Anorexia Nervosa

People who intentionally starve themselves into an emaciated state yet remain convinced that they are overweight are suffering from a condition known as anorexia nervosa. Anorexia is a severe emotional disorder that is increasingly common, especially among young women in industrialized countries where cultural expectations encourage women to be thin. Fueled by popular fixations with thin and lean bodies, anorexia is also affecting a growing number of men, particularly athletes and those in the military. People with anorexia are terrified of becoming obese and refuse to maintain a normal weight, putting themselves in danger of starvation.

Anorexia rarely begins in people who are older than 40 years of age. It most commonly appears in the teenage years, affecting up to 3 in 100 adolescents. Although anorexia seldom emerges before puberty, associated mental conditions, such as depression and obsessive-compulsive behavior, are usually more severe when it does. The onset of anorexia is often preceded by a traumatic or stressful event and it is usually accompanied by other emotional difficulties. Anorexia is a life-threatening condition that can result in death from starvation, heart failure, electrolyte imbalance, or suicide.

There are two main types of anorexia nervosa:

• Restricting Type—characterized by dieting, fasting, and/or excessive exercise
• Binge-Eating/Purging Type (anorexic-bulimic)—characterized by self-induced vomiting and/or misuse of laxatives, enemas, and/or diuretics. Binge eating may or may not occur; purging is common even after small amounts of food have been eaten. This type carries greater medical risk.

top

Anorexia Signs and Symptoms

The primary sign of anorexia nervosa is severe weight loss, accompanied by any number of physical and psychological symptoms and unusual behaviors related to food, eating, or exercise. A person for whom a healthy weight would be 125 pounds, for example, may drop 20, or even as much as 60 pounds below this. At the same time, the person may insist that he or she is overweight.

Anorexia Physical Signs

• Scanty or absent menstrual periods
• Thinning hair
• Dry skin
• Cold or swollen hands and feet
• Bloated or upset stomach

Anorexia Psychological Signs

• Distorted perception of self (that is, a great difference between how an individual believes he or she looks and his or her actual physical appearance)
• Inability to remember things
• Poor judgment
• Refusal to acknowledge the gravity of the illness
• Obsessive-compulsive behavior (excessive need to control personal environment)
• Depression (feelings of ineffectiveness; loss of interest in friends and former activities; lack of spontaneity; rigid thinking; lack of initiative; flattened emotional response; irritability; insomnia; diminished interest in sex)

Anorexia Behavioral Symptoms

• Unusual behaviors related to food or eating (for example, hoarding or concealing food, refusing to eat in public, eating only one type of food, ritually cutting food into tiny pieces, intense study of diets and calories, planning and preparing elaborate meals for others)
• Compulsive exercising
• Preoccupation with body size or body image
• Preoccupation with weight control, dieting

Anorexia Causes

There is no specific cause of anorexia. Medical experts agree that several factors work together in a complex fashion to lead to the eating disorder. These may include:

• Severe trauma or emotional stress (such as the death of a loved one or sexual abuse) during puberty or prepuberty.
• Abnormalities in brain chemistry. Changes in serotonin levels, a brain chemical that regulates appetite, may contribute to other symptoms of anorexia nervosa such as depression, impulsiveness, obsessive behaviors, or other mood disorders. In addition, the process of purging may deplete tryptophan, an amino acid necessary for the production of serotonin, leading to further imbalances.
• A cultural environment that puts a high value on thin or lean bodies.
• Overbearing, controlling, and critical parents who do not show emotional warmth.
• A tendency toward perfectionism, fear of being ridiculed or humiliated, a desire to always be perceived as being "good." A belief that being perfect is necessary in order to be loved. Because perfection is impossible, the inability to attain perfection reinforces the person's sense of being unworthy of being loved. Not eating, according to some experts, is a passive act of revenge directed toward those who will never love the person because of his or her lack of perfection.
• Family history of anorexia. About one-fifth of those with anorexia have a relative with an eating disorder. In fact, it is common to discover that someone with anorexia has a mother or sister with this eating disorder as well. If one identical twin has anorexia, the other has more than a 50% chance of also developing it. It is not clear, however, to what extent this family connection is due to heredity and or to learned behavior.
• Infection. Some researchers report an association between beta-hemolytic streptococcal infection or Epstein Barr virus (the virus that causes mononucleosis) and development of anorexia.

continue: Risk Factors, Diagnosis, Preventative Care

top .  pages 1 2 3 4 5 6 7 . send to friend . eating disorders site map

Reviewed: 03/2006