Medline Medical Encyclopedia: Anorexia nervosa. Paul Ballas, D.O., Department of Psychiatry. 21 December 2006 <http://www.nlm.nih.gov/medlineplus/ency/article/000362.htm>.
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NOTES
- Characterized by the refusal to eat even at the minimal body weight for that person's height
- Other symptoms: intense fear of weight gain and distorted body image
- Inadequate eating or excessive exercising
- Cause of anorexia not known
- Social attitudes towards body appearance and family factors are believed to play a role in it's development
- Usually occurs in adolescence or young adulthood
- Affecting 1-2% of the female population
- Affecting 0.1-0.2% of male population
- Seen mainly in Caucasian women who are high academic achievers who have a goal-oriented family or personality
- It's suggested that conflicts within a family could contribute to the development of this eating disorder
- Causes are still not well understood
- Anorexia nervosa is a serious and potentially deadly medical condition
- Leads to death in 10% of cases
- Experienced treatment programs have a two-thirds success rate in restoring normal weight (relapse is very common)
- Women who develop this eating disorder at an early age have a better chance of complete recovery
- People with anorexia will continue to prefer a lower body weight and be preoccupied with food and calories to some extent
- Weight management may be difficult after recovery
- Long-term treatment may be necessary to help maintain a healthy body weight
SYMPTOMS
- Weight loss of 15% or more below a person's expected weight
- Inappropriate use of laxatives, enemas, or diuretics in order to loose weight
- Self imposed food intake restrictions
- No menstrual period
- Skeletal muscle atrophy
- Loss of fatty tissue
- Low blood pressure
- Dental cavities may be present because of self induced vomiting
- Blotchy or yellow skin
- Depression
- Denial (refuse to realize that they have an eating disorder)
The diagnosis of anorexia nervosa is based upon ruling out other causes of endocrine, metabolic, digestive, and central nervous system abnormalities to explain a person's weight loss. Such as celiac disease, inflammatory bowel disease, Addison's disease, etc.
TESTS (TO FIND ANOREXIA)
- CHEM-20
- Urinalysis
- Thyroid function tests
- Other blood and urine tests
- ECG
TREATMENT
When treating anorexia nervosa, the biggest challenge is to make the person recognize that their eating behavior is a problem and that it is not a solution to other problems. Most people who suffer from anorexia nervosa deny that they have an eating disorder, so, most individuals enter treatment when their condition is fairly advanced.
The purpose of treatment is...
- To restore normal body weight and eating habits
- Resolve psychological issues
Hospitalization may be indicated in some cases (when body weight falls below 30% of a person's expected weight).
Treatment includes supportive care by health care providers, structured behavioral therapy, psychotherapy, anti-depressant drug therapy, etc. Severe and life-threatening malnutrition may require intravenous feeding.
COMPLICATIONS
- Severe dehydration, leads to cardiovascular shock
- Electrolyte imbalance (potassium insufficiency)
- Cardiac arrhythmias related to electrolyte imbalance and the loss of cardiac muscle
- Severe malnutrition
- Thyroid gland deficiencies, leads to cold intolerance and constipation
- Appearance of fine body hair called lanugo
- Bloating or edema
- Decrease in white blood cells, leads to increased susceptibility to infection
- Osteoporosis
- Tooth erosion and decay (from self-induced vomiting)
- Seizures related to fluid shifts from excessive diarrhea or vomiting
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