Anorexia nervosa

Introduction

Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low or abnormal weight, food restriction, fear of gaining weight and a strong desire to be thin, resulting in food restriction. It is a complex disease that is a combination of biological, psychological and social factors. People with anorexia are always concerned about controlling their weight and body shape. They always feel unhappy about these things so they use extreme measures that tend to affect their daily activities.

This condition usually occurs in women. Many people with anorexia see themselves as overweight even though they are in fact underweight. If asked they usually deny they have a problem with low weight. Often they weigh themselves frequently, eat only small amounts and only eat certain foods. Some will exercise excessively, force themselves to vomit or use laxatives to produce weight loss.  Some people have died because of this disease. This shows that anorexia is a disease that is quite difficult to treat.

Common Causes of Anorexia

The exact causes of anorexia nervosa is not well understood. Like other diseases anorexia is caused by biological, psychological and social factors:

Biological Factors

Although experts do not yet know which genes are involved in the disease? There are some genes that make some people more susceptible to anorexia. Some people have a genetic tendency for sensitivity and persistence, all of the characteristics associated with anorexia nervosa.

Psychological Factors

Young women may have obsessive compulsive disorder which makes them easy to follow strict diets and skip meals, though they are very hungry. They may be crazy about perfectism. This makes them think that they can never get a perfect body. They have very high levels of anxiety and then they cut their diets to deal with that anxiety.

Social Factors

Modern culture makes many people want to own beautiful bodies. Success and personal values are often associated with the shape of the body. This puts a lot of pressure on many people especially young girls.

Feminine

Anorexia is common in women. Recently the incidence of anorexia has risen probably due to increasing social pressure.

Youth

Anorexia is a common disease in adolescents. Although anyone of any age can suffer from this disease, however people over the age of 40 rarely get it. Adolescents are more likely to be affected by physical changes during puberty. They may face more social pressure. In addition they become more sensitive to criticism or even comments on their weight and body shape.

Genetic

Changes in certain genes can make people susceptible to anorexia.

Family History

People whose family members such as parents, brothers, sisters or even relatives have anorexia, will have a higher risk of anorexia.

Weight Change

When a person changes their weight whether intentionally or not, the changes can receive positive feedback if they lose weight or negative comments if they gain weight. The changes in these comments can make someone start dieting thoroughly. In addition, hunger and weight loss can change the way brains work. This can make them prolong their diet and cannot return to normal eating habits.

Changes In Life

Changes such as leave or death of a relative can bring negative emotions and increase the risk of anorexia.

Job

Athletes, actors, dancers and models have a high incidence of anorexia. Their trainers and parents may accidentally increase this rate by suggesting that they should lose more weight.

Communication And Society

Mass media such as TVs and fashion magazines regularly show pictures of models. These images seem to equate slenderness with success and fame.

Common Symptoms of Anorexia

The physical signs of anorexia are related to hunger and behavior problems related to incorrect perception of weight and extreme fear of gaining weight or becoming obese. Physical signs may include:

• Lose weight quickly
• Look sick
• Abnormal blood counts
• Tired
• Insomnia
• Dizziness
• Faint nails
• Hair loss or weakness
• No menstruation
• Constipation
• Dry skin
• Irregular heartbeat
• Low blood pressure
• Dehydration
• Osteoporosis
• Swollen hands and legs
• Mood swings
• Reduced sexual desire
• Depression
• Patient wants to commit suicide

Emotional and behavioral symptoms may include efforts to lose weight:

• Give reasons for not wanting to eat.
• Excessive diet or exercise.
• Always deny that they are hungry.
• Control the foods they consume by vomiting immediately after digestion or abuse of laxatives, weight loss devices or diuretics.
• Eat very little and only eat some safe foods which are usually low in fat and low in calories.

Syndrome

Complications may include osteoporosis, infertility and heart damage. Women will often stop having menstrual periods.

Remedies

Treatment of anorexia involves restoring a healthy weight, treating the underlying psychological problems and addressing behaviors that promote the problem. While medications do not help with weight gain, they may be used to help with associated anxiety or depression. A number of types of therapy may be useful including an approach where parents assume responsibility for feeding their child, known as Maudsley family therapy and cognitive behavioral therapy known as CBT is a psychosocial intervention that is the most widely used evidence-based practice for improving mental health.

Sometimes people require admission to hospital to restore weight. Evidence for benefit from nasogastric tube feeding. Some people will just have a single episode and recover while others may have many episodes over years.

If your doctor suspects that you have anorexia nervosa, he or she will do several tests and exams to help diagnosis

These exams and tests generally include:

·         Physical exam: This may include measuring your height and weight, checking your vital signs such as heart rate, blood pressure and temperature, checking your skin and nails for problems, listening to your heart and lungs and examining your abdomen.

·         Lab tests: These may include a Complete Blood Count (CBC) and more specialized blood tests to check electrolytes and protein as well as functioning of your liver, kidney and thyroid. A urinalysis also may be done.

·         Psychological evaluation: A doctor or mental health professional will likely ask about your thoughts, feelings and eating habits. You may also be asked to complete psychological self-assessment questionnaires.

·         X-rays/ECG: X-rays may be taken to check your bone density, check for stress fractures or broken bones or check for pneumonia or heart problems. Electrocardiograms (ECG) may be done to look for heart irregularities.

Other Method

Treatment for anorexia is generally done using a team approach which includes doctors, mental health professionals and dietitians, all with experience in eating disorders. Ongoing therapy and nutrition education are highly important to continued recovery.

Hospitalization and other programs

If your life is in immediate danger, you may need treatment in a hospital emergency room for such issues as a heart rhythm disturbance, dehydration, electrolyte imbalances or a psychiatric emergency. Hospitalization may be required for medical complications, severe psychiatric problems, severe malnutrition or continued refusal to eat.

Some clinics specialize in treating people with eating disorders. They may offer day programs or residential programs rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time.

Medical care

Because of the complications, you may need frequent monitoring of vital signs, hydration level and electrolytes as well as related physical conditions. In severe cases, people with anorexia may initially require feeding through a tube that's placed in their nose and goes to the stomach i.e. nasogastric tube. Care is usually coordinated by a primary care doctor or a mental health professional.

Restoring a healthy weight

The first goal of treatment is getting back to a healthy weight. You can't recover from anorexia without returning to a healthy weight and learning proper nutrition. Those involved in this process may include:

·         Your primary care doctor who can provide medical care and supervise your calorie needs and weight gain

·         A psychologist or other mental health professional who can work with you to develop behavioral strategies to help you return to a healthy weight

·         A dietitian who can offer guidance getting back to regular patterns of eating including providing specific meal plans and calorie requirements that help you meet your weight goals

·         And at last, Your family who will likely be involved in helping you maintain normal eating habits

Psychotherapy

These types of therapy may be beneficial for anorexia:

·         Family-based therapy: This is the only evidence-based treatment for teenagers with anorexia because the teenager with anorexia is unable to make good choices about eating and health while in the grips of this serious condition. This therapy mobilizes parents to help their child with re-feeding and weight restoration until the child can make good choices about health.

·         Individual therapy: For adults cognitive behavioral therapy specifically enhanced cognitive behavioral therapy has been shown to help. The main goal is to normalize eating patterns and behaviors to support weight gain. The second goal is to help change one-sided beliefs and thoughts that maintain restrictive eating.

Medications

No medications are approved to treat anorexia because none has been found to work very well. However, antidepressants or other psychiatric medications can help treat other mental health disorders you may also have such as depression or anxiety.

Obstacles

One of the biggest challenges in treating anorexia is that people may not want treatment. Barriers to treatment may include:

·         Thinking you don't need treatment

·         Fearing weight gain

·         Not seeing anorexia as an illness but rather a lifestyle choice

At the end…

People with anorexia can recover. However, they're at increased risk of relapse during periods of high stress or during triggering situations. Ongoing therapy or periodic appointments during times of stress may help you stay healthy.

If you suspect that you or someone you know has anorexia or another eating disorder, seek help immediately. Eating disorders can become increasingly dangerous the longer they go untreated. In severe cases, the effects on the body caused by eating disorders can be fatal and thus incurable.

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