Anorexia Nervosa

1 January 2017

Individuals with anorexia are known to control body weight commonly through the means of voluntary starvation, purging, excessive exercise or other weight control measures, such as diet pills or diuretic drugs. While the condition primarily affects adolescent females, approximately 10% of people with the diagnosis are male. Anorexia nervosa, involving neurobiological, psychological, and social components, is a complex condition that can lead to death in severe cases. The term anorexia is of Greek origin: a (prefix of negation), n (link between two vowels) and orexis (appetite), thus meaning of a lack of desire o eat. “Anorexia Nervosa” is frequently shortened to “anorexia” in the popular media. This is technically incorrect, as the term “anorexia” used separately refers to the medical symptom of reduced appetite. (wikipedia. com, 2001) Anorexia nervosa, or simply anorexia, is a physical illness in which the sufferer basically starves herself. Clinically, a person is anorexic if she has 85 percent or less of the normal body weight for someone of her age and height, yet continues to fast or diet. An estimated one percent of teenage girls and women in their twenties have the disease.

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It’s a serious condition that can cause grave health problems if untreated. About 20 percent of cases of anorexia end in death by suicide or starvation – one of the highest death rates of all the psychiatric illness. Although the disorder is less common in men (who make up about 10 percent of all cases), research suggests the number of men with anorexia has been growing in the last decade. (ahealthyme. com, 2003) This disorder is characterized by self-imposed dietary limitations, behavior directed toward losing weight, peculiar patterns of handling food, weight loss, disturbance of body image, and in women, amenorrhea.

It is one of the few psychiatric illnesses that may have a course that is unremitting until death (Kaplan and Sadock, M. d. , 1991). Anorexia is an illness that usually occurs in teenage girls, but it can also occur in teenager boys, and adult women and men. People with anorexia are obsessed with being thin. They lose a lot of weight and are terrified of gaining weight. They believe they are fat even though they are very thin. Anorexia isn’t just a problem with food or weight. It’s an attempt to use food and weight to deal with emotional problems. (familydoctor. org, 2002)

This is a serious, occasionally chronic, and potentially life threatening eating disorder defined by a refusal to maintain minimal body weight within 15 percent of an individual’s normal weight. Other essential features of this disorder include denial of the seriousness of the illness and amenorrhea (absence of at least three consecutive menstrual cycles when they are otherwise expected to occur). There are two subtypes of anorexia nervosa. In the restricting subtype, people maintain their low body weight purely by restricting their food intake and, possible, by excessive exercise.

Individuals with the binge eating/purging subtype also restrict their food intake, but also regularly engage in binge eating and/or purging behaviors such as self induced vomiting or misuse of laxatives, diuretics, or enemas. Many people move back and forth between subtypes during the course of their illness. Starvation, weight loss, and related medical complications are quite serious and can result in death. People who have an ongoing preoccupation with food and weight even when they are thin would benefit from exploring their thoughts and relationships with a therapist.

The term anorexia literally means loss of appetite, but this is a misnomer. In fact, people with anorexia nervosa often ignore hunger signals and thus control their desire to eat. Often they may cook for others and be preoccupied with food and recipes, yet they will not eat themselves. Obsessive exercise that may accompany the starving behavior can cause others to assume falsely that the person must be healthy. (“NAMI”, 2000) The disorder was first described in 1868 by Sir William Gull and given the name anorexia nervosa in 1874. In a classical paper, he called attention to its neurotic peculiarities.

The reaction occurs largely in young, single women. Most patients are intellectually superior and in personality characteristics are introverted, stubborn, selfish, perfectionist and overly sensitive and manifest compulsive and self–punitive behavior. Anorexia nervosa does occur in males, although rarely. A study of anorexic boys by Taipale and his colleagues lead them to conclude that psycho dynamically the future anorexic boy adapted well to the development days of infancy and childhood. (Kolb and Brodie, 1989) Anorexia affects both body and the mind. It may start as dieting, but it gets out of control.

You think about food, dieting, and weight all the time. You have a distorted body image. Other people say you are too thin, but when you look in the mirror, you see a fat person. Anorexia usually starts in the teen years. If not treated early, anorexia can become a lifetime long problem. Untreated anorexia can lead to starvation and serious health problems, such as bone thinning, kidney damage, and heart problems. Some people die from these problems. People who have anorexia often strongly deny that they have a problem. They do not see or believe that they do.

It is usually up to their loved ones to get help for them. If you are worried about someone, you can look for a certain signs. People who have anorexia: •Weight much less than is healthy or normal. •Are very afraid of gaining weight. •Refuse to stay at a normal weight. •Think they are overweight even when they are very thin. Their lives become focused on controlling their weight. They may: •Obsess about food, weight, and dieting. •Strictly limit their food intake. For example, they may limit themselves to just a few hundred calories a day or refuse to eat certain food, such as anything with fat or sugar. Exercise a lot, even when they are sick. •Vomiting or use of laxatives or water pills (diuretics) to avoid weight gain. •Develop odd habits food, like cutting all their food into tiny pieces or chewing every bite a certain number of times. •Become secretive. As starvation sets in, they start to develop signs of serious problems throughout the body. For instance, they may: •Feel weak, tired or faint. •Have thinning hair, dry skin, and brittle nails. •Stop having menstrual periods. •Feel cold all the time. •Have low blood pressure and a slow heartbeat. Have purplish skin color on their arms and legs from poor blood flow. •Have swollen feet and hands. •Grow a layer of baby-fine hair over their body. (yahoohealth. com, 2001) People with anorexia often hide their condition, so the warning signs are not always easy to spot. They may pull away from family and friends make excuses not to eat around other people, and lie about their eating habits. Furthermore, anorexics will typically try to explain away their disordered eating behaviors when confronted. But as anorexia progresses, the signs and symptoms become increasingly obvious and difficult to deny.

Anorexia can have dangerous psychological and behavioral effects on all aspects of an individual’s life and can affect other family members as well. The individual can become seriously underweight, which can lead to depression and social withdrawal. The individual can become irritable and easily upset and have difficulty interacting with others. Sleep can become disrupted and lead to fatigue during the day. Attention and concentration can decrease. Most individuals with anorexia become obsessed with food and thoughts of food. They think about it constantly and become compulsive about eating rituals.

They may collect recipes, cut their food into tiny pieces, prepare elaborate calorie-laden meals for other people, or hoard food. Additionally, they may exhibit other obsessions and/or compulsions related to food, weight, or body shape that meet the diagnostic criteria for an obsessive compulsive disorder. Other psychiatry problems are also common in people with anorexia nervosa, including affective (mood) disorder, anxiety disorders, and personality disorders. Generally, individuals with anorexia are compliant. Sometimes, they are overly compliant.

Sometimes, they are overly compliant, to the extent that they lack adequate self-perception. They are eager to please and strive for perfection. They usually do well in school and may often overextend themselves in a variety of activities. ( Wade TD AND Bulik CM, 2000) The families of anorexics often appear to be “perfect”. Physical appearances are important to them. Performance in other areas is stressed as well, and they are often high achievers. While control and perfection are critical issues for individuals with anorexia, aspects of their life other than their eating habits are often found to be out of control as well.

Many have, or have had at some point in their lives, addictions to alcohol, drugs, or gambling compulsions involving sex, exercising, housework, and shopping are not uncommon. In particular, people with anorexia often exercise compulsively to speed the weight-loss process. All of these features can negatively affect one’s daily activities. Diminished interest in previously preferred activities can result. Some individuals also have symptoms that meet the diagnostic criteria for a major depressive disorder. (Medicinenet. com, 2001) The severe calories restriction of anorexia has dire physical effects.

When the body doesn’t get the fuel it needs to function normally, it goes into starvation mode. It slows down to conserve energy and turns in on itself for essential nutrients. It essence, the body begins to consume itself. As the self-starvation continues and more body fat is lost, the medical complications pile up. •Loss of menstrual periods. •Lack of energy and weakness. •Feeling cold all the time. •Dry, yellowish skin. •Constipation and abdominal pain. •Restlessness and insomnia. •Dizziness, fainting, and headaches. •Growth of fine hair all over the body and face. womenshealth. org,2004) If anorexia continues unchecked, the health problems only get worse. Overtime, anorexia causes hair loss, infertility, stunted growth, osteoporosis, heart problem, kidney failure, and death. Other effects of anorexia include tooth decay and gum damage from malnutrition and vomiting, and damage to the esophagus and larynx from acid reflux. Anorexia can also lead to depression, severe mood swings, and thoughts of suicide. While the physical and emotional consequences of anorexia can be devastating, the good news is that it’s a treatable condition.

With the right treatment team, people with anorexia can and do get better. They can regain their health, learn to eat normally again, and develop healthier attitudes about food and their bodies. Since anorexia involves both mind and body, both attitudes and behaviors, a team approach is often best. Those who may involve in anorexia treatment include medical doctors, mental health professionals, and dieticians. The participation and support of family members also makes a big difference in anorexia treatment success. A hospital stay is needed for those who are seriously underweight or who have severe medical problems.

The goals of treatment are to restore a healthy weight and healthy eating habits. Achieving a more healthy weight helps the body as well as the brain to recover from anorexia. When the body and brain are no longer in starvation mode, you’ll find that you can think more clearly. And, you may have more control over your eating disorder behavior, rather than being controlled by thoughts. Initial Treatment Ideally, you can take charge of anorexia with the help of a team that includes a mental health professional (such as a psychologist or licensed counselor), a medical health professional (such as a doctor or nurse), and a registered dietitian.

If your medical condition is not life-threatening, initial treatment likely will include: Psychological Counseling. A counselor will help you learn healthy ways to think about food and your body. Family therapy can also help your family members support your recovery. Medical Treatment. If malnutrition or starvation has started to break down your body, medical treatment will be a top priority. Your health professional will treat any medical conditions that have been caused by anorexia, such as osteoporosis, heart problems, or depression. Nutritional Counseling.

A registered dietitian will help you take charge of your weight in a healthy way. You will learn healthy eating patterns and gain a good understanding of nutrition. Family Therapy. Parents learn about anorexia and how to help their child change her diet and exercise patterns. This includes preparing meals for their child and monitoring eating and exercising. An important part of there recovery will include learning new eating behaviors, learning emotional self case, and develop trust in people who are trying to help. For the teen with anorexia, family involvement is a key part of treatment is a key pert of treatment.

Family therapy helps parents support their child, both emotionally and physically. Any brothers or sisters also need support during treatment. Family, group, and individual counseling are all effective and are often combined. For the adult with anorexia, family members may be involved in treatment, though less so than with a teen. Ongoing Treatment Chronic forms of anorexia may require ongoing treatment for many years, including hospitalization when needed. Ongoing treatment usually includes: Psychological Counseling. A counselor will help you develop your own plan to use new coping and stress management skills and prevent relapse.

Your counselor can help you at those times when it is hard to stick to healthy ways of thinking about food and your body. Family therapy can also help your family members support your recovery. Medical Treatment. Your health professional will follow your health and weight, because anorexia affects all organ systems in your health body. If needed, you will be treated for conditions such as osteoporosis, heart problems, or depression. Nutritional Counseling. A registered dietitian will help you take charge of your eating and weight in a healthy way.

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