Anorexia

Definition

Anorexia is an eating disorder

gaining weight, a distorted mental picture of what one

looks like, and extreme dieting in order to lose weight. Many anorexics

also exercise for long periods or take diuretics (drugs that increase urine

output) in order to lose weight.

—a psychiatric condition marked by fear of’s body actually

Description

The

(DSM-IV), the reference that doctors use to diagnose mental illness, specifies

that a person must have a body weight that is only 85 percent of

normal for their sex, age, and height, combined with a fear of becoming

fat and a preoccupation with the size and shape of the body in order to be

diagnosed with anorexia. In addition, a girl must miss three or more menstrual

periods in a row to fit the diagnostic criteria.

Other signs that are commonly seen in young people with anorexia

include osteoporosis (brittle bones), slowed growth, hair loss, aches in the

joints and muscles, feeling cold much of the time, low blood pressure,

slowed heart rate, and dry skin.

Diagnostic and Statistical Manual of Mental Disorders fourth edition

Demographics

There are between eight and thirteen young people per 100,000 in the

United States and Canada who meet the strict DSM-IV criteria for anorexia.

On the other hand, many doctors think there are other adolescents

and young adults who have a milder form of anorexia but are not counted

because they do not meet all the DSM-IV criteria; thus the disorder may

be more widespread than the official figures indicate.

Anorexia is most common in teenagers and young adults; 40 percent of

diagnosed patients are between fifteen and nineteen years old. A few patients

begin to show signs of the disorder between the ages of seven and twelve. At

the upper end of the age spectrum, 10 percent of patients are women over

the age of forty; it is estimated that between 1 and 3 million women in the

so-called baby boomer generation are struggling with eating disorders. The

female/male ratio for anorexia is thought to be

nine females to every male. Although gay men are

at somewhat higher risk of anorexia, heterosexual

men can also develop the disorder.

At one time it was thought that anorexia is

primarily a disease of middle-class Caucasians;

however, in recent years, more cases of the disorder

are appearing in African American and

Hispanic women.

Causes and Symptoms

Although there is general agreement that anorexia

is caused by a combination of factors, doctors disagree

about which are the most important. There

is considerable evidence that genetic factors play

an important role. Another factor that is being

researched is the role of a brain chemical involved

in both anorexia and depression.

Other factors that have been cited by researchers

include personality traits, family issues,

and cultural values. Many anorexics are high

achievers with a tendency toward perfectionism,

and controlling their weight appears to be part of

a larger need to be in control of their lives. In terms of family issues, some

psychiatrists think that anorexia may be a way for the young person to

separate from their family and establish their own identity.

In addition, as many as 50 percent of girls hospitalized for anorexia

were sexually abused as children, leading doctors to think that they may

be afraid of growing into mature women and want to keep a childish

figure as long as possible. Last, cultural emphasis on thinness as a mark

of social status has been blamed for encouraging girls (and older women)

to lose more weight than is healthful.

The symptoms of anorexia include psychological as well as physical

symptoms. Anorexia affects most of the body

’s major organ systems:

•

episodes of weakness and dizziness, low levels of calcium and

magnesium in the blood, and anemia (red blood cell count that

is too low)

•

of scalp hair, sore muscles, swelling of

the joints caused by abnormal eating

patterns, risk of developing osteoporosis,

a bone disorder in which the bones break

or fracture more easily than is normal as

the result of the loss of minerals in bone

caused by starvation

Muscles, bones, and skin: dry skin, loss

•

ulcers, bleeding in the digestive tract,

and an increased risk of disorders of the

liver and pancreas

Digestive system: constipation, stomach

•

the loss of body fat means that the body

loses heat more rapidly

Temperature regulation: feeling cold, as

•

distorted notions of the body, and an

increased risk of suicide

Psychological symptoms: depression,

Diagnosis

Anorexia is usually diagnosed during an office

visit to the patient

although she or he may be sent to a psychiatrist

for an additional evaluation. Primary care doctors

are now encouraged to give a screening test to an adolescent or young

adult who seems unusually concerned about weight or asks the doctor a

lot of questions about weight loss. These screeners are short sets of five

questions about eating habits that the patient can quickly answer. Other

questionnaires that the doctor may use include the Clinical Eating Disorder

Rating Instrument (CEDRI) or the Eating Disorder Examination

(EDE); these take a little longer for the patient to fill out.

If the doctor thinks that the patient may have anorexia, he or she can

look for some of the physical signs that accompany the disorder after

weighing the patient. Besides extreme thinness, these signs typically

include a yellowish discoloration of the skin, signs of dehydration, an

abnormally low blood pressure reading, and a slow heartbeat. The doctor

will order laboratory tests of the patient

the blood chemistry and the red blood cell count are normal. The patient

will also be given an electrocardiogram (ECG) to check for abnormal

heart rhythms and other potential heart problems.

Treatment

The treatment of anorexia is difficult and complicated, partly because many

patients deny that they have a problem. It is common, in fact, for anorexics

to argue with the doctor that they simply have a different lifestyle and

should be left alone. Hospitalization may be necessary if the patient is

having serious medical complications related to starvation or has threatened

suicide. In the hospital she (or he) will be given fluids and nutrients intravenously

at first in order to stop the weight loss and bring other physical

problems under control. The patient will then be given psychotherapy

(usually cognitive-behavioral therapy or CBT) and education about nutrition.

Antidepressants may be given to treat anxiety or emotional depression,

but they are not considered effective in treating the eating disorder by itself.

Anorexics who do not need to be hospitalized for serious physical

conditions may be treated on an outpatient basis or in a day hospital.

They are often referred to a dietitian for personalized advice about

healthful eating patterns and sample menus. Group psychotherapy is

considered less effective than either individual treatment or family

therapy in treating anorexia because the patients in a treatment group are

likely to compete to see who can stay the thinnest. Family therapy is

particularly recommended for patients under eighteen and for families

in which the mother has an eating disorder.

Prognosis

Anorexia is a potentially life-threatening illness with one of the highest

death rates among psychiatric disorders; between 6 and 20 percent of

patients die either from starvation or suicide. Because treatment is complicated

and may take years, the prognosis varies. Most patients need

monitoring over a period of months to years to help them maintain a

healthy weight and not slip back into disordered eating habits. One very

real problem since the coming of the Internet is the rise of a number of

websites promoting anorexia, encouraging people with the disorder to

consider it a valid lifestyle decision rather than an illness.

Prevention

There is not likely to be any new medical or psychological treatment for

anorexia in the next few years. For now, prevention of anorexia depends

on early recognition of an unhealthy concern with weight, since girls as

young as five or six are known to worry about their weight, especially if

their mothers or older sisters are dieting. In some cases the child

can help detect the problem or offer advice.

’s pediatrician

The Future

It can be difficult to change an entire society

and a very limited notion of physical attractiveness. In addition, the availability

of Web sites promoting anorexia increases the difficulty of

teaching young people healthy eating habits even if they do not measure

up to celebrity-inspired notions of glamour or beauty. A 2006 study at

Stanford University found that 36 percent of the patients in the eating

disorders unit of the university

this percentage, 96 percent had learned new techniques for dieting or

losing weight from the Web sites.

’s obsession with thinness’s hospital visited these Web sites, and of

Encyclopedia Health of Diseases and Disorders

Search This Blog

Anorexia

Labels

Comments

Post a Comment

Popular posts from this blog

Fetal Alcohol Syndrome

Bipolar Disorder

Avian Influenza