Eating Disorders - Anorexia Nervosa

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General Information

DEFINITION - A psychological eating disorder in which a person refuses to eat adequately - in spite of hunger - and loses enough weight to become emaciated. The illness usually begins with a normal weight-loss diet. The person eats very little and refuses to stop dieting after a reasonable weight loss. The body perception is distorted; person sees self as "fat" when weight is normal or much less.

BODY PARTS INVOLVED - All body cells.

SEX OR AGE MOST AFFECTED - Female adolescents and young adults.

Distorted body image

The person continues to feel fat -

• Even when emaciated.
• Cessation of menstrual periods.

CAUSES - Unknown. Possible causes include family and internal conflicts (sexual conflicts); phobia about putting on weight; changes in fashion in USA (slimness is identified with beauty); a symptom of depression or personality disorder.

RISK INCREASES WITH

• Peer pressure to be thin.
• History of slight overweight.
• Perfectionistic, compulsive or overachieving personalities.
• Psychological stress.
• Athletes, ballet dancers, cheerleaders.

HOW TO PREVENT - Confront personal problems realistically. Try to correct or cope with problems with the help of counselors, therapists, family and friends. Develop a realistic attitude about weight.

What To Expect

DIAGNOSTIC MEASURES

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood tests for anemia and electrolyte imbalance.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Psychotherapy or counseling for the patient and family.
• Treatment can usually be done on an outpatient basis.
• Hospitalization during crises for intravenous or tube feeding.
• Psychiatric hospitalization for at least 2 to 3 weeks (sometimes).

POSSIBLE COMPLICATIONS

• Chronic anorexia nervosa caused by patient's resistance to treatment.
• Electrolyte disturbances or irregular heartbeat. These may be life-threatening.
• Osteoporosis.
• Suicide.

PROBABLE OUTCOME - Treatable if the patient recognizes the emotional disturbance, wants help and cooperates in treatment. Without treatment, this can cause permanent disability or even death. Persons with anorexia nervosa have a high rate of attempted suicide due to low self-esteem. Therapy may continue over several years. Relapses are common, especially when stressful situations occur.

How To Treat

GENERAL MEASURES

• The goal of treatment is for the patient to establish healthy eating patterns to regain normal weight. The patient can accomplish this with behavior-modification training supervised by a qualified professional.

MEDICATION - Lithium or other antidepressants may be prescribed by your doctor.

ACTIVITY - No restrictions, but avoid overexertion.

DIET - A controlled refeeding program will be established. Vitamin and mineral supplements may be prescribed.

Call Your Doctor If

• Life-threatening symptoms occur, including: rapid, irregular heartbeat; chest pain; or loss of consciousness. Call immediately. This is an emergency!
• You have symptoms of anorexia nervosa or observe them in a family member.
• Weight loss continues, despite treatment.

From the Complete Guide to Symptoms, Illness & Surgery by H. Winter Griffith, M.D. © 1995 The Putnam Berkley Group, Inc.; electronic rights by Medical Data Exchange.