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Anorexia Nervosa

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Anorexia nervosa is an eating disorder that occurs when an individual is unrealistically concerned about being overweight or feels an overwhelming need to be so thin that in either case she/he eats so little she/he becomes malnourished. Anorexia nervosa is an illness with both physical and psychological components. Its victims can literally starve themselves to death. Others may suffer from cardiac arrest as a result of malnutrition, while still others commit suicide.

The cause of anorexia nervosa is not clear. It appears to result from a number of different psychological, social, and biological factors acting together. However, so far no biological factor has been identified as causative, and the physical abnormalities found in people (mostly girls) with anorexia nervosa are the result of malnutrition.

Factors that increase the risk of anorexia nervosa include concerns of identity and separation from parents and home. There may be a parental history of depression or alcohol abuse, anorexia may be present in siblings, or the family may magnify the cultural emphasis on weight, eating, and fitness. Excessive family expectations and cultural pressure for high performance may also contribute to the cause.

What are the Symptoms of Anorexia Nervosa?
Severe weight loss and refusal to maintain a healthy weight is present. Severe restriction of food, and obsession with food (preparation, calorie counting, etc.) may be present, as may be a rigid schedule of obsessive exercise, even when in physical pain. In women, amenorrhea (loss of monthly menstrual cycle) due to insufficient body fat may occur, which can lead to loss of calcium from bone, and eventual osteoporosis. Dry skin, brittle hair and fingernails, and the development of a layer of soft downy hair called “Lanugo” on face, back, and arms may become evident. Constipation, anemia, swollen joints, and muscle atrophy may occur. As the anorexia becomes more severe, individuals can experience lethargy, insomnia, increased feelings of worthlessness and hopelessness, and other symptoms of depression. Breathing, pulse, and blood pressure rates fall.

How is it diagnosed?
Both physical and psychological factors are considered in arriving at a diagnosis of anorexia nervosa. These include a refusal to maintain body weight over a minimal normal weight range for age and height, e.g., weight loss leading to maintenance of body weight 15 per cent below that expected. An intense fear of gaining weight or becoming fat, and a distortion in the way in which the patient’s body weight, size, or shape is experienced is evident. And, in women, the absence of three consecutive menstrual cycles when otherwise expected to occur.
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