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| What is it? |
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| * Eating disorder in young previously healthy women, who develop a paralysing fear of becoming fat, and a distorted self-image. |
| * Patient refuses to eat adequately, and continues to want to lose weight even after a reasonable weight loss. |
| * Primary affects teenage and young adult females. Occasionally young males are affected. |
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| Cause |
| * Cause is unknown. Suggested causes include family and internal conflicts (sexual conflicts). |
| * Phobia about putting on wieght; changes in fashion (slimness is identified with beauty). |
| * A symptom of depression or personality disorder. |
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| Signs and Symptoms |
| 1. Weight loss to 15% lower than ideal body weight. |
| 2. High energy level despite body wasting. |
| 3. Intense fear of obesity. |
| 4. Depression. |
| 5. Appetite loss. |
| 6. Constipation and abdominal pain, often associated with the over-use of laxatives. |
| 7. Cold intolerance. |
| 8. Refusal to maintain a minimum standard weight for age and height. |
| 9. Distorted body image. The person continues to feel fat even when emaciated. |
| 10. Cessation of menstrual periods. |
| 11. Onset prior to age 25. |
| 12. No known medical illness to account for loss. |
| 13. No other known psychiatric disorder. |
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| Associated Risk Factors |
| * Peer pressure to be thin. |
| * History of slight overweight. |
| * Perfectionistic, compulsive or overachieving personalities. |
| * Psychological stress. |
| * Ballet dancer, models, cheerleaders, and athletes. |
| * Inadequate interpersonal relationships. |
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| Prevention |
| Confront personal problems realistically. Try to correct or cope with problems with the help of counselors, therapists, family and friends. |
| Develop a rational attitude about weight. |
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| Prognosis |
| * Treatable if the patient recognizes the emotional disturbance, wants help and cooperates in treatment. |
| * Without treatment, this can cause permanent disability and death. Persons with anorexia nervosa have a high rate of attempted suicide due to low self esteem. |
|
| General Measures |
| * The goal of treatment is for the patient to establish healthy eating patterns so as to regain normal weight. The patient can accomplish this with behavior-modification training supervised by qualified professionals. The appropriate treatment approach addresses underlying issues of control and self-perception. |
| * Treatment can usually be done on an outpatient basis. |
| * Psychotherapy or counseling for the patient and family. |
| * Hospitalization during crises for intravenous or tube feeding to correct electrolyte imbalance, or if patient is suicidal. |
| * Therapy may continue over several years. Relapses are common, especially when stressful situations occur. |
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| Medication |
| Antidepressants, or antianxiety medications may be prescribed. |
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| Activity |
| Increased activity as weight is gained back. |
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| Diet |
| * A controlled refeeding program will be established. |
| * Vitamin and mineral supplements may be prescribed. |
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| Possible Complications |
| * Chronic anorexia nervosa caused by patient's resistance to treatment. |
| * Electrolyte disturbances or irregular heartbeat. These may be lift-threatening.
|
| * Osteoporosis. |
