achievers and have a goal-oriented family or personality. However, this eating disorder is not more common in higher socioeconomic groups. Some experts have suggested that conflicts within a family may also contribute to anorexia. It is thoughts that anorexia is a way for a child to draw attention away from marital problems, for example, and bring the family back together. Other psychologists have suggested that anorexia may be an attempt by young women to gain control and separate from their mothers. The causes, however, are still not well understood.

In some cases, prevention may not be possible. Encouraging healthy, realistic attitudes toward weight and diet may be helpful. Sometimes, counselling can help.

Symptoms:

weight loss of 15% or greater below the expected weight

inappropriate use of laxatives, enemas, or diuretics (water pills) in an effort to lose weight

self-imposed food intake restrictions, often hidden

absence of menstruation

skeletal muscle atrophy

loss of fatty tissue

low blood pressure

dental cavities may be present with self-induced vomiting

blotchy or yellow skin

depression may be present in addition to the eating disorder

most individuals with anorexia nervosa refuse to recognize that they have an eating disorder (denial)

Signs and tests:

Diagnosis is based upon ruling out other causes of endocrine, metabolic, and central nervous system abnormalities to explain the weight loss.

These tests may be used:

chem-20

urinalysis

ECG

This disease may also alter the results of the LH response to GnRH test.

Treatment:

The biggest challenge in treating anorexia nervosa is having the patient recognize that the eating disorder is in itself, a problem, not a solution to other problems. This means that most individuals enter treatment when their condition is fairly advanced.

The purpose of treatment is first to restore normal body weight and eating habits, and then attempt to resolve psychological issues. Hospitalization may be indicated in some cases (usually when body weight falls below 30% of expected weight).

Supportive care by health care providers, structured behavioral therapy, psychotherapy, and anti-depressant drug therapy are some of the methods that are used for treatment. Severe and life-threatening malnutrition may require intravenous feeding.

Support groups:

The stress of illness can often be helped by joining a support group where members share common experiences and problems. This is not an easy task since, as mentioned previsouly, most people who suffer from anorexia deny that they have an eating disorder. Prognosis:

Anorexia nervosa is a serious medical condition which leads to death in 10% of cases. It is more deadly than heroin addiction. Experienced treatment programs have a two-thirds success rate in restoring normal weight, but relapse is common.

Women who develop this eating disorder at an early age have a better chance of complete recovery. Most people with anorexia will continue to prefer a lower body weight and be preoccupied with food and calories to some extent, however. Weight management may be difficult, and long-term treatment may be necessary to help maintain a healthy body weight.

Complications:

The presence of any of these suggests a severe disease, and hospitalization may be required:

severe dehydration, possibly leading to cardiovascular shock

electrolyte imbalance (such as potassium insufficiency)

cardiac arrhythmias related to the loss of cardiac muscle and electrolyte imbalance

severe malnutrition

thyroid gland deficiencies which can lead to cold intolerance and constipation

appearance of fine baby-like body hair (lanugo)

bloating or edema

decrease in white blood cells which leads to increased susceptibility to infection

osteoporosis

tooth erosion and decay with self-induced vomiting

seizures related to fluid shifts due to excessive diarrhea or vomiting

Call us if symptoms suggestive of anorexia nervosa are present.

Go to the emergency room or call the local emergency number if fainting, irregular pulse, seizures, or other severe symptoms develop in a person with anorexia nervosa.

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