This page contains information on Anorexia nervosa which I pulled off the web. Authors and sight address included when available.
ANRED Family Doctor Medicine Net
What is Anorexia?
Anorexia nervosa is often considered to be a type of eating disorder in an entire spectrum of
eating disorders. It is also, and more importantly, a psychological disorder. It is a
condition that goes beyond out-of-control dieting. The person with anorexia initially begins
dieting to lose weight. Over time, the weight loss becomes a sign of mastery and control. The
drive to become thinner is actually secondary to concerns about control and/or fears relating
to one's body. The individual continues the endless cycle of restrictive eating, often to a
point close to starvation, in order to feel a sense of control over the body. This becomes an
obsession and is similar to an addiction to any type of drug or substance.
Anorexia generally affects females, but can affect males as well. And while anorexia typically
begins to manifest itself during early adolescence, it is also seen in young children and
adults.
Anorexia nervosa is an illness that usually occurs in teenage girls, but it can also occur in
teenage boys, and adult women and men. People with anorexia are obsessed with being thin. They
lose a lot of weight and are terrified of gaining weight. They believe they are fat even
though they are very thin. Anorexia isn't just a problem with food or weight. It's an attempt
to use food and weight to deal with emotional problems.
Anorexia nervosa: the relentless pursuit of thinness
Person refuses to maintain normal body weight for age and height.
Weighs 85% or less than what is expected for age and height.
In women, menstrual periods stop. In men levels of sex hormones fall.
Young girls do not begin to menstruate at the appropriate age
Person denies the dangers of low weight.
Is terrified of becoming fat.
Is terrified of gaining weight even though s/he is markedly underweight.
Reports feeling fat even when very thin.
In addition, anorexia nervosa often includes depression, irritability, withdrawal, and
peculiar behaviors such as compulsive rituals, strange eating habits, and division of foods
into "good/safe" and "bad/dangerous" categories. Person may have low tolerance for change and
new situations; may fear growing up and assuming adult responsibilities and an adult lifestyle.
May be overly engaged with or dependent on parents or family. Dieting may represent avoidance
of, or ineffective attempts to cope with, the demands of a new life stage such as adolescence.
What is the difference between anorexia and bulimia?
People with anorexia starve themselves, avoid high-calorie foods and exercise constantly. People with bulimia eat huge amounts of food, but they throw up soon after eating, or take laxatives or diuretics (water pills) to keep from gaining weight. People with bulimia don't usually lose as much weight as people with anorexia.
What causes anorexia?
At this time, no definite cause of anorexia nervosa has been determined. However, research
within the medical and psychological fields continues to explore possible causes.
Some experts feel that possible underlying causes can relate to demands from society and the
family. For many individuals with anorexia, the destructive cycle begins with the pressure to
be thin and attractive. A poor self-image compounds the problem.
Other researchers feel that this disorder can stem from a particular dysfunction often seen in
families of anorexia patients. In this particular type of dysfunction, family members become
so interdependent that each cannot achieve their identity as an individual. Thus, family
members are unable to function as healthy individuals and are dependent on other family
members for their identity. Part of this dysfunction includes a fear of growing up by the
children of these families, especially girls. Restrictive dieting may prevent their bodies
from developing in a normal manner, and, in their thinking, restricts the maturational process
and maintains the parent-child relationship that the family has come to rely on.
Although no organic cause for anorexia has been identified, some evidence points to a
dysfunction in the part of the brain (hypothalamus) which regulates certain metabolic processes.
Medical complications?
Anorexia can have dangerous effects on all aspects of an individual's life. It can affect
other family members as well. Being seriously underweight can lead to depression and social
withdrawal. The individual can become irritable and easily upset, and have difficulty interacting with others. Sleep can become disrupted and lead to fatigue during the day. Attention and concentration can decrease. All of these features can negatively affect one's daily activities. Diminished interest in previously preferred activities can result. Some individuals also have symptoms that meet the criteria for a Major Depressive Disorder.
1. Most individuals with anorexia become obsessed with food and thoughts of food. They think about it constantly and become compulsive about eating rituals. They may collect recipes or hoard food. Additionally, they may exhibit other obsessions and/or compulsions related to food, weight, or body shape that meet the criteria for an Obsessive-Compulsive Disorder.
Generally, individuals with anorexia are compliant. Sometimes, they are overly compliant, to the extent that they lack adequate self- perception. They are eager to please and strive for perfection. They usually do well in school and may often overextend themselves in a variety of activities. The families of anorexics often appear to be "perfect." Physical appearances are important to them. Performance in other areas is stressed as well, and they are often high achievers.
While control and perfection are critical issues for individuals with anorexia, aspects other than their eating habits are often found to be out of control as well. Many have, or have had at some point in their lives, addictions to alcohol, drugs, or gambling. Compulsions involving sex, exercising, housework, and shopping are not uncommon.
Most of the medical complications of anorexia nervosa result from starvation. Few organs are spared the progressive deterioration brought about by anorexia.
Although not life-threatening, abnormally slow heart action (bradycardia) and unusually low blood pressure (hypotension) are frequent manifestations of starvation and are commonly associated with anorexia. Of greater significance are disturbances in the heart rate (arrhythmia). A reduction in the work capacity of the heart is associated with severe weight loss and starvation.
Gastrointestinal complications are also associated with anorexia. Constipation and abdominal pain are the most common symptoms. The rate at which food is absorbed into the body is slowed down. Starvation and overuse of laxatives can seriously disrupt the body's normal functions involved in the elimination process. While liver function is generally found to be normal, there is evidence of enzyme changes and overall damage to the liver.
The glandular (endocrine) system in the body is profoundly affected by anorexia. The complex physical and chemical processes involved in the maintenance of life can be disrupted, with serious consequences. Disturbances in the menstrual cycle are frequent and can affect not only child-bearing but also bone density growth, which is very important to a woman's health as she ages. Hormonal imbalances are found in men with anorexia as well. Continual restrictive eating can trick the thyroid into thinking that the body is starving, causing it to slow down in an attempt to preserve calories.
1. Kidney (renal) function may be thought to be normal. However, there are significant changes in many patients, resulting in potassium deficiency, increased urination, or decreased urination.
Anorexics who use a large quantity of laxatives or who frequently vomit are at great risk for electrolyte imbalance, which can have life-threatening consequences.
Anemia is frequently found in anorexic patients. Suppressed immunity and a high risk for infection are suspected, but not clinically proven.
Physical symptoms, other than the obvious loss of weight, can be seen. Anorexia can cause dry, flaky skin that takes on a yellow tinge. Fine, downy hair grows on the face, back, arms, and legs. Despite this new hair growth, loss of hair on the head is not uncommon. Nails can become brittle. Frequent vomiting can erode dental enamel and eventually lead to tooth loss.
Treatment of anorexia must focus on more than weight gain. In fact, weight gain should be
secondary to the more serious underlying issues facing the anorexic. Some individuals recover
fully after a single episode. Some experience a fluctuating pattern of weight gain followed by
a relapse. Others experience a progressively deteriorating course of the illness over many
years and still others never fully recover. As with many other addictions, it takes a
day-to-day effort to control the urge to relapse.
There are a variety of treatment approaches. Treatment typically depends primarily on the
resources available to the individual.
For those individuals whose weight loss has become so severe or has seriously impaired other
body systems, hospitalization may be necessary. Because of increasing insurance restrictions,
many patients find that a short hospitalization followed by a day treatment program is an
effective alternative to longer inpatient programs. Most individuals, however, initially seek
outpatient treatment involving psychological as well as medical intervention.
Patients can be treated by a medical doctor, a clinical psychologist, or both, depending upon
the progression of the disorder. A psychiatrist with both medical and psychological training
is perhaps the best treatment provider. An appropriate treatment approach addresses underlying
issues of control and self-perception. Family dynamics are explored, and often the family is
included in the treatment plan. Nutritional education provides the patient a healthy
alternative to weight management. Group counseling or support groups often assist the
individual in the recovery process. The ultimate goal of treatment should be for the
individual to accept herself and lead a physically and emotionally healthy life
Treatment of anorexia is difficult, because people with anorexia believe there is nothing
wrong with them. Patients in the early stages of anorexia (less than 6 months or with just a
small amount of weight loss) may be successfully treated without having to be admitted to the
hospital. But for successful treatment, patients must want to change and must have family and
friends to help them.
People with more serious anorexia need care in the hospital, usually in a special unit for
people with anorexia and bulimia. Treatment involves more than changing the person's eating
habits. Anorexic patients often need counseling for a year or more so they can work on
changing the feelings that are causing their eating problems. These feelings may be about
their weight, their family problems or their problems with self-esteem. Some anorexic patients
are helped by taking medicine that makes them feel less depressed. These medicines are
prescribed by a doctor and are used along with counseling.
Deliberate self-starvation with weight loss
Fear of gaining weight
Refusal to eat
Denial of hunger
Constant exercising
Greater amounts of hair on the body or the face
Sensitivity to cold temperatures
Absent or irregular periods
Loss of scalp hair
A self-perception of being fat when the person is really too thin
National Association of Anorexia Nervosa and Associated Disorders (ANAD)
Eating Disorders Awareness and Prevention (EDAP)
Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED)
Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED)
P.O. Box 7
Highland Park, IL 60035
Telephone: 847-831-3438
603 Stewart Street, Suite 803
Seattle, WA 98101
Telephone: 800-931-2237
(A clearinghouse for information about eating disorders)
P.O. 5102
Eugene, OR 97405
Telephone: 541-344-1144