Anorexia nervosa

What is it?

Anorexia nervosa is a lack of appetite or an aversion to food that leads to starvation. It is an illness that usually occurs in teenage girls, but it can also occur in teenage boys and adults. People with anorexia are obsessed with being thin. They lose a lot of weight and are terrified of gaining weight. They believe they are fat even though they are very thin. Anorexia is not just a problem with food or weight, it is an attempt to use food and weight to deal with emotional problems.

What are the causes?

Family problems, inability to adjust in society, self-identity conflict (problem in body image) depression and other psychological problems are the associated causes for this disorder. The person may try to deal physically with emotions that are otherwise difficult to express.

What are the symptoms?

Deliberate self-starvation with major weight loss Fear of gaining weight Refusal to eat Denial of hunger Constant exercising Greater amounts of hair on the body or face Sensitivity to cold temperatures Absent or irregular menstrual periods Loss of scalp hair A self-perception of being fat when the person is really too thin Thinking may be confused or slowed, and an anorexic patient may have poor memory and lack judgment.

What are the risk factors?

The following factors may increase the risk of an eating disorder like anorexia:Sex. Teenage girls and young women are more likely than teenage boys and young men to develop eating disorders.Age. Although eating disorders can occur in midlife, they are more common the teens and 20s.Family influences. People who feel less secure in their families, whose parents and siblings may be overly critical, are at higher risk of eating disorders.Heredity. Eating disorders are more common in people who have close family members with eating disorders.Emotional disorders. People with depression, anxiety disorders and obsessive-compulsive disorder are more likely to also have an eating disorder. Excessive exercise. People who participate in highly competitive athletic activities are at greater risk of developing an eating disorder.

What is the treatment?

Treatment of anorexia is difficult, because people with anorexia believe there is nothing wrong with them. Patients in the early stages of anorexia (less than 6 months or with just a small amount of weight loss) may be successfully treated without having to be admitted to the hospital. But for successful treatment, patients must want to change and must have family and friends to help them. People with more serious anorexia need care in the hospital, usually in a special unit for people with anorexia and bulimia. Treatment involves more than changing the person's eating habits. Anorexic patients often need counseling for a year or more so they can work on changing the feelings that are causing their eating problems. These feelings may be about their weight, their family problems or their problems with self-esteem. Some anorexic patients are helped by giving drugs like antidepressants, anti-anxiety agents and appetite stimulants. These medicines are prescribed by a doctor and are used along with counseling. For adolescents with anorexia, family therapy that employs cognitive-behavioural techniques works best.

What are the complications?

Eating disorders can result in serious health problems. The most serious health risk from anorexia is death, either because of severe weight loss or by suicide. Other problems include: Heart disease. Anorexia can cause irregular heart rhythms and result in smaller heart muscles. Heart disease is a common cause of death for people with anorexia.Hormonal changes. Changes in reproductive hormones and in thyroid hormones can cause absence of menstruation (amenorrhoea), infertility, bone loss and retarded growth.Imbalance of minerals and electrolytes. The body needs adequate levels of minerals, particularly calcium and potassium, in order to maintain the electric currents that keep the heart beating. Disruption of the body's levels of fluids and minerals creates an electrolyte imbalance. Unless restored, this imbalance can be life-threatening.Nerve damage. Anorexia may cause brain and nerve damage, seizures and loss of feeling.Blood disorders. Lack of nutrition can reduce the body's levels of vitamin B-12, causing anaemiaand affecting the body's ability to produce enough red blood cells.Digestive problems. Anorexia can cause constipationand bloating.

DoctorNDTV Team

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