World Wide
Anorexia Nervosa

What is anorexia nervosa?

Purposeful loss of weight beyond state with intense fear of gaining weight or becoming fat, even though underweight and/or disturbance in perception of body weight or shape, undue influence of body weight or shape on self-evaluation, or denial of seriousness of the current low body weight.

 

There are two types of anorexia nervosa:

  • - Restricting type: during current episode, person has not regularly engaged in binge-eating or purging behavior (ie, self-induced vomiting or the misuse of laxatives, diuretics, or enemas).

  • - Binge-eating or purging type: during the current episode, person has regularly engaged in binge-eating or purging behavior (ie, self-induced vomiting or the misuse of laxatives, diuretics or enemas).


Epidemiology


0.5 to 1 % of girls and young women 0.2 % of boys and young men During the adolescent years at 14.5 and 18 years. However, men and women of any age can get anorexia.

Who are more likely to be affected by anorexia nervosa?

     Persons with:

  • Low self-esteem.

  • Perfectionism.

  • Obsessiveness.

  • Serotonergic system genetic defects relate to susceptibility.

  •        Family factor:

  • History of eating disorder.

  • Family dieting.

  • Focus in weight in the family

  •        Psychiatric illnesses :

  • Depression

  • Anxiety

  • Obsessive-compulsive disorder

What are signs and symptoms of anorexia nervosa?

  • - In children, the weight and height being lower than expected for their age.

  • - In adults, low body mass index (BMI)

  • - Distortion of body image

  • - Missing meals or eating very little

  • - Taking appetite suppressants

  • - Stop menstruation.

  • - Over exercising.

  •       Symptoms of malnutrition:

  • - Cold hands and feet.

  • - Dry skin.

  • - Fatigue.

  • - Muscle wasting.

  • - Constipation.

  •       Psychosocial changes:

  • - Fighting with the family.

  • - Performing less optimally in school.

  • - Withdrawing from friends.

What diseases are similar in symptoms to anorexia nervosa?

  • Cancer.

  • Central nervous system tumors.

  • Hyperthyroidism.

  • Diabetes mellitus.

  • Gastrointestinal problems.

  • Depression.

  • Sleep disorder.

When to see a doctor?

If you suffer from any of the symptoms listed above you should see a doctor ;  Unfortunately, many people with anorexia don’t want treatment. If you have someone close to you and you are worried about, urge them to talk to a doctor.

Diagnosis

  • Distortion of body image , a hallmark of anorexia nervosa

  • Establish patient’s eating and exercise patterns

  • A full psychosocial history is required

  • Assess use of vomiting or medications designed to promote weight loss

  • Evaluation of weight loss

  • For girls, a full menstrual history should be obtained

By collecting and interrupting previous information, an accurate diagnosis can be reached. In some cases, some laboratory tests and radiographs are performed to rule out the presence of other underlying disease causing similar symptoms.

Treatment

       It involves a combination of talking therapy and supervised weight gain. Treatment should be started as soon as possible to avoid complications or severe weight loss with the following strategies:

  • Psychotherapy

  • Medication

  • Nutrition counseling

  • Group and/or family therapy

  • Hospitalization : in case of serious complications caused by malnutrition or depression and suicidal thoughts or behaviors.

Prevention

There is no effective preventative method but to have healthy eating habits and realistic attitudes about food and body image may be useful.