Anorexia Nervosa

Anorexia Nervosa

The Eating Disorders are characterized by severe disturbances in eating behaviour. Anorexia Nervosa is characterized by a refusal to maintain a minimally normal body weight.

Features

A disturbance in perception of body shape and weight is an essential feature. The individual refuses to maintain a minimally normal body weight, is intensely afraid of gaining weight, and exhibits a significant disturbance in the perception of the shape or size of his or her body.

1.     The individual maintains a body weight that is below a minimally normal level for age and height

2.     Individuals with this disorder intensely fear gaining weight or becoming fat. This intense fear of becoming fat is usually not alleviated by the weight loss.

3.     The experience and significance of body weight and shape are distorted in these individuals

Some individuals feel globally overweight. Others realize that they are thin, but are still concerned that certain parts of their bodies, particularly the abdomen, buttocks, and thighs, are "too fat”.

Symptoms

Anorexia nervosa is a complex condition, but the main sign is usually severe weight loss. The person may also talk about being overweight, although objective measures, such as BMI, show that this is not true.
Behavioral changes may include a refusal to eat, exercising excessively, and use of laxatives or vomiting after consuming food.
Other physical signs and symptoms resulting from a lack of nutrients include:

• severe loss of muscle mass
• listlessness, fatigue, exhaustion
• hypotension, or blood pressure
• light-headedness or dizziness
• hypothermia, or low body temperature, and cold hands and feet
• bloated and constipation
• dry skin
• swollen hands and feet
• alopecia, or hair loss
• loss of menstruation or less frequent periods
• insomnia
• osteoporosis, or loss of bone density
• brittle nails
• irregular or abnormal heart rhythms
• lanugo, fine downy hair growing all over the body, and increased facial hair

Signs of vomiting include bad breath and tooth decay, due to the acid in the vomit.
Psychological signs and symptoms are:

• excessive concern about being fat or overweight
• frequently measuring and weighing themselves and inspecting their bodies in the mirror
• obsession with food
• lying about food intake
• not eating or refusing to eat
• self-denial
• lack of emotion or a depressed mood
• reduced sex drive
• obsessive-compulsive behavior
• irritability
• over-exercising

Food and eating become associated with guilt. It may be difficult to talk to the person about a possible problem, as they will likely refuse to acknowledge that anything is wrong.

Causes

The following risk factors have been associated with it:

• being susceptible to depression and anxiety
• having difficulty handling stress
• being excessively worried, afraid, or doubtful about the future
• being perfectionist and overly concerned about rules
• having a negative self image
• having eating problems during early childhood or infancy
• having had an anxiety disorder during childhood
• holding specific ideas regarding beauty and health, which may be influenced by culture or society
• having a high level of emotional restraint or control over their own behavior and expression

The person may be overly worried about their weight and shape, but this is not necessarily the key factor.

Diagnosis

An early diagnosis and prompt treatment increase the chance of a good outcome. A full medical history can help with diagnosis.
These include:

• diabetes
• chronic infections
• malabsorption
• immunodeficiency
• inflammatory bowel disease (IBS)
• hyperthyroidism

Treatment

Treatment can involve medication, psychotherapy, family therapy, and nutrition counselling. It can be difficult for a person to accept that they have anorexia, and it can be hard to engage them in treatment, as the resistance to eating is hard to break.