What Is Anorexia Nervosa And What Are The Symptoms Of Anorexia Nervosa?

Anorexia nervosa can be defined as a mental illness affecting almost every organ in the body resulting in many complications. But these complications can be reversed by timely introduction of healthy nutrition and psychological help. This illness is characterized by an unreasonably intense fear of getting fat even though the patients are under weight. The patients also suffer marked weight loss due to self imposed starvation. Anorexia targets about 1% of the population and the patients are predominantly young adolescent girls but females of higher age group also sometimes suffer this illness. Another aspect of this illness is that it sometimes affects men too and studies show that men constitute about 10% of anorexia patients. This disease is more prevalent in developed nations but seldom occurs in poor developing nations.

Most people are exposed to excessive media attention regarding weight loss and dieting and this creates the impression that a slim body is essential for success and advancement in life. The obsession about weight loss and dieting has increased many fold thanks to media and high priority is attached to a slender and thin body. Many young girls perceive themselves to be overweight though in reality they are underweight.

The onset of anorexia nervosa occurs around the age of 17 .The typical anorexia patient is generally a highly talented, perfection oriented teenage adolescent female with a successful family background who rarely engage in typical adolescent activities such as dating and attending parties. Anorexia sometimes affects some middle aged persons and males too. Family members of the anorexia patient are rarely aware of the condition of their child and always feel proud that their child is good in studies and well behaved.

Anorexia patients have wrong perception about their body and weight and feel overweight even though they look emaciated. Some patients feel that only certain parts of their body as being fat compared to the whole body. In young adults or adolescents if the body mass index is less than 17.5,it can be safely assumed that the person suffers from anorexia. A typical anorexia patient maintains a body weight less than 85 percent of normal weight due to weight loss activities or by willful refusal to gain weight by blocking weight gain during the normal process of growth.

The patients of anorexia are haunted more by the fear of weight gain than the fear of dying due to starvation. While pursuing weight loss, the anorexia patient is not happy when the target of weight loss is achieved but feels greater fear of gaining the weight back which was lost. As they lose weight more, the fear of weight gain paradoxically increases which makes them pursue weight loss activities more vigorously resulting in more weight loss that again increases the fear of weight gain creating a vicious circle.

The ill effects of anorexia are the absence of menstrual cycles in females in the reproductive age group, cardiac complications, gastrointestinal complications, electrolyte disturbances, decreased libido, impaired sleep, dry skin, poor concentration, depression, preoccupation with food, sleep disorders, obsessive compulsive disorders and other problems. Anorexia patients feel that everything is alright with them but their family, friends and doctors who attend them conspire to fatten them which should be resisted. The patients of anorexia are fond of rituals and convert all of their daily activities into rituals. All routine activities such as bathing, home work are ritualized by them and any deviation from normal work routines instantly triggers anxiety in anorexia patients.

They are obsessed with burning up calories leading to excessive exercises to burn up imagined excess calories present in the body. They measure calories of whatever they consume and frequently measure their weight and spend more time in front of mirrors inspecting their shape and size. They tend to isolate themselves from social activities due to the fear of breaking their ritual routines and also due to low self esteem. They suffer from lack of libido because of low sex hormone secretions from sex glands due to malnutrition. Anorexia patients take pride in their power to overcome the feeling hunger though in fact they are always hungry and preoccupied with thoughts of food, dieting and weight affecting their performance in studies or work.

For the treatment of anorexia nervosa, the initial goal should be to prevent death by starvation. The family should be educated about the illness and about the process of treatment. The patient should be reassured about the positive outcome of the treatment. The only treatment needed for anorexia is consumption of proper nutritious food in right quantities and proper psychiatric counseling by experts in handling eating disorders.

The treatment of anorexia involves proper documentation of medical history of the patient regarding, exercise participation, binging and purging behaviors, past medical history, family history of medical and psychiatric disorders, eating habits and rituals, body image, substance abuse, personality, mood and anxiety disorders, suicidal thoughts,use of laxatives, diuretics or diet pills, menstrual pattern and weight perceptions.

A comprehensive physical examination should be carried out on the patient regarding vital signs, marital status and standard weight and height. Laboratory tests should be carried out to check thyroid function, urine analysis, blood, electrolyte levels, liver function and heart condition. The treatment should also involve psychotherapy by experts dealing with eating disorders and should continue even after the patient regains normal weight. Cognitive techniques are used to correct dysfunctional thinking about weight and diet. Whole family therapy is very useful by educating about right family environment for quick recovery. Family therapy should continue even after the patient has regained normal weight to prevent relapse.

Anorexia Nervosa is a chronic illness that may take time and efforts to get cured . It may involve single episode or multiple episodes of starvation, recovery and relapses. The duration of this illness may vary from person to person according to the condition and seriousness. The mortality rates for this illness is about 5 to 20 percent. Death occurs due to electrolyte imbalance, starvation and suicide due to depression. But with proper medical care and family support this illness can be easily cured even though it may take time.

Anorexia Nervosa F.A.Q

What is anorexia nervosa?

A person with anorexia nervosa (an-uh-RECK-see-uh nur-VOH-suh), often called anorexia, has an intense fear of gaining weight. Someone with anorexia thinks about food a lot and limits the food she or he eats, even though she or he is too thin. Anorexia is more than just a problem with food. It's a way of using food or starving oneself to feel more in control of life and to ease tension, anger, and anxiety. Most people with anorexia are female. An anorexic:

* Has a low body weight for her or his height

* Resists keeping a normal body weight

* Has an intense fear of gaining weight

* Thinks she or he is fat even when very thin

* Misses 3 menstrual periods in a row (for girls/women who have started having their periods)

Who becomes anorexic?

While anorexia mostly affects girls and women (85 - 95 percent of anorexics are female), it can also affect boys and men. It was once thought that women of color were shielded from eating disorders by their cultures, which tend to be more accepting of different body sizes. It is not known for sure whether African American, Latina, Asian/Pacific Islander, and American Indian and Alaska Native people develop eating disorders because American culture values thin people. People with different cultural backgrounds may develop eating disorders because it’s hard to adapt to a new culture (a theory called “culture clash”). The stress of trying to live in two different cultures may cause some minorities to develop their eating disorders.

What causes anorexia?

There is no single known cause of anorexia. Eating disorders are real, treatable medical illnesses with causes in both the body and the mind. Some of these things may play a part:

* Culture. Women in the U.S. are under constant pressure to fit a certain ideal of beauty. Seeing images of flawless, thin females everywhere makes it hard for women to feel good about their bodies. More and more, men are also feeling pressure to have a perfect body.

* Families. If you have a mother or sister with anorexia, you are more likely to develop the disorder. Parents who think looks are important, diet themselves, or criticize their children's bodies are more likely to have a child with anorexia.

* Life changes or stressful events. Traumatic events (like rape) as well as stressful things (like starting a new job), can lead to the onset of anorexia.

* Personality traits. Someone with anorexia may not like her or himself, hate the way she or he looks, or feel hopeless. She or he often sets hard-to-reach goals for her or himself and tries to be perfect in every way.

* Biology. Genes, hormones, and chemicals in the brain may be factors in developing anorexia.

What are signs of anorexia?

Someone with anorexia may look very thin. She or he may use extreme measures to lose weight by:

* Making her or himself throw up

* Taking pills to urinate or have a bowel movement

* Taking diet pills

* Not eating or eating very little

* Exercising a lot, even in bad weather or when hurt or tired

* Weighing food and counting calories

* Eating very small amounts of only certain foods

* Moving food around the plate instead of eating it

Someone with anorexia may also have a distorted body image, shown by thinking she or he is fat, wearing baggy clothes, weighing her or himself many times a day, and fearing weight gain.

Anorexia can also cause someone to not act like her or himself. She or he may talk about weight and food all the time, not eat in front of others, be moody or sad, or not want to go out with friends. People with anorexia may also have other psychiatric and physical illnesses, including:

* Depression

* Anxiety

* Obsessive behavior

* Substance abuse

* Issues with the heart and/or brain

* Problems with physical development

What happens to your body with anorexia?

With anorexia, your body doesn't get the energy from foods that it needs, so it slows down. Can someone with anorexia get better?

Yes. Someone with anorexia can get better. A health care team of doctors, nutritionists, and therapists will help the patient get better. They will:

* Help bring the person back to a normal weight

* Treat any psychological issues related to anorexia

* Help the person get rid of any actions or thoughts that cause the eating disorder

These three steps will prevent “relapse” (relapse means to get sick again, after feeling well for a while).

Is it safe for young people to take antidepressants for anorexia?

It may be safe for young people to be treated with antidepressants. However, drug companies who make antidepressants are required to post a “black box” warning label on the medication. A “black box” warning is the most serious type of warning on prescription drugs.

It may be possible that antidepressants make children, adolescents, and young adults more likely to think about suicide or commit suicide.

The latest information from the FDA — including what drugs are included in this warning and things to look for — can be found on their Web site at http://www.fda.gov.

Some research suggests that the use of medicines — such as antidepressants, antipsychotics, or mood stabilizers — may sometimes work for anorexic patients. It is thought that these medicines help the mood and anxiety symptoms that often co-exist with anorexia. Other recent studies, however, suggest that antidepressants may not stop some patients with anorexia from relapsing. Also, no medicine has shown to work 100 percent of the time during the important first step of restoring a patient to healthy weight. So, it is not clear if and how medications can help anorexic patients get better, but research is still happening.

Some forms of psychotherapy can help make the psychological reasons for anorexia better. Psychotherapy is sometimes known as “talk therapy.” It uses different ways of communicating to change a patient’s thoughts or behavior. This kind of therapy can be useful for treating eating disorders in young patients who have not had anorexia for a long time.

Individual counseling can help someone with anorexia. If the patient is young, counseling may involve the whole family. Support groups may also be a part of treatment. In support groups, patients, and families meet and share what they’ve been through.

Some researchers point out that prescribing medicines and using psychotherapy designed just for anorexic patients works better at treating anorexia than just psychotherapy alone. Whether or not a treatment works, though, depends on the person involved and his or her situation. Unfortunately, no one kind of psychotherapy always works for treating adults with anorexia.

What is outpatient care for anorexia treatment and how is it different from inpatient care?

With outpatient care, the patient receives treatment through visits with members of their health care team. Often this means going to a doctor’s office. Outpatients usually live at home.

Some patients may need “partial hospitalization.” This means that the person goes to the hospital during the day for treatment, but sleeps at home at night.

Sometimes, the patient goes to a hospital and stays there for treatment. This is called inpatient care. After leaving the hospital, the patient continues to get help from her health care team and becomes an outpatient.

Can women who had anorexia in the past still get pregnant?

It depends. When a woman has “active anorexia,” meaning she currently has anorexia, she does not get her period and usually does not ovulate. This makes it hard to get pregnant. Women who have recovered from anorexia and are at a healthy weight have a better chance of getting pregnant. If you’re having a hard time getting pregnant, see your doctor.

Can anorexia hurt a baby when the mother is pregnant?

Yes. Women who have anorexia while they are pregnant are more likely to lose the baby. If a woman with anorexia doesn’t lose the baby, she is more likely to have the baby early, deliver by C-section, deliver a baby with a lower birthweight, and have depression after the baby is born.

What should I do if I think someone I know has anorexia?

If someone you know is showing signs of anorexia, you may be able to help.

1. Set a time to talk. Set aside a time to talk privately with your friend. Make sure you talk in a quiet place where you won’t be distracted.

2. Tell your friend about your concerns. Be honest. Tell your friend about your worries about her or his not eating or over exercising. Tell your friend you are concerned and that you think these things may be a sign of a problem that needs professional help.

3. Ask your friend to talk to a professional. Your friend can talk to a counselor or doctor who knows about eating issues. Offer to help your friend find a counselor or doctor and make an appointment, and offer to go with her or him to the appointment.

4. Avoid conflicts. If your friend won’t admit that she or he has a problem, don’t push. Be sure to tell your friend you are always there to listen if she or he wants to talk.

5. Don’t place shame, blame, or guilt on your friend. Don’t say, “You just need to eat.” Instead, say things like, “I’m concerned about you because you won’t eat breakfast or lunch.” Or, “It makes me afraid to hear you throwing up.”

6. Don’t give simple solutions. Don’t say, "If you'd just stop, then things would be fine!"

7. Let your friend know that you will always be there no matter what.

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