Anorexia nervosa, or just anorexia, is an eating disorder in which people have an unreasonable fear of becoming fat. People lose so much weight that they become gaunt. Even then, they still see themselves as fat.
Anorexia nervosa is fairly uncommon, with groups at highest risk being adolescent girls and young women. It affects women much more than men, and is more common in some jobs (e.g., modeling, ballet dancing). It can be life threatening if untreated.
The cause is unknown, but anorexia probably results from a combination of factors, such as depression, other psychological problems, intense peer pressure, hormone changes at puberty, and stress. Adolescents may have concerns about sexuality, and these concerns lessen with anorexia because it delays sexual maturity. As children, anorexics were often obedient. As adolescents, they develop anorexia, which becomes their first rebellious act.
The most common symptoms include loss of weight, exercising too much, menstrual periods that stop, complaints of being fat from someone who is overly thin, depression, and loss of appetite. It can cause medical problems, including skin, heart, blood, bone, and hormone disorders. Dehydration, constipation, and frequent infections may occur.
The health care provider makes a diagnosis from the medical history (especially weight and diet), physical examination, and laboratory tests to rule out other conditions. No specific tests exist for anorexia. Extreme weight loss without physical illness, especially in a young woman, is usually an important sign.
Anorexics often deny their illness and may make themselves vomit with syrup of ipecac (causing dental cavities), misuse laxatives and enemas, and use diet and water pills.
Anorexia requires long-term care, including counseling or psychotherapy. Relapses are common, especially during periods of stress. Recovery depends on the individual.
Treatment first involves working with the person and family. Drugs may be prescribed for depression or anxiety. Programs may use negative and positive feedback, emotional support, education, and reassurance to address fears about gaining weight. Often, the whole family needs counseling. Other medical problems and illness that may have resulted from starvation need treatment, which may mean hospitalization.
Many people remain ill for a long time. Participation in an outpatient program after hospitalization is critical for successful treatment. The death rate associated with anorexia can be rather high.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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