Anorexia Nervosa

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• QHow is anorexia nervosa diagnosed?

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  A NewYork-Presbyterian Hospital answered

  Parents, family members, spouses, teachers, coaches, and instructors may be able to identify an individual with anorexia, although many persons with the disorder initially keep their illness very private and hidden. A detailed history of the individual's behavior from family, parents, and teachers, clinical observations of the person's behavior, and, sometimes, psychological testing contribute to the diagnosis. Family members who note symptoms of anorexia in a loved one can help by seeking an evaluation and treatment early. Early treatment can often prevent future problems.
  Anorexia, and the malnutrition that results, can adversely affect nearly every organ system in the body, increasing the importance of early diagnosis and treatment. Anorexia can be fatal. Consult your physician for more information.
• QWhat is anorexia nervosa?

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  A NewYork-Presbyterian Hospital answered

  Anorexia nervosa (or simply anorexia) is an eating disorder in which people intentionally starve themselves. It causes extreme weight loss, which the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH), defines as at least 15 percent below the individual's normal body weight. Food and weight become obsessions. Compulsiveness may cause strange eating rituals or the refusal to eat in front of others. It is not uncommon for people with anorexia to collect recipes and prepare gourmet feasts for family and friends, but not partake in the meals themselves. They may also adhere to strict exercise routines to keep off weight.
  
  Each year millions of people in the United States are affected by serious and sometimes life-threatening eating disorders. More than 90 percent of those afflicted are adolescent and young adult women. It is suggested that the reason women in this age group are particularly vulnerable to eating disorders is because of their tendency to go on strict diets to achieve an "ideal" figure. Researchers have found that such stringent dieting can play a key role in triggering eating disorders.
  
  The consequences of eating disorders can be severe -- 5 percent to 20 percent of cases of anorexia nervosa leads to death from starvation, cardiac arrest, other medical complications, or suicide.

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• QHow do society's demands on girls raise the risk for anorexia?

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  A Mental Fitness, Inc. answered

  

  Girls today are expected to accomplish the impossible: They're supposed to be caring while out-competing their friends, and look great doing it. In this video, Dr. Stephen Hinshaw, of  NORMAL nonprofit, discusses how this "triple bind" can result in depression, and strategies that can help.

  

  Find out more about this DVD:

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• QWhat are the complications of anorexia nervosa?

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  A NewYork-Presbyterian Hospital answered

  Medical complications that may result from anorexia include, but are not limited to, the following:

  • Cardiovascular (heart): While it is difficult to predict which anorexic patients might have life-threatening cardiac consequences that result from their illness, up to 95 percent of hospitalized anorexic patients have been found to have low heart rates. Myocardial (heart muscle) damage that can occur as a result of changes in the heartbeat, or repeated vomiting, may be life threatening. Common cardiac complications that may occur include the following: - arrhythmias (a fast, slow, or irregular heartbeat) - bradycardia (slow heartbeat) - hypotension (low blood pressure)
  • Hematological (blood): An estimated one-third of anorexic patients have mild anemia (low red blood cell count). Leukopenia (low white blood cell count) occurs in up to 50 percent of anorexic patients.
  • Gastrointestinal (stomach and intestines): Normal movement in intestinal tract often slows down with very restricted eating and severe weight loss. Gaining weight and some medications help to restore normal intestinal motility.
  • Renal (kidney): Dehydration often associated with anorexia results in highly concentrated urine. Polyuria (increased production of urine) may also develop in anorexic patients when the kidneys ability to concentrate urine decreases. Renal changes usually return to normal with the restoration of normal weight.
  • Endocrine (hormones): Amenorrhea (cessation of the menstrual cycle) is one of the hallmark symptoms of anorexia, when a menstrual period is missed for three or more months without any other underlying cause. Amenorrhea often precedes severe weight loss and continues after normal weight is restored. Reduced levels of growth hormones are sometimes found on anorexic patients and may explain growth retardation sometimes seen in anorexic patients. Normal nutrition usually restores normal growth.
  • Skeletal (bones): Persons with anorexia are at an increased risk for skeletal fractures (broken bones). When the onset of anorexic symptoms occurs before peak bone formation has been attained (usually mid to late teens), a greater risk of osteopenia (decreased bone tissue) or osteoporosis (bone loss) exists. Bone density is often found to be low in females with anorexia, and low calcium intake and absorption is common.

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• QWho becomes anorexic?

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  A Riverside Health System answered

  While anorexia mostly affects girls and women (85 - 95 percent of anorexics are female), it can also affect boys and men. It was once thought that women of color were shielded from eating disorders by their cultures, which tend to be more accepting of different body sizes. It is not known for sure whether African American, Latina, Asian/Pacific Islander, and American Indian and Alaska Native people develop eating disorders because American culture values thin people. People with different cultural backgrounds may develop eating disorders because it's hard to adapt to a new culture (a theory called "culture clash"). The stress of trying to live in two different cultures may cause some minorities to develop their eating disorders.

  This answer is based on source information from The National Women's Health Information Center.

• QWhat are the symptoms of anorexia nervosa?

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  A NewYork-Presbyterian Hospital answered

  The following are the most common symptoms of anorexia. However, each individual may experience symptoms differently. Symptoms may include:

  • low body weight (less than 85 percent of normal weight for height and age)
  • intense fear of becoming obese, even as individual is losing weight
  • distorted view of one's body weight, size, or shape; sees self as too fat, even when very underweight; expresses feeling fat, even when very thin
  • refuses to maintain minimum normal body weight
  • in females, absence of three menstrual cycles without another cause
  • excessive physical activity
  • denies feelings of hunger
  • preoccupation with food preparation
  • bizarre eating behaviors

  The following are the most common physical symptoms associated with anorexia - often that result from starvation and malnourishment. However, each individual may experience symptoms differently. Symptoms may include:

  • dry skin that when pinched and released, stays pinched
  • dehydration
  • abdominal pain
  • constipation
  • lethargy
  • fatigue
  • intolerance to cold temperatures
  • emaciation
  • development of lanugo (fine, downy body hair) yellowing of the skin

  Persons with anorexia may also be socially withdrawn, irritable, moody, and/or depressed. The symptoms of anorexia nervosa may resemble other medical problems or psychiatric conditions. Always consult your physician for a diagnosis.

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• QHow is my body affected in anorexia?

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  A Aggie Read, RN , Nursing, answered on behalf of Sigma Nursing

  Anorexia nervosa is an eating disorder of malnourishment, which can affect all body systems. Some of the more common body changes that can be seen in those with anorexia nervosa are:

  • weight loss
  • fatigue and dizziness
  • hair loss
  • loss of tooth enamel
  • loss of muscle tone
  • loss of skin elasticity
  • low heart rate
  • low blood pressure
  • kidney problems

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• QHow is outpatient and inpatient care for anorexia different?

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  A Riverside Health System answered

  With outpatient care, the patient receives treatment through visits with members of their health care team. Often this means going to a doctor's office. Outpatients usually live at home.
  Some patients may need "partial hospitalization". This means that the person goes to the hospital during the day for treatment, but sleeps at home at night.
  Sometimes, the patient goes to a hospital and stays there for treatment. This is called inpatient care. After leaving the hospital, the patient continues to get help from her health care team and becomes an outpatient.
  This answer is based on source information from the National Women's Health Information Center.

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• QHow can a person change their thinking to improve anorexia?

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  A Deepak Chopra , Alternative & Complementary Medicine, answered

  Anywhere that life hurts we have locked ourselves into some kind of false identification, telling ourselves private, unchallenged stories about who we are. The cure for anorexia is to somehow pry awedge between "I" and this powerful, secret identification. The same applies to all suffering because each person arbitrarily identifies with one thing after another that tells an inaccurate story of who he or she is. Even if you were able to surround yourself with pleasure every minute of the day, the wrong story of who you are will wind up bringing deep suffering.
• QWhen should I call my doctor if I have anorexia nervosa?

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  A RealAge answered

  If you have anorexia nervosa and you are concerned about when to call your doctor, you may already be one step on the path to getting better, because people who have anorexia nervosa often don't realize they have it or deny that they have a problem.
  
  People who suffer from the eating disorder anorexia nervosa often have a distorted body image and a fear of becoming overweight that causes them to restrict their food intake to a point of near-starvation. Often they don't call the doctor on their own behalf, but those phone calls are made by their family members and other people who care about them and are concerned about symptoms that they are observing. Some symptoms, including the following, are related to how a person feels emotionally and their behaviors.

  • You believe that you are overweight even when those around you, including possibly your doctor, say that you are underweight.
  • You think about food all the time.
  • You pretend to eat or lie to others about how much you have eaten.
  • You skip meals.
  • You weigh all of your food.
  • You exercise more than anyone you know.
  • You weigh yourself several times a day.
  • You take laxatives, diuretics and/or diet pills to try to lose weight.
  • You find yourself withdrawing from social situations, possibly because of a fear of eating in public, or because you feel you need to exercise instead.
  • You seem to be more irritable, depressed and/or anxious than you used to be.

  Anorexia nervosa can also cause physical symptoms including the following.

  • You are underweight and/or have a body mass index below 17.
  • Your menstrual periods, which used to be regular, have become irregular or stopped completely.
  • You frequently feel cold.
  • Your scalp hair is thinning.
  • You notice increased body hair.
  • Your skin feels dry and has a yellow tint.
  • Your nails are brittle.
  • You are often constipated.
  • You feel tired often.
  • You feel weak.
  • You have trouble sleeping.
  • You have been unable to become pregnant, despite trying.

  All of these symptoms may signal that you are at risk of serious complications from anorexia nervosa, and they are all good reasons to call your doctor. The earlier anorexia nervosa is diagnosed, the more likely that your treatment will be successful.