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cont. from
- Age and gender—anorexia is most common in teens and young adult women
- Early onset of puberty
- Living in an industrialized country
- Depression—although depression is associated with the development of
anorexia, it does not cause the disorder. Depression in a family member also
appears to increase the likelihood of developing an eating disorder.
-
Obsessive-compulsive disorder (OCD) or other anxiety disorders—OCD is
present in up to two-thirds of people with anorexia. OCD associated with an
eating disorder is often accompanied by a compulsive ritual around food
(such as cutting it into tiny pieces); phobia, another type of anxiety
disorder that may also be present in someone with an eating disorder, and/or
OCD tend to emerge before the eating disorder while panic attacks may
develop after the diagnosis is made.
-
Avoidant and/or
narcissistic personality disorder(s)—approximately
one-third of those with the restricting type of anorexia have avoidant
personalities, which is characterized by feelings of inadequacy, social
inhibition, extreme sensitivity to negative comments or criticism, and
avoidance of interpersonal relationships, both at work and on an intimate
level.
Borderline personality disorder (exceptionally unstable interpersonal
relationships, extremely poor self-image, and excessively impulsive
behaviors) may be a risk factor as well but such individuals are more likely
to develop bulimia.
- Participation in sports and professions that put emphasis on a lean body
(such as dance, gymnastics, running, figure skating, horse racing, modeling,
wrestling, acting)
- Difficulty dealing with stress (pessimism, tendency to worry, refusal to
confront difficult or negative issues)
- History of sexual abuse or other traumatic event
- Dieting
top
While your healthcare provider will rely on points discussed in Signs and
Symptoms such as excessive weight loss, refusal to maintain normal body weight,
and distorted self-perception, he or she will also ask a series of questions to
better determine whether or not anorexia is present. The SCOFF questionnaire,
developed in Great Britain, is proving to be a very reliable method for
diagnosing anorexia. A "yes" response to at least two of the following questions
is a strong indicator of an eating disorder:
- S "Do you feel sick because you feel full?"
- C "Do you lose control over how much you eat?"
- O "Have you lost more than 13 pounds recently?"
- F "Do you believe that you are fat when others say that you are
thin?"
- F "Does food and/or thoughts of food dominate your life?"
If an eating disorder is suspected, the healthcare provider will order a
number of laboratory tests. These serve to determine blood count (to assess for
signs of anemia that may be related to lack of iron or vitamin B12), levels of
electrolytes (minerals such as potassium, calcium, and magnesium), amylase
(serum amylase is elevated when there is frequent vomiting), and protein, and
kidney, liver, and thyroid functions. He or she may also order an
electrocardiogram (which gives a graphic record of the electrical activity of
the heart); this may be abnormal if there is a deficiency in an electrolyte or
nutrient such as potassium or calcium. If a diagnosis of anorexia is made, the
healthcare provider will require frequent office visits to monitor the
condition. It is best for a person with anorexia to work with a
multidisciplinary team including his or her primary care physician, a
psychologist or psychiatrist, and a registered dietitian.
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The most effective prevention strategy is the development, from an early age,
of healthy eating habits and a strong http://www.realmentalhealth.com/eating_disorders/binge_eating_02_2.asp. Cultural values that place a
premium on lean or thin bodies need to be questioned. Education about the
life-threatening nature of anorexia is also an important part of prevention.
In those who
have already been diagnosed and treated for anorexia, avoiding
recurrence of the eating disorder is the primary goal.
- Family and friends should be urged not to focus on the patient's
condition or on issues of food or weight. Mealtimes, for example, should be
reserved for social interaction and relaxation, without any discussion of
the disease.
- Careful and frequent monitoring of weight and other physical signs by
the healthcare provider can reveal signs of a relapse.
- Cognitive or other forms of psychotherapy can help the person to develop
coping skills and change the unhealthy thought processes that underlie
anorexia nervosa.
- Family therapy is helpful in addressing underlying contributing factors
in the home environment and in enlisting the support and understanding of
family members.
continue: Treatment of Anorexia .
section table of contents
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Reviewed: 03/2006
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