Information about anorexia.

Anorexia Nervosa At A Glance

• Anorexia nervosa is an eating disorder and, more importantly, a psychological disorder.
• The cause of anorexia has not been definitively established, but self-esteem and self-image issues, societal pressures, and genetic factors likely each play a role.
• Anorexia affects females far more often than males and is most common in adolescent females.
• Anorexia tends to affect the middle and upper socioeconomic classes and Caucasians more than less advantaged classes and ethnic minorities in the United States.
• The disorder affects about 1% of adolescent girls in the U.S.
• People with anorexia tend to show compulsive behaviors, may become obsessed with food, and often show behaviors consistent with other addictions in their efforts to overly control their food intake and weight.
• The extreme dieting and weight loss can lead to a potentially fatal degree of malnutrition.
• Other possible consequences of anorexia include heart-rhythm disturbances, digestive abnormalities, bone density loss, anemia, and hormonal and electrolyte imbalances.
• Most medications treat symptoms that are associated with anorexia much better than they address the specific symptoms of anorexia themselves.
• The treatment of anorexia must focus on more than just weight gain and often involves a combination of individual, group, and family psychotherapies in addition to nutritional counseling.
• The Maudsley model of family therapy, in which the family actively participates in helping their loved one achieve a more healthy weight, is considered the most effective method of family therapy for treating anorexia in adolescents.
• The prognosis of anorexia is variable, with some people making a full recovery. Others experience a fluctuating pattern of weight gain followed by a relapse, or a progressively deteriorating course over many years.
• As with many other addictions, it takes a day-to-day effort to control the urge to relapse, and treatment may be needed on a long-term basis.
• Increased understanding of the causes and treatments for anorexia remain the focus of ongoing research in the effort to improve the outcomes of individuals with this disorder.

Anorexia nervosa - 


affects primarily girls and young women. The disease is known in medicine since the 1600s. Those who are affected often feel fat, even though she weighs too little. The idea of putting on weight doing her terrified. What to eat ordinary food gives anxiety. Despite this anorexic thinking all the time on food. The whole life revolves around food, anxiety and fear of gaining weight. Anorexia The disease is in most cases but sometimes the process can be lengthy. Without treatment, the disease leads in some cases to death due to starvation or suicide.



How common are eating disorders?
Among younger teens anorexia nervosa is the most common eating disorder and affects approximately 1%. In older teenagers and women between 20 and 40 binge eating problems are common. The most severe form of binge eating, bulimia, affects approximately 1-2% of all women aged 18-30 years. A somewhat milder form is binge eating disorder, suffered a further approximately 2%.
A total affected approximately 4-5% of all women at some time from a severe eating disorder. If one also counts with milder eating disorders, such as "anorexia lite", the figure might be twice as high.

What is anorexia nervosa?

Anorexia nervosa, commonly referred to simply as anorexia, is one type of eating disorder. More importantly, it is also a psychological disorder. Anorexia is a condition that goes beyond out-of-control dieting. A person with anorexia often initially begins dieting to lose weight. Over time, the weight lossbecomes a sign of mastery and control. The drive to become thinner is actually secondary to concerns about control and/or fears relating to one's body. The individual continues the endless cycle of restrictive eating, often accompanied by other behaviors such as excessiveexercising or the overuse of diet pills, diuretics, laxatives, and/or enemas in order to reduce body weight, often to a point close to starvation in order to feel a sense of control over his or her body. This cycle becomes an obsession and, in this way, is similar to any type of addiction.

Who is at risk for anorexia?

Approximately 95% of those affected by anorexia are female, but males can develop the disorder as well. While anorexia typically begins to manifest itself during early adolescence, it is also seen in young children and adults. In the U.S. and other countries with high economic status, it is estimated that about one out of every 100 adolescent girls has the disorder. Caucasians are more often affected than people of other racial backgrounds, and anorexia is more common in middle and upper socioeconomic groups. According to the U.S. National Institute of Mental Health (NIMH), an estimated 0.5%-3.7% of women will suffer from this disorder at some point in their lives.

Many experts consider people for whom thinness is especially desirable, or a professional requirement (such as athletes, models, dancers, and actors), to be at risk for eating disorders such as anorexia nervosa.

What causes anorexia?

At this time, no definite cause of anorexia nervosa has been determined. However, research within the medical and psychological fields continues to explore possible causes.

Studies suggest that a genetic (inherited) component may play a more significant role in determining a person's susceptibility to anorexia than was previously thought. Researchers are currently attempting to identify the particular gene or genes that might affect a person's tendency to develop this disorder, and preliminary studies suggest that a gene located at chromosome 1p seems to be involved in determining a person' s susceptibility to anorexia nervosa.

Other evidence had pinpointed a dysfunction in the part of the brain, the hypothalamus (which regulates certain metabolic processes), as contributing to the development of anorexia. Other studies have suggested that imbalances in neurotransmitter (brain chemicals involves in signaling and regulatory processes) levels in the brain may occur in people suffering from anorexia.

Feeding problems as an infant, a general history of undereating, and maternal depressive symptoms tend to be risk factors for developing anorexia. Other personal characteristics that can predispose an individual to the development of anorexia include a high level of negative feelings and perfectionism. For many individuals with anorexia, the destructive cycle begins with the pressure to be thin and attractive. A poor self-image compounds the problem. People who suffer from any eating disorder are more likely to have been the victim of childhood abuse.

While some professionals remain of the opinion that family discord and high demands from parents can put a person at risk for developing this disorder, the increasing evidence against the idea that families cause anorexia has mounted such that professional mental-health organizations no longer ascribe to that theory. Possible factors that protect against the development of anorexia include high maternal body mass index as well as personal high self-esteem

How is anorexia diagnosed?

Anorexia nervosa can be a difficult disorder to diagnose, since individuals with anorexia often attempt to hide the disorder. Denial and secrecy frequently accompany other symptoms. It is unusual for an individual with anorexia to seek professional help because the individual typically does not accept that she or he has a problem (denial). In many cases, the actual diagnosis is not made until medical complications have developed. The individual is often brought to the attention of a professional by family members only after marked weight loss has occurred. When anorexics finally come to the attention of the health-care professional, they often lack insight into their problem despite being severely malnourished and may be unreliable in terms of providing accurate information. Therefore, it is often necessary to obtain information from parents or other family members in order to evaluate the degree of weight loss and extent of the disorder. Health professionals will sometimes administer questionnaires for anorexia as part of screening for the disorder.

The actual criteria for anorexia nervosa are found in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR).

There are four basic criteria for the diagnosis of anorexia nervosa that are characteristic:

1. The refusal to maintain body weight at or above a minimally normal weight for age and height. Maintaining a body weight less than 85% of the expected weight.
2. An intense fear of gaining weight or becoming fat, even though the person is underweight
3. Self-perception that is grossly distorted, excessive emphasis on body weight in self-assessment, and weight loss that is either minimized or not acknowledged completely.
4. In women who have already begun their menstrual cycle, at least three consecutive periods are missed (amenorrhea), or menstrual periods occur only after a hormone is administere

What are anorexia symptoms and signs (psychological and behavioral)?

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 todepression 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 psychiatric problems are also common in people with anorexia nervosa, including affective (mood) disorders, anxiety disorders, and personality disorders.
• Generally, individuals with anorexia are compliant in every other aspect of their life except for their relationship with food. 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. 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 exercisecompulsively 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.

What are anorexia symptoms and signs (physical)?

Most of the medical complications of anorexia nervosa result from starvation. Few organs are spared the progressive deterioration brought about by anorexia.

• Heart and circulatory system: Although not life-threatening, an abnormally slow heart rate (bradycardia) and unusually low blood pressure (hypotension) are frequent manifestations of starvation and are commonly associated with anorexia. Of greater significance are disturbances in the heart rhythm (arrhythmia). A reduction in the work capacity of the heart is associated with severe weight loss and starvation.
• Gastrointestinal complications are also associated with anorexia.Constipation and abdominal pain are the most common symptoms. The rate at which food is absorbed into the body is slowed down. Starvation and overuse of laxatives can seriously disrupt the body's normal functions involved in the elimination process. While liver function is generally found to be normal, there is evidence of changes in enzyme levels and overall damage to the liver.
• The glandular (endocrine) system in the body is profoundly affected by anorexia. The complex physical and chemical processes involved in the maintenance of life can be disrupted, with serious consequences. Disturbances in the menstrual cycle are frequent, and secondary amenorrhea (absence of menstrual periods) affects about 90% of adolescent girls with anorexia. Menstrual periods typically return withweight gain and successful treatment. Hormonal imbalances are found in men with anorexia as well. Continual restrictive eating can trick the thyroid into thinking that the body is starving, causing it to slow down in an attempt to preserve calories.
• Kidney (renal) function may appear normal. However, there are significant changes in kidney function in many people with anorexia, resulting in increased or decreased urination or potentially fatal potassium deficiency.
• Bone density loss (osteopenia or thinning of the bones) is a significant complication of anorexia, since women acquire 40%-60% of their bone mass during adolescence. Studies have shown that bone loss can occur fairly rapidly in girls with anorexia. While some studies have shown that bone density may be restored if overall health improves and anorexia is successfully treated, other studies suggest that an increased risk for fracture may persist later in life.
• Anorexics who use a large quantity of laxatives or who frequently vomit are at great risk for electrolyte imbalance, which can have life-threatening consequences.
• Anemia is frequently found in anorexic patients. In addition to having fewer red blood cells, people with anorexia tend to have lower numbers of white blood cells, which play a major role in protecting the body from developing infections. Suppressed immunity and a high risk for infection are suspected but not clinically proven.
• Physical symptoms, other than the obvious loss of weight, can be seen. Anorexia can cause a lower body temperature as well as dry, flaky skin that takes on a yellow tinge. Fine, downy hair grows on the face, back, arms, and legs. Despite this new hair growth, loss of hair on the head is not uncommon. Nails can become brittle. Frequent vomiting can erode dental enamel and eventually lead to tooth loss.