Anorexia Nervosa

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Anorexia Nervosa:  Characterized by self-imposed starvation and excessive leanness; a wasted condition of the body (emaciation), nutritional deficiencies, and atrophic changes.  The patient may gorge, vomit, and purge during starvation or after returning to normal weight.  Anorexia nervosa usually affects adolescent and young adult females, it also affects older women and occasionally affects males.  It usually develops in a patient who's of normal weight or only about 5lb overweight.

Prognosis varies but is poor if body image distortion exists.  The outlook improves if the diagnosis is made early or if the patient voluntarily seeks help and wants to overcome the disorder.  Mortality ranges from 5% to 15%, the highest mortality associated with a psychological disturbance.

Causes:  Researchers in neuroendocrinology are seeking a  physiologic cause but have found nothing definite.  The true cause is unknown.  It is clear, however, that social attitudes that equate slimness  with beauty play an important role in provoking this disorder.  Emotional factors may contribute to this disorder as well.

Symptoms:

Usually a 25% or greater weight loss coupled with a compulsion to be thin.

May have the need to exercise frequently

May be angry

Though the patient refuses to eat, he may be obsessed with food or cooking.

Despite evidence to the contrary, the patient believes that he is fat.

May feel hopelessness, guilt, anxiety, depress, and have low self esteem.

Systolic blood pressure may fall below 50 mm Hg, signaling circulatory collapse, and the patient may develop cardiac dysrhythmias, possibly leading to cardiac arrest.

Treatment:

Treatment aim to promote weight gain and control the patient's compulsive gorging and purging, and to correct starvation symptoms.

The patient may require hospitalization in a medical or psychiatric unit.

Group and or individual psychotherapy

Behavior modification

Vitamin and mineral supplements

Reasonable diet

Contact Anorexia Nervosa and Related Eating Disorder support organization

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