|Home > Facts > Anorexia nervosa|
More About:anorexia and nervosa
...nervosa is an eating disorder characterized by fre
...anorexia nervosa. Many people with bulimia will co...nervosa Bulimia nervosa Definit
...anorexia nervosa and bulimia nervosa, have formal d...nervosa and bulimia nervosa,
...anorexia nervosa, bulimia nervosa, binge eating dis...nervosa, bulimia nervosa, bin
...anorexia nervosa and bulimia nervosa are considered...nervosa and bulimia nervosa a
...anorexia nervosa and up to 10 percent of those may ...nervosa and up to 10 percent of those may d
...anorexia nervosa, bulimia nervosa, or eating disord...nervosa—A serious eating diso
...anorexia nervosa at some point in their lives. Betw...nervosa and binge eating syndrome. Individu
...anorexia and bulimia, as a result of parents puttin...nervosa, an eating disorder characterized by extre
...anorexia nervosa are at especially high risk of dev...nervosa—An eating disorder that invo
Highlight any text in the article to look up more information!
Anorexia nervosa is an eating disorder that involves self-imposed starvation. The individual is obsessed with becoming increasingly thinner and limits food intake to the point where health is compromised. Anorexia nervosa can be fatal.
Anorexia is often thought of as a modern problem, but the English physician Richard Morton first described it in 1689. In the twenty-first century anorexia nervosa is recognized as a psychiatric disorder in the Diagnostic and Statistical Manual for Mental Disorders Fourth Edition (DSM-IV-TR) published by the American Psychiatric Association.
Individuals with anorexia are on an irrational, unrelenting quest to lose weight, and no matter how much they lose and how much their health is compromised, they want to lose more weight. Recognizing the development of anorexia can be difficult, especially in a society that values and glamorizes thinness. Dieting is often the trigger that starts a person down the road to anorexia. The future anorectic may begin by skipping meals or taking only tiny portions. She (most anorectics are female) always has an excuse for why she does not want to eat, whether it is not feeling hungry, feeling ill, having just eaten with someone else, or not liking the food served. She also begins to read food labels and knows exactly how many calories and how much fat are in everything she eats. Many anorectics practically eliminate fat and sugar from their diets and seem to live on diet soda and lettuce. Some future anorectics begin to exercise compulsively to burn extra calories. Eventually these practices have serious health consequences. At some point, the line between problem eating and an eating disorder is crossed.
Anorexia nervosa is diagnosed when most of the following conditions are present:
Anorectics spend a lot of time looking in the mirror, obsessing about clothing size, and practicing negative self-talk about their bodies. Some are secretive about eating and will avoid eating in front of other people. They may develop strange eating habits such as chewing their food and then spitting it out, or they may have rigid ideas about “good” and “bad” food. Anorectics will lie about their eating habits and their weight to friends, family, and healthcare providers. Many anorectics experience depression and anxiety disorders.
There are two major subtypes of anorectics. Restrictive anorectics control their weight by rigorously limiting the amount of calories they eat or by fasting. They may exercise excessively or abuse drugs or herbal remedies claim to increase the rate at which the body burns calories. Purge-type anorectics eat and then get rid of the calories and weight by self-induced vomiting, excessive laxative use, and abuse of diuretics or enemas.
Anorexia is a disorder of industrialized countries where food is abundant and the culture values a thin appearance. About 1% of Americans are anorectic and female anorectics outnumber males 10:1. In men, the disorder is more often diagnosed in homosexuals than in heterosexuals. Some experts believe that number of diagnosed anorectics represents only the most severe cases, and that many more people have anorexic tendencies, but their symptoms do not rise to the level needed for a medical diagnosis.
Anorexia has been characterized as a “rich white girl” disorder. Most anorectics are white, and about three-quarters of them come from households at the middle income level or above. However, in the 2000s, the number of blacks and Hispanics diagnosed with anorexia has increased. Competitive athletes of all races have an increased risk of developing anorexia nervosa, especially in sports where weight it tied to performance. Jockeys, wrestlers, figure skaters, cross-country runners, and gymnasts (especially female gymnasts) have higher than average rates of anorexia. People such as actors, models, cheerleaders, and dancers (especially ballet dancers) who are judged mainly on their appearance are also at high risk of developing the disorder.
Anorexia can occur to people as young as age 7. However, the disorder most usually begins during adolescence. It is most likely to start at one of two times, either age 14 or 18. Interestingly, this corresponds with the age of transitioning into and out of high school. The younger the age at which anorexic behavior starts, the more difficult it is to cure. Preteens who develop anorexia often show signs of compulsive behavior and depression in addition to anorexia.
Anorexia is a complex disorder that does not have a single cause. Research suggests that some people have a predisposition toward anorexic and that something then triggers the behavior, which then becomes self-reinforcing. Hereditary, biological, psychological and social factors all appear to play a role.
other mental disorders such as depression. Research in this area is relatively new and the findings are unclear. People with anorexia tend to feel full sooner than other people. Some researchers believe that this is related to the fact that stomach of people with anorexia tends to empty more slowly than normal; others think it may be related to the appetite control mechanism of the brain.
Signs and Symptoms
Anorexic behavior has physical and psychological consequences. These include:
A physical examination begins with weight and blood pressure and moves through all the signs listed above. Based on the physical exam, the physician will order laboratory tests. In general these tests will include a complete blood count (CBC), urinalysis, blood chemistries (to determine electrolyte levels), and liver function tests. The physician may also order an electrocardiogram to look for heart abnormalities.
Several different mental status evaluations can be used. In general, the physician will evaluate things such as whether the person is oriented in time and space, appearance, observable state of emotion (affect), attitude toward food and weight, delusional thinking, and thoughts of self-harm or suicide.
Treatment choices depend on the degree to which anorexic behavior has resulted in physical damage and whether the person is a danger to him or herself. Medical treatment should be supplemented with psychiatric treatment (see Therapies below). Patients are frequently uncooperative and resist treatment, denying that their life may be endangered and insisting that the doctor only wants to “make them get fat.”
Hospital impatient care is first geared toward correcting problems that present as immediate medical crises, such as severe malnutrition, severe electrolyte imbalance, irregular heart beat, pulse below 45 beats per minute, or low body temperature. Patients are hospitalized if they are a high suicide risk, have severe clinical depression, or exhibit signs of an altered mental state. They may also need to be hospitalized to interrupt weight loss, stop the cycle of vomiting, exercising and/or laxative abuse, treat substance disorders, or for additional medical evaluation.
Day treatment or partial hospitalization where the patient goes every day to an extensive treatment program provides structured mealtimes, nutrition education, intensive therapy, medical monitoring, and supervision. If day treatment fails, the patient may need to be hospitalized or enter a full-time residential treatment facility.
Anorexia nervosa is a chronic disease and relapses are common and to be expected. Outpatient treatment provides medical supervision, nutrition counseling, self-help strategies, and therapy after the patient has reached some weight goals and shows stability.
A nutrition consultant or dietitian is an essential part of the team needed to successfully treat anorexia. The first treatment concern is to get the individual medically stable by increasing calorie intake and balancing electrolytes. After that, nutritional therapy is needed support the long process of recovery and stable weight gain. This is an intensive process involving of nutrition education, meal planning, nutrition monitoring, and helping the anorectic develop a healthy relationship with food.
Medical intervention helps alleviate the immediate physical problems associated with anorexia, but by itself, it rarely changes behavior. Psychotherapy plays a major role in the helping the anorectic understand and recover from anorexia. Several different types of psychotherapy are used depending on the individual’s situation. Generally, the goal of psychotherapy is help the individual develop a healthy attitude toward their body and food. This may involve addressing at the root causes of anorexic behavior as well as addressing the behavior itself.
Some types of psychotherapy that have been successful in treating anorectics are listed below.
About half the people treated for anorexia nervosa recover completely and are able (sometimes with difficulty) to maintain a normal weight. Of the remaining 50% between 6% and 20% die, usually of health complications related to starvation. About 20% remain dangerously underweight, and the rest remain thin.
Some ways to prevent anorexia nervosa from developing are as follows:
Relapses happen to many people with anorexia. People who are recovering from anorexia can help prevent themselves from relapsing by:
Carleton, Pamela and Deborah Ashin. Take Charge of Your Child’s Eating Disorder: A Physician’s Step-By-Step Guide to Defeating Anorexia and Bulimia.. New York: Marlowe & Co., 2007.
Heaton, Jeanne A. and Claudia J. Strauss. Talking to Eating Disorders: Simple Ways to Support Someone Who Has Anorexia, Bulimia, Binge Eating or Body Image Issues. New York, NY: New American Library, 2005.
Kolodny, Nancy J. The Beginner’s Guide to Eating Disorders Recovery.Carlsbad, CA: Gurze Books, 2004.
Liu, Aimee. Gaining: The Truth About Life After Eating Disorders. New York, NY: Warner Books, 2007.
Messinger, Lisa and Merle Goldberg. My Thin Excuse: Understanding, Recognizing, and Overcoming Eating Disorders. Garden City Park, NY: Square One Publishers, 2006.
Rubin, Jerome S., ed. Eating Disorders and Weight Loss Research. Hauppauge, NY: Nova Science Publishers, 2006.
Walsh, B. Timothy. If Your Adolescent Has an Eating Disorder: An Essential Resource for Parents. New York, NY: Oxford University Press, 2005.
“Surfing for Thinness: A Pilot Study of Pro-Eating Disorder Website Usage in Adolescents With Eating Disorders.” Pediatrics 118, no. 6 (December 2006): e1635-43. <http://pediatrics.aappublications.org/cgi/content/full/118/6/e1635>
American Psychological Association. 750 First Street, NE, Washington, DC 20002-4242. Telephone: (800) 374-2721; (202) 336-5500. TDD/TTY: (202)336-6123. Website: <http://www.apa.org>
National Association of Anorexia Nervosa and Associated Disorders (ANAD). P.O. Box 7 Highland Park, IL 60035. Telephone: (847) 831-3438. Website: <http://www.anad.org>
National Eating Disorders Association. 603 Stewart Street, Suite 803, Seattle, WA 98101. Help and Referral Line: (800) 931-2237. Office Telephone: (206) 382-3587. Website: <http://www.edap.org>
American Family Physicians “Anorexia nervosa.” Familydoctor.org, April 2005. <http://familydoctor.org/>
Anorexia Nervosa and Related Eating Disorders. “Athletes With Eating Disorders.” October 6, 2006. <http://www.anred.com/ath.html>
Anorexia Nervosa and Related Eating Disorders. “;The Better-Known Eating Disorders.” January 16, 2006. <http://www.anred.com/defswk.html>
Anorexia Nervosa and Related Eating Disorders. “Eating Disorders and Pregnancy.” October 18, 2006. <http://www.anred.com/pg.html>
Anorexia Nervosa and Related Eating Disorders. “Males With Eating Disorders.” February 6, 2007. <http://www.anred.com/males.html>
Levey, Robert and Brenda Williams-Wilson. “Anorexia Nervosa.” emedicine.com, April 17, 2006. <http://www.emedicine.com/med/topic144.htm>
Liburd, Jennifer, D.A. “Eating Disorder: Anorexia.” emedicine .com, May 3, 2006. <http://www.emedicine.com/ped/topic115.html>.
Medline Plus. “Eating Disorders.” U. S. National Library of Medicine, April 2, 2007. <http://www.nlm.nih/gov/medlineplus/eatingdisorders.html>
National Association of Anorexia Nervosa and Associated Disorders “Facts About Eating Disorders.” undated; accessed April 3, 2007.<http://www.anad.org/>
Tish Davidson, A.M.