Anorexia nervosa

Basic Information

What is Anorexia nervosa?

A psychological eating disorder in which a person refuses to eat adequately in spite of hunger and loses enough weight to become emaciated. The illness usually begins with a normal weight-loss diet. The person eats very little and refuses to stop dieting after a reasonable weight loss. The person's body perception is distorted; the person continues to feel fat-even when emaciated.

Anorexia nervosa signs and symptoms

  • Weight loss of at least 15% of body weight without physical illness.
  • High energy level despite body wasting.
  • Intense fear of obesity.
  • Depression.
  • Appetite loss.
  • Constipation.
  • Cold intolerance.
  • Refusal to maintain a minimum standard weight for age and height.
  • Distorted body image. The person continues to feel fat even when emaciated.
  • Cessation of menstrual periods.

Causes

Unknown. Possible causes include family and internal conflicts (sexual conflicts); phobia about putting on weight; changes in fashion in U.S. (slimness is identified with beauty); a symptom of depression or personality disorder.

Risk increases with

  • Peer or social pressure to be thin.
  • History of slight overweight.
  • Perfectionistic, compulsive or overachieving personality.
  • Psychological stress.
  • Being an athlete, ballet dancer, cheerleader or model.

Preventive measures

  • Confront personal problems realistically. Try to correct or cope with problems with the help of counselors, therapists, family and friends.
  • Develop a realistic attitude about weight.

Expected outcomes

  • Treatable if the patient recognizes the emotional disturbance, wants help and cooperates in treatment.
  • Without treatment, this can cause permanent disability or even death. Persons with anorexia nervosa have a high rate of attempted suicide due to low self-esteem.
  • Therapy may continue over several years. Relapses are common, especially when stressful situations occur.

Possible complications

  • Chronic anorexia nervosa caused by patient's resistance to treatment.
  • Electrolyte disturbances or irregular heartbeat. These may be life-threatening.
  • Osteoporosis.
  • Suicide.

Anorexia Nervosa Treatment

General measures

  • The goal of treatment is for the patient to establish healthy eating patterns to regain normal weight. The patient can accomplish this with behavior-modification training supervised by a qualified professional.

Medication for Anorexia nervosa

A variety of psychotherapy medications have some benefit, but there is no one medication that is consistently useful.

Prozac (Fluoxetine), Periactin (Cyproheptadine)

Activity

No restrictions, but avoid overexertion or compulsive exercise to lose weight.

Diet

  • A controlled refeeding program will be established.
  • Vitamin and mineral supplements may be prescribed.

Notify your physician if

  • Life-threatening symptoms occur, including rapid, irregular heartbeat, chest pain, or loss of consciousness. Call immediately. This is an emergency!
  • You have symptoms of anorexia nervosa or observe them in a family member.
  • Weight loss continues, despite treatment.

Last updated 14 June 2011


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