Anorexia Nervosa Overview
Anorexia nervosa is a serious mental health condition and a life threatening eating disorder. It is characterized by an abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight.
People with anorexia place a high value on controlling their weight and shape, using extreme efforts that significantly interfere with their lives.
To prevent weight gain or to continue losing weight, people with anorexia usually severely restrict the amount of food they eat. They may control calorie intake by vomiting after eating or by misusing laxatives, diet aids, diuretics or enemas. They may also try to lose weight by exercising excessively. No matter how much weight is lost, the person continues to fear weight gain.
Anorexia isn’t really about food. It’s an extremely unhealthy and sometimes life-threatening way to try to cope with emotional problems. Anorexia, like other eating disorders, can take over your life and can be very difficult to overcome. But with treatment, you can gain a better sense of who you are, return to healthier eating habits and reverse some of anorexia’s serious complications.
Dietary restrictions can lead to nutritional deficiencies, which can severely affect overall health and result in potentially life threatening complications.
Anorexia nervosa is different than anorexia. Anorexia means a loss of appetite or the inability to eat, and it can be a symptom of various diseases.
Signs and Symptoms of Anorexia
Anorexia nervosa is a complex condition. The main signs of the condition is significant weight loss. It may be difficult to notice signs and symptoms because what is considered a low body weight is different for each person, and some individuals may not appear extremely thin.
Following are some of the common physical signs and symptoms of anorexia due to lack of nutrients:
- Abdominal Pain
- Absence of menstruation
- Arrhythmia
- Constipation
- Dizziness lightheadedness
- Dry skin
- Extreme weight loss
- Exhaustion
- Fatigue
- Hair loss
- Insomnia
- Infertility
- Intolerance of cold
- Low blood pressure
- Low body temperature with cold hands and feet
- severe loss of muscle mass
- swollen hands and feet
- Upset stomach
Causes of Anorexia
The exact causes of anorexia nervosa are unknown. Psychological, environmental, and social factors may contribute to the development of anorexia. it’s probably a combination of biological, psychological and environmental factors.
- Biological: Although it’s not yet clear which genes are involved, there may be genetic
changes that make some people at higher risk of developing anorexia. Some people may have a genetic tendency toward perfectionism, sensitivity and perseverance, these are traits associated with anorexia. - Psychological: Some people with anorexia may have obsessive-compulsive personality traits that make it easier to stick to strict diets and forgo food despite being hungry. They may have an extreme drive for perfectionism, which causes them to think they’re never thin enough. And they may have high levels of anxiety and engage in restrictive eating to reduce it.
- Environmental: Modern Western culture emphasizes thinness. Success and worth are often equated with being thin. Peer pressure may help fuel the desire to be thin, particularly among young girls.
Complications of Anorexia
Anorexia can have many complications, at its most severe, it can be fatal. A person with anorexia can die suddenly, even when someone is not severely underweight. This can result from abnormal heart rhythms (Arrhythmia) or an imbalance of electrolytes, minerals such as sodium, potassium and calcium that maintain the balance of fluids in the body.
Following are some of the complications of anorexia:
- Anemia
- Bone loss (osteoporosis), increasing the risk of fractures
- Electrolyte abnormalities, such as low blood potassium, sodium and chloride
- Gastrointestinal problems, such as bloating, constipation, diarrhea or nausea
- Heart problems, such as mitral valve prolapse, abnormal heart rhythms or heart failure
- In females, absence of a period
- In males, decreased testosterone
- Kidney problems
- Loss of muscle
If a person with anorexia becomes severely malnourished, every organ in the body can be damaged, including the brain, heart and kidneys. This damage may not be fully reversible, even when the anorexia is under control.
In addition to the host of physical complications, people with anorexia also commonly have the following other mental health disorders as well:
- Alcohol and dug abuse
- Depression, anxiety and other mood disorders
- Obsessive-compulsive disorders
- Personality disorders
- Self-injury, suicidal thoughts or suicide attempts
Diagnosis of Anorexia
Several tests and exams are performed to help pinpoint a diagnosis of anorexia nervosa, and to rule out other medical causes for the weight loss.
Following are the common diagnostics tests and physical exams performed to check for anorexia:
- 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.
- Other studies: 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 may be done to look for heart irregularities.
Treatment of Anorexia
Treatment for anorexia must address both psychological and physical problems. The treatment team should include a mental health professional and a primary care doctor.
Successful treatment usually includes continuous medical care, regular therapy, nutritional counseling, and mediations. Certain antidepressants are used to treat anorexia, but they are not always very effective.
It is important to evaluate for bone loss, electrolyte levels in the blood and heart function. Psychologists and other types of mental health professionals can help a person let go of self-destructive thoughts and behaviors and adopt a more positive outlook. Support groups of other recovering anorexics, when properly moderated by a mental-health professional, could also be very helpful.
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