Anorexia nervosa is an eating disorder characterized
by immoderate food restriction and irrational fear of gaining weight, as well
as a distorted body self-perception. It typically involves excessive weight
loss and is usually found more in females than in males. Because of the fear of
gaining weight, people with this disorder restrict the amount of food they
consume. This restriction of food intake causes metabolic and hormonal disorders.
Outside of medical literature, the terms anorexia nervosa and anorexia are often
used interchangeably; however, anorexia is simply a medical term for lack of
appetite, and people with anorexia nervosa do not in fact, lose their
appetites. Patients suffering from anorexia nervosa may experience dizziness,
headaches, drowsiness and a lack of energy.
Anorexia nervosa is characterized by low body
weight, inappropriate eating habits, obsession with having a thin figure, and
the fear of gaining weight. It is often coupled with a distorted self-image which
may be maintained by various cognitive biases that alter how the affected
individual evaluates and thinks about her or his body, food and eating. Those
suffering from anorexia often view themselves as "too fat" even if they
are already underweight. They may practice repetitive weighing, measuring, and
mirror gazing, alongside other obsessive actions to make sure they are still
thin, a common practice known as "body checking".
Anorexia nervosa most often has its onset in
adolescence and is more prevalent among adolescent females than adolescent
males. However, more recent studies show the onset age has decreased from an
average of 13 to 17 years of age to 9 to 12. While it can affect men and women
of any age, race, and socioeconomic and cultural background, anorexia nervosa
occurs in ten times more females than males.
People with anorexia nervosa continue to feel
hunger, but they deny themselves all but very small quantities of food. The
average caloric intake of a person with anorexia nervosa is 600–800 calories
per day, but extreme cases of complete self-starvation are known. It is a
serious mental illness with a high incidence of comorbidity and similarly high
mortality rates to serious psychiatric disorders. People suffering from
anorexia have extremely high levels of ghrelin (the hunger hormone that signals
a physiological desire for food) in their blood. The high level of ghrelin
suggests that their bodies are desperately trying to make them hungry; however,
that hunger call is being suppressed, ignored, or overridden. Nevertheless, one
small single-blind study found that intravenous administration of ghrelin to
anorexia nervosa patients increased food intake by 12–36% over the trial
period.
The term anorexia nervosa was established in 1873 by
Sir William Gull, one of Queen Victoria's personal physicians. The term is of
Greek origin: an- (ἀν-, prefix denoting negation) and orexis (ὄρεξις,
"appetite"), thus meaning a lack of desire to eat. However, while the
term "anorexia nervosa" literally means "neurotic loss of
appetite", the literal meaning of the term is somewhat misleading. Many
anorexics do enjoy eating and have certainly not lost their appetites as the
term "loss of appetite" is normally understood; it is better to
regard anorexia nervosa as a self-punitive addiction to fasting, rather than a
literal loss of appetite.
Signs
and Symptoms
Anorexia nervosa is an eating disorder characterized
by attempts to lose weight, sometimes to the point of starvation. A person with
anorexia nervosa may exhibit a number of signs and symptoms, the type and
severity of which may vary in each case and may be present but not readily
apparent. Anorexia nervosa, and the associated malnutrition that results from
self-imposed starvation, can cause severe complications in every major organ
system in the body.
Hypokalaemia, a drop in the level of potassium in
the blood, is a sign of anorexia nervosa. A significant drop in potassium can
cause abnormal heart rhythms, constipation, fatigue, muscle damage and
paralysis.
Between 50% and 75% of individuals with an eating
disorder experience depression. In addition, one in every four individuals who
are diagnosed with anorexia nervosa also exhibit obsessive-compulsive disorder.
Symptoms for a typical patient include:
1. Refusal
to maintain a normal body mass index for their age
2. Amenorrhea,
the absence of three consecutive menstrual cycles
3. Fearful
of even the slightest weight gain and takes all precautionary measures to avoid
weight gain and becoming overweight
4. Obvious,
rapid, dramatic weight loss
5. Lanugo:
soft, fine hair growing on the face and body. One theory is that this is
related to hypothyroidism as a similar hypertrichosis occurs in hypothyroidism.
6. Obsession
with calories and fat content of food
7. Preoccupation
with food, recipes, or cooking; may cook elaborate dinners for others, but not
eat the food themselves
8. Dieting
despite being thin or dangerously underweight
9. Rituals:
cuts food into tiny pieces; refuses to eat around others; hides or discards
food
10. Purging:
uses laxatives, diet pills, ipecac syrup, or water pills; may engage in
self-induced vomiting; may run to the bathroom after eating in order to vomit
and quickly get rid of the calories (see also bulimia nervosa).
11. May
engage in frequent, strenuous exercise
12. Perception
of self to be overweight despite being told by others they are too thin and, in
most cases, underweight.
13. Becomes
intolerant to cold and frequently complains of being cold from loss of
insulating body fat or poor circulation resulting from extremely low blood
pressure; body temperature lowers (hypothermia) in effort to conserve energy
14. Depression:
may frequently be in a sad, lethargic state
15. Solitude:
may avoid friends and family; becomes withdrawn and secretive
16. Cheeks
may become swollen because of enlargement of the salivary glands caused by
excessive vomiting
17. Swollen
joints
18. Abdominal
distension
19. Bad
breath (from vomiting or starvation-induced ketosis)
20. Hair
loss or thinning
21. Fatigue
22. Rapid
mood swings
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