Anorexia

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Anorexia
Anorexia Signs

Anorexia nervosa is an eating disorder and one of psychiatric diseases, sometimes compared to alcoholism or even drug addiction. Anorexia presents itself with an inadequate loss of weight, constant attempts to lose weight and refusal to eat. Anorexia usually starts in adolescents, however, it can also start in adults and children. The incidence of anorexia in women is nine times higher than in men. Anorexia in men is usually more common in childhood.

Causes

The exact causes of anorexia nervosa are unknown, however, it is believed that several factors play a role in developing this disease:

  • Social-cultural factors seem to have the greatest impact: mass media, peer pressure and slim body cultivation strongly affect the psychology of the patients.
  • Personal characteristics, such as perfectionism, low self-esteem and ignorance of other problems.
  • Family problems, such as no boundaries, lack of independency and failure to accept puberty.
  • Some scientists believe that impaired noradrenalin and serotonin metabolism might play a role in developing anorexia nervosa.
  • Sexual abuse is another possible cause.
  • It is believed that anorexia is not a hereditary disease. Still, some character traits might be passed from parents.
  • Psychoanalytically anorexia nervosa is described as a regress to a lower level of maturity – the ignorance of sexual maturity.

Signs and Symptoms

Anorexia usually starts with a strict diet: firstly, fatty foods are refused, the portions become small, later the meals become rare. The patients usually eat slowly so that surrounding people would not notice the small portions. In some cases the food is being hidden. Frequently the patients cook food themselves, after that pretending to have eaten while cooking. The appetite is lost, the weight is continuously decreasing; however, the patients mistakenly believe they are overweight. Essential signs of anorexia:

  • Decreasing body weight; BMI (Body Mass Index) becomes less than or equal to 17,5.
  • A strong fear to gain weight. In some cases body shape perception is impaired.
  • Menstruations disappear in females. Delayed maturity is an important sign in boys.
  • The patients use various measures helping to lose weight: laxatives, diuretics, vomiting, exercising many times a day and even amphetamines.
  • Gradually other interests are lost, the patients become closed emotionally. Also, they become obsessive about food and weight. Finally, other mental diseases, like depression, anxiety and personality disorders contribute.
  • The patients tend not to accept anorexia; they usually hide their disease. 

Complications

  • Loss of fat and muscle tissue. Extreme fatigue.
  • Atrophy of cardiac muscles, dysrhythmia.
  • Amenorrhea, atrophy of the uterus.
  • Skin infections and skin swelling.
  • Atrophy of the stomach, constipations, reflux and pancreatic dysfunction.
  • Anemia, leucopenia and impaired immunity, as well as avitaminosis and hypoproteinemia.
  • Thinning of the bones, erosions of the teeth.
  • Hypocalcaemia, which causes seizures and nerve damage.
  • Infertility.

Treatment

Anorexia is treated by preserving vital bodily functions (maintaining the balance of water and electrolytes, restoring the lost nutrients). The treatment is then continued in a psychiatric institution. The duration of the treatment is from a few weeks to several months.

Dietary treatment: the patients have to eat at least 6 times a day. At the beginning of the treatment they have to consume 1000 calories per day, after that the calorie intake is increased. It is very important to observe the patients during and after the meals. The patients are weighed 1-2 times a week. The aim of the treatment is to achieve optimal weight.

Psychotherapy is also used. In this case, psychoanalytical therapy is most effective. The complications of anorexia are treated simultaneously, so are depression and anxiety.

Prognosis

Anorexia is a very dangerous disease. The mortality rate is around 10%. In 20% of the cases, the disease might become chronic. 40% of the patients might fully recover from anorexia. The prognosis is bad if the treatment is ineffective or if the disease has been left untreated for more than a year, or if it is followed by other psychiatric diseases. In some cases anorexia might lead to bulimia nervosa.

   

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