Anorexia Nervosa is an eating disorder and is more commonly known as Anorexia. It is defined as an irrational fear of gaining weight which leads to a form of food restriction.

A significant problem is that it doesn’t feel irrational to the person going through it. Often, this creates a distorted self-perception of ones own body and leads to excessive weight loss and sometimes excessive means to reach this goal.

Typically this condition begins in early adolescence or early adulthood. There are many complicated medical problems or implications that stem from this condition.

Obsession begins on having a thin figure.Other behaviors include mirror gazing, repetitive weighing, measuring, body checking, and others.

A fear of gaining weight sets in that can be overwhelming.

More often seen in females than males.

Typically seen in ages 13-17 but can begin at any age.

Part of treatment helps the patient understand that self perception is often distorted or confused.

 

Signs and Symptoms

–  Excessive Weight loss
–  Decreased appetite
–  Excessive Dieting
–  Starvation
–  Malnutrition
–  Hypokalaemia – drop in potassium in blood
–  Amenorrhea  –  absences of three consecutive menstrual cycles
–  Obsession with fat and calories
–  Purging  (Vomiting, laxatives, diet pills, water pills, and more)
–  Solitude
–  Misconception of being overweight
–  Bad breath
–  Hair loss
–  Fatigue
–  Excessive sleeping or not enough
–  Depression or sadness

 

Medical Complications

1.)  Growth problems
2.)  Delay of Puberty
3.)  Decreased Bone Mass
4.)  Hepatic Steatosis – (Fatty Liver)
5.)  Malnutrition
6.)  Others

 

Causes:

1.)  Genetic

–  Additional studies are being done to look at emotional and physical changes that occur due to genetics
–  Studies looking at other medical issues that lead people into developing an obsession.
–  Genetic Mutations, Brain chemicals, Proteins, hormones and other areas of the body are being studied to see their relation with Anorexia.

2.)  Environmental

–  Sociocultural studies are being done to compare Countries and their beliefs and expectations to identify if Environmental factors.
–  Such things evaluated are gender, ethnicity, and socioeconomic status.
–  Models and Dancers have additional social pressures.
–  Anorexia tends to be seen in cultures where obesity is prevalent.

 

Diagnosis and Evaluation

****  should always be made by a competent medical professional.

Many other serious medical issues can result in weight loss.

Anorexia, in those cases, should be made after other medical issues are ruled out.

1.)  Weight loss associated with mental illness
2.)  Mental Health Evaluation should be done.
2.)  Blood work is required.  (CBC, Thyroid, Liver functioning, and many other things)
3.)  Urinalysis
4.)  EKG
5.)  Gastrointestinal evaluation

Anorexia Nervosa is classified as an Axis I disorder in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV).

It is classified as an eating disorder.

 

Treatment

Addresses several areas

1.)  Improve Health

–  This deals with several issues including weight gain, proper nutrition, dietary improvements including vitamins.

2.)  Treating mental health disorders associated to this condition.

3.)  Improving behaviors and thoughts related to this disorder

–  Behavior changes are essential for successful management of this condition
–  Often initial motivation evaporates and return of behavior is easy to fall back upon.

Medication Options

Olanzapine

–  This mental health medication helps and is effective in certain aspects of Anorexia.
–  It can be an appetite stimulant as well.

Dietary Options

Nutrition Counseling
Medical Nutrition Therapy

.  Zinc  (can help facilitate weight gain)
.  Omega-3 fatty acids
.  Multivitamin
Vitamins

Therapy

.  Family Therapy
.  Cognitive Behavioral Therapy
.  Yoga
.  Others

Prognosis

In most cases – the duration of symptoms is just under 2 years.
More often than not, a good outcome will be seen when family-based treatment is given.

Severe cases – recovery is around 55-80 months on average.
Full Recovery, or close to, is seen in over 75% of the time.

In extremely severe cases the outcome or complications can be severe from weight loss, suicide, and even death.

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