Anorexia Nervosa

Anorexia Nervosa A normal female takes a stroll down the streets of Manhattan and ends up at Times Square, probably one of the most colorful places on earth, which also has an abundant number of advertisements. As this female looks up at the pictures, she can see a Calvin Klein ad. The image portrays people who are the idols of our youth; young, thin, beautiful men and women. These young people depict the”ideal” body. As this female walks, she begins to notice her own physical attributes and wonders what it would take for her to look like that Calvin Klein model.

Despite the fact that the greatest majority of us could never attain these physiques, many, especially young women, deeply desire to have bodies like these. And many will go to great lengths to attain their goal. This often means stringent, unhealthy diets, laxative abuse, and even forcing themselves to vomit. Although the medias portrayal of the “perfect body” may not be the soul source of eating disorders, they play a big part. Anorexia nervosa is a disorder of self-starvation, which manifests itself in an extreme aversion to food and can cause psychological, endocrine, and gynecological problems. It almost exclusively affects adolescent white girls, with symptoms involving a refusal to eat, large weight loss, a bizarre preoccupation with food, hyperactivity, a distorted body image and cessation of menstruation.

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Although the symptoms can be corrected if the patient is treated in time, about 10-15 percent of anorexia nervosa patients die, usually after losing half their normal body weight. Anorexia nervosa patients typically come from white, middle to upper-middle class families that place heavy emphasis on high achievement, perfection, eating patterns and physical appearance. (There has never been a documented case of anorexia nervosa in a black male or female.) A newly diagnosed patient often is described by her parents as a “model child,” usually because she is obedient, compliant, and a good student. Although most teenagers experience some feelings of youthful rebellion, persons with anorexia usually do not outwardly exhibit these feelings, tending instead to be childish in their thinking, in their need for parental approval, and in their lack of independence. Psychologists theorize that the patients desire to control her own life manifests itself in the realm of eating-the only area in the patients mind where she has the ability to direct her own life (Mental Health, Long).

In striving for perfection and approval, a person with anorexia may begin to diet in order to lose just a few pounds. Dieting does not stop there. An abnormal concern with dieting is established. Nobody knows what triggers the disease, but suddenly, losing five to ten pounds is not enough. The anorectic patient becomes intent on losing weight.

It is not uncommon for someone who develops the disorder to starve herself until she weighs just 60 or 70 pounds. Throughout the starvation process, she either denies being hungry or claims to feel full after eating just a few bites. Another form of anorexia nervosa is an eating disorder known as “bulimia.” Patients with this illness indulge in “food binges,” and then purge themselves through vomiting immediately after eating or through the use of laxatives or diuretics. While on the surface these patients may appear to be well adjusted socially, this serious disease is particularly hard to overcome because it usually has been a pattern of behavior for a long time. Psychological symptoms such as social withdrawal, obsessive-compulsiveness and depression often precede or accompany anorexia nervosa. The patients distorted view of herself and the world around her are the cause of these psychological disturbances (Mental Health, Long). Distortion of body image is another prevalent symptom.

While most normal females can give an accurate estimate of their body weight, anorectic patients tend to perceive themselves as markedly larger than they really are. When questioned, most feel that their emaciated state (70-80 lbs.) is either “just right” or “too fat”(Mayohealth) Profound physical symptoms occur in cases of extreme starvation. These include loss of head hair, growth of fine body hair, constipation, intolerance of cold temperatures and low pulse rate. Certain endocrine functions also become impaired. In females this results in a cessation of menstruation (amenorrhea) and the absence of ovulation. Menstruation usually will not resume until endocrine balanced is restored. Ovulation is suppressed because production for certain necessary hormones decreases.

Anorexia in boys has effects similar to those in girls: severe weight loss, psychosocial problems and interruption of normal reproductive system processes. Treatment for anorexia nervosa is usually threefold, consisting of nutritional therapy, individual psychotherapy and family counseling. A team made up of pediatricians, psychiatrists, social workers and nurses often administers treatment. Some physicians hospitalize anorexia patients until they are nutritionally stable. Others prefer to work with patients in the family setting.

But no matter where therapy is started, the most urged concern of the physician is getting the patient to eat and gain weight. This is accomplished by gradually adding calories to the patients daily intake. If she is hospitalized, privileges are sometimes granted in return for weight gain. This is known as a behavior contract, and privileges may include such desirable activities as leaving the hospital for an afternoons outing. Physicians and hospital staff make every effort to ensure that the patient does not feel overwhelmed and powerless.

Instead, weight gain is encouraged in an atmosphere in which the patient feels in control of her situation, and in which she wants to gain weight. Individual psychotherapy is necessary in the treatment of anorexia to help the patient understand the disease process and its effects. Therapy focuses on the patients relationship with her family, friends, and the reasons she may have fallen into a pattern of self-starvation. As a patient begins to learn more about her condition, she is often more willing to try to help herself recover. In cases of severe depression, drugs such as antidepressants are part of therapy.

Behavior improvement generally occurs rapidly in the cases and the patient is able to respond more quickly to treatment. The third aspect of treatment, family therapy, is supportive in nature. It examines how the patient and her parents relate to each other. Persons with anorexia often become a source of family tension because refusals to eat cause frustration in the parents. The goal of family therapy is to help family members relate more effectively to one another, to encourage more mature thinking in the anorexic patient and to help all family members work together for the well being of the patient and the family unit.

In treating anorexia, it is extremely important to remember that immediate success does not guarantee a permanent cure. Sometimes, even after successful hospital treatment and return to a normal weight, patients suffer relapses. Follow-up therapy lasting three to five years …

Anorexia Nervosa

Anorexia Nervosa Anorexia is an eating disorder that usually strikes women between the ages of fifteen and thirty-five. An estimated one thousand females will die each year from anorexia. About eighty percent of females suffer from a sub clinical eating disorder and twenty percent will turn into full-blown anorexics in their lifetime. These are statistics that we know of. Anorexia can be hidden very well by many that suffer from it; therefore there are many cases we do not know of. Anorexia is a disorder in which preoccupation with dieting and thinness leads to excessive weight loss. The individual may not realize that weight loss or restricted eating is a problem.

(Internet Mental Health Anorexia may not be noticed in the early stages because it often starts as an innocent diet. They often become hyperactive because they exercise frantically in an attempt to burn calories to lose weight. Even though the anorexic is emaciated, she still feels “fat” and wants to hide her “ugly, fat body”. A victim does not need to appear underweight or even average to suffer any signs or symptoms of anorexia.

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Many men and women with eating disorders appear not to be underweight, but this does not mean they suffer any less or are in any less danger. This is why in later and more dangerous stages; family members may not notice the disease because the anorexic usually wears layered and baggy clothes. ( Presence of a low self-esteem is the most common element in anorexia nervosa. Stress, anxiety and unhappiness can also be leading factors in an anorexic life. Anorexia is their way of dealing and coping with the negative things going on in their life.

Most people with eating disorders share certain personality traits, low self-esteem, feelings of helplessness and a fear of becoming fat. People with Anorexia tend to be “too good to be true.” They rarely disobey, keep their feelings to themselves, and tend to be perfectionists, good students, and excellent athletes. Some researchers believe that people with anorexia restrict food, particularly carbohydrates, to gain a sense of control in some area of their lives. They have followed the wishes of others in their lives, and they have not learned how to cope with the problems typical of adolescence, growing up, and becoming independent. Controlling their own weight offers two advantages in their eyes; first they can take control of their bodies and secondly, gain approval of others.

Eventually they become out of control, becoming dangerously thin. (Microsoft Encarta 98 Encyclopedia). Victims suffering with Anorexia get a sense of power out of their eating disorder. It is not uncommon to find an anorexic that feels high after periods of starvation. This is due to their feelings of inadequacy. Their poor self image and perception leads to feelings of guilt, they feel like they never do anything right and nothing they ever do is enough.

Starvation is an accomplishment in their eyes, something they can do right. They also feel that their life would be better if they could lose weight, or that more people would like them if they lost weight. Anorexics feel a need to control physical and emotional surroundings. In this way eating disorders are a negative coping mechanism, used to control emotions or to keep them suppressed. It feels easier to think about food, food intake, hunger, planning meals or avoiding them, instead of dealing with their emotions.

Eating disorders can have a numbing effect, and can give victims a feeling of power over their emotions. (Mind & Body- Signs and symptoms- Something Fishy Website on Eating Disorders) Another major reason why women develop anorexia nervosa is societal pressures. In our society today there is an obsession with being thin in order to be beautiful. The waif look was recently popular causing many people to want to look like the models in magazines. Genetic factors can also play a role in anorexia.

Eating disorders appear to run in families. Female relatives are most often affected. Although genetic factors may play a role in the development of anorexia, other influences play a role such as behavioral and environmental. A recent study found that mothers who are overly concerned about their daughters weight and physical attractiveness might put the girls at increased risk of developing an eating disorder. Also girls with eating disorders often have a father and brothers who are overly critical of their weight.

(Eating Disorders-Decade of the Brain The most famous known case of Anorexia is probably that of Karen Carpenter, who died from heart failure resulting from Anorexia Nervosa. This disease can be defined as self-starvation leading to a loss of body weight fifteen percent below normal, accompanied with hyperactivity, hypothermia, and amenorrhea. Hypothermia results when the bodys natural insulation becomes non-existent and the victim becomes cold all the time. Amenorrhea is the absence of at least three menstrual cycles; this is also affected by the loss of fat stores in the body. ( Men who are affected by anorexia are usually into professions such as gymnastics, or modeling, acting and wrestling. Occupations or sports activities that have specific weight or body shape requirements are what cause the problems.

Although anorexia is labeled as a womens disease, more and more males are being diagnosed with it. Studies show that for every ten females with an eating disorder one male is affected. Males are under diagnosed because males are less likely to ask for help, especially with a “womens disease”. It is also believed that males with anorexia have a history of poor relationships with their parents. Also they have inhibited sexual expression and confused sexual identity.

Many men suffering from anorexia are short, and fat before they stop eating. (Male Anorexia- Many medical complications come along with Anorexia. Starvation can damage vital organs such as the heart and brain. To protect itself the body shifts into slow gear.

Monthly menstrual periods stop, breathing, pulse and blood pressure rates drop, and thyroid function slows. Frequent headaches are due to lowered blood pressure and decreased oxygen supply to brain. They are always cold because of the lack in circulation due to lowered blood pressure and slowed heart rate, and a slowed metabolism. A lack in potassium in the blood caused the low blood pressure. Their heart rate becomes slow or irregular and they develop electrolyte imbalances and vitamin deficiencies.

Nails and hair become brittle; the skin gets very dry and yellows, and often becomes covered with soft hair called lanugo. Excessive thirst and frequent urination may occur. Dehydration is because of constipation from not eating. (“Anorexia Nervosa” Mild anemia, swollen joints, reduced muscle mass, and headaches commonly occur in Anorexia.

Their bones are more prone to breakage due to the lack in calcium. In some patients the brain shrinks, causing personality changes. Luckily this condition can be reversed when normal weight is reestablished. Anorexia patients also suffer from other psychiatric illnesses. Some suffering from clinical depression, and others from anxiety, personality, or substance abuse disorders and many are at risk for suicide.

(“Anorexia Nervosa”- In an attempt to understand eating disorders, scientists have studied the biochemical on the neuroendocrine system. Through studying the neuroendocrine system they found it regulates appetite and digestion, sleep, physical growth and development, emotions, thinking, kidney function, and memory. These are all functions of the mind and body, which are usually seriously disturbed in people with eating disorders. Also the hormone vasopressin is a brain chemical found to be abnormal in people with eating disorders. Researchers have shown that levels of this hormone are elevated in patients with Anorexia, and other eating disorders.

Normally it is released in response to physical and possibly emotional stress, vasopressin may contribute to the obsessive behavior seen in some patients with eating disorders. Eating disorders are most successfully treated when diagnosed early. Unfortunately even when a family member confronts the sick person about their behavior, individuals with the disorder will most likely deny they have a problem. Therefore people with eating disorders may not receive help or treatment for Anorexia until they have already become dangerously thin and malnourished. Eating disorders in males may be more often overlooked because anorexia is rare in boys and men. Getting and keeping people with these disorders in treatment can be very difficult.

Treatment is very important, the longer these abnormal eating patterns go on the more difficult it is to overcome the disorder. Families need to offer support and encouragement to help with the success of the treatment. People suffering from Anorexia are suffering from an interaction of emotional and physiological problems. Treatment must involve a variety of different doctors and approaches. Usually a treatment team will include an, internist, a nutritionist, and individual psychotherapist, and a pschopharmacologist (someone who is very knowledgeable about medications useful in treating the disorder).

Patients need to undergo psychotherapy that will teach the patient how to change abnormal thoughts and behavior. Some antidepressant medications may be effective when combined with other forms of treatment. (“Anorexia Nervosa,” Microsoft Encarta 98 Encyclopedia.) Treatment can save the life of someone with Anorexia. Friends, relatives, teachers, and physicians all play a role in helping the ill person start to get back to normal eating patterns and a normal life. Bibliography 1.

The Harvard Medical School Mental Health Letter, May 1998. “Male Anorexia.” Internet Mental Health ( America Online. 2. “Eating Disorders-Decade of the Brain.” America Online. 3.

“Mind and Body- Signs and Symptoms- Something Fishy Website on Eating Disorders.” America Online. 4. “Anorexia Nervosa.” Wellness Web Homepage America Online. 5.

“Anorexia Nervosa,” Microsoft Encarta 98 Encyclopedia. 1993-1997 Microsoft Corporation.

Anorexia Nervosa

Eating disorders are a cause for serious concern from both a psychological and a
nutritional point of view. They are often a complex expression of underlying
problems with identity and self concept. These disorders often stem from
traumatic experiences and are influenced by society`s attitudes toward beauty
and worth (Eating Disorder Resource Center, 1997). Biological factors, family
issues, and psychological make-up may be what people who develop eating
disorders are responding to. Anyone can be affected by eating disorders,
regardless of their socioeconomic background (Eating Disorder Resource Center,
1997). Anorexia nervosa is one such disorder characterized by extreme weight
loss. It is the result of self imposed and severe restrictions of food and fluid
intake, a distorted body image, an intense fear of becoming fat, and a poor self
esteem. Besides dieting to extremes, anorexics often over exercise to lose
weight. Anorexics themselves are often the last to realize how undernourished
and underweight they are. Even after reaching a weight that is dangerously low,
they feel good initially, about losing the weight. No matter how much is lost,
anorexics continue to feel fat and desire to lose more weight. It is this denial
that makes it so hard to convince anorexics to seek help (Eating Disorder
Resource Center, 1997). This paper`s focus is to look in more detail at the
psychological and societal factors contributing to anorexia nervosa, as well as
the nutritional and physiological complications that arise for people on such
severely restrictive diets. Psychological and Societal Contributions Anorexia
Nervosa was first described by an English physician by the name of Richard
Morton in 1689. Until 1914, it was considered a disease that arose from a morbid
mental state and a disturbed nerve force. That year, Dr. Simmonds, a
pathologist, found one woman=s refusal to eat to be the direct result of an
anterior pituitary lesion. This shifted the focus away from the emotional
aspects of the disorder to more physiological and endocrinological terms. It was
not until 1938 that anorexia nervosa was once again considered a largely
emotional disorder (Blackman, 1996). In fact, one of the criteria for the
diagnosis of anorexia nervosa according to the manual of The American Medical
Association (DSM IV) is an intense fear of gaining weight or becoming fat, even
though underweight. Another clearly psychological requirement for diagnosis, is
a disturbance in the way in which one=s body weight or shape is experienced,
undue influence of body weight or shape on self evaluation, or denial of the
seriousness of the current low body weight (Blackman, 1996). Anorexia nervosa
may be a primary disorder in which other psychiatric conditions are secondary,
such as depression. It may also be secondary itself to a disorder such as
schizophrenia or co-morbid with obsessive compulsive disorder. As well, it can
also be a component of a personality disorder (Blackman, 1996; Carlat, 1997).

The anorexic sufferer is typically female. Ninety-percent of all cases occur
among adolescent girls or young women but the number of males with the disorder
is on the rise (Blackman, 1996; Carlat, 1997; Kinzl, 1997). It is estimated that
1% of girls ages 12-18 meet the criteria for full blown anorexia and as many as
5-10% have milder forms of such eating disorders if the criteria is applied less
stringently (Blackman, 1996). Anorexics are usually high achieving youngsters
who may be heavily involved in sports (e.g. gymnastics, swimming, cheer leading,
ballet, etc.). These people are often competitive, perfectionistic, with
obsessive compulsive personality features. Fears of growing up or discomfort
toward sexuality may also be precipitating factors (Blackman, 1996). Studies
have shown that 75% of American Women are dissatisfied with their appearance and
as many as 50% are on a diet at any one time. Even more alarming is that 90% of
high school junior and senior women regularly diet, even though only between
10%-15% are over the weight recommended by the standard height-weight charts
(Council on Size and Weight Discrimination, 1996). The majority of these women
do not develop eating disorders; however, 1% of teenage girls and 5% of
college-age women do become anorexic or bulimic (Council on Size and Weight
Discrimination, 1996). Perhaps these figures represent the women who are less
able to cope with their bodily dissatisfaction and thus are the ones who take
dieting to the extreme. The disordered eating behavior usually starts out with a
pattern of dieting or particular food choices, such as avoiding certain foods
which are seen as fattening. As the disorder progresses, anorexics become
resourceful in hiding their troublesome behavior and may start to avoid eating
with their families. They may also attempt further weight loss by compulsive
exercising. The condition can become well advanced before parents even notice,
as anorexics may wear many layers of clothes to conceal their thinness. Often
the diagnosis is not made until the person is brought to a clinic for problems
such as physical weakness, lack of energy, excessive sleepiness, and recent poor
performance in school (Blackman, 1996). Actually, certain familial relationships
seem to be more prevalent among anorexic sufferers. Studies have shown many
anorexic families are enmeshed, overprotective, conflict avoidant, and as
co-opting the anorexic in destructive alliances with one parent or another. The
parents themselves tend to be more affectionate and neglectful than parents of
non anorexic children. The father in particular is often controlling (Blackman,
1996). Physical and/or sexual abuse are also not uncommon features in families
with anorexics (Carlet, 1996; Kinzyl, 1997). Even though these trends are trends
often seen, there are many anorexic families that do not fit this profile. One
of the other major contributors to the disorder is society and its values.

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Anorexics are sensitive to society=s approval of what is an acceptable weight or
body size (Blackman, 1996). Self worth is equated with a desirable slim
appearance. This creates a vulnerability to eating disorders for people who are
especially concerned with meeting this ideal. Western culture in particular has
an obsession with looks. Slim, attractive people are linked to beauty, success,
and happiness. Our society teaches us to value such superficial standards and
bombards us with images of the idealized female body through mediums such as
magazines, films, and television (Blackman, 1996). One only has to watch
television or read the latest magazines and take note of just how few overweight
or average looking people there are appearing in advertisements to verify this
fact. Anorexia nervosa in fact predominates in industrialized developed
countries; yet is extremely rare in less industrialized and non western
countries (Blackman, 1996). As well, immigrants who have migrated to a
westernized country have been found to become more prone to develop eating
disorders (Blackman, 1996). For the sufferer of anorexia, the onset of the
disease often begins with a chance remark by someone important to them, possibly
a coach or a friend. They may suggest that they are getting fat, big, clumsy, or
that their performance (if they are athletes) is suffering (Blackman, 1996).

These remarks, as unintentional or innocent as they may seem to the person
making them, only serve to reinforce society=s attitude that gaining weight is
unacceptable. For others, it may will be the media itself that precipitates the
development of the disorder. Some patients cite wanting to look like a favorite
film star or model as their initial motivation to lose weight (Blackman, 1996).

Males With Eating Disorders Typically, dieting and eating disorders such as
anorexia nervosa are associated with females at or near adolescence. A group
that often gets overlooked in the studies are males. Eating disorders are not
rare among males; 10-15% of all bulimic patients are male, while 0.2% of all
adolescent and young males meet the stringent criteria for bulimia. These
figures are similar for anorexia nervosa (Carlat, 1997). Males are now being
studied more frequently to determine whether or not they differ significantly
from females with respect to eating disorders. If males are found to not differ
significantly from females in this respect, then those who support a more
biologically based view of the disease, gain support. Things such as
schizophrenia or depression for instance could then be seen as major determining
factors. If however, it is found that certain cultural and psychological risk
factors are the same for both males and females, then the sociocultural view of
eating disorder etiology gains support (Carlet, 1997). Males in fact do share
some similar central features as females who suffer from anorexia; but they also
have their own unique issues with regard to social pressures and vulnerabilities
(Carlet, 1997). Unlike females who typically Afeel emailprotected, males are often obese
to begin with. Males are more likely to diet to attain goals in a particular
sport like wrestling or swimming. Males also diet to prevent themselves from
developing medical complications witnessed in other family members such as
cardiovascular disease and diabetes (Blackman, 1996). In several cases involving
males, their profession was found to be clearly related to the onset of the
eating disorder (Carlat, 1997). One patient studied by Carlat et al. reported
taking appetite suppressing pills in an effort to keep slim for acting roles and
within several months he began a pattern of binge eating and self-induced
vomiting. In the same study, which involved 135 males with eating disorders, 22%
had anorexia nervosa, 73% were single and 131 were Caucasian. The average age of
onset was 19.3 years. The average education level was 1.6 years of college at
the time of their first treatment (Carlat, 1997). This does not necessarily mean
that this group is more susceptible to developing eating disorders as these
results could have been influenced by how the sample was taken. With regard to
the core concerns about body image and weight, it appears that males with
anorexia may be more similar to their female counterparts than to male bulimic
patients (Carlat, 1997). Like females, Carlat et al. found that male anorexics
clearly feared weight gain and desired a body weight of only 75% of their ideal
body weight (Carlat, 1997). Perhaps the biggest finding with males is the high
prevalence of homosexuality/bisexuality in those with eating disorders as
compared to the general population. Recent data estimates 1%-6% of healthy males
are homosexual and that only 2% of females with eating disorders are homosexual
(Carlat, 1997). Homosexuality was found to have a 27% prevalence among male
patients with eating disorders however. Anorexic males in particular were also
found more likely to be asexual (defined as having a lack of interest in sex for
a year prior to assessment). This is also a common finding in females (Carlat,
1997; Murnen, 1997). With anorexia, it is thought to be to due to the
testosterone lowering effect of protein-calorie malnutrition, combined with
active repression of sexual desire (Carlat, 1997). The high rate of
homosexuality and bisexuality among males with eating disorders can serve as
evidence for both psychosocial and biological views of the etiology of eating
disorders. Psychosocially, homosexuality can be seen as a risk factor that puts
males in a subculture system that places the same importance on looks and
appearance in men as the larger culture places on women (Carlat, 1997). It is
these similar cultural pressures toward thinness that cause eating disorders (Carlat,
1997). From a biological point of view, it can be argued that brain structure
between homosexual men and heterosexual women are similar (Carlat, 1997),
particularly a tiny precise cell cluster known as the third interstitial nucleus
of the anterior hypothalamus or INAH3. This cluster of cells in gay men was
found to be about half the size of the cluster in straight men which puts them
in the same size range as heterosexual women. This particular part of the
hypothalamus has been strongly implicated in regulating male-typical sexual
behavior (Nimmons, 1994). It may be argued then that homosexual men react to
environmental stressors in a biologically feminine way, increasing their risk of
eating disorders (Carlat, 1997). Males, like the females studied by Carlat et
al. , were shown to have high rates of co-morbid major depression, substance
abuse, anxiety disorders, and personality disorders. One year after initially
being treated, 59% still suffered from their eating disorder. (Carlat, 1997).

This is a cause for concern as there are so many concurrent complications that
can arise from eating disorders, especially anorexia nervosa. Adverse Effects of
Anorexia Nervosa Anorexic patients are often found to suffer from osteoporosis,
anemia, and hypotension (Carlat, 1997). Chronic starvation due to anorexia has
also been linked to seizure activity and fainting attacks (Blackman, 1996). The
anorexic often looks pale, tired, wasted, bradycardia (slow heart rate) may be
present, and the skin is cold to the touch. Another common feature is the
presence of fine downy hair on arms and torso. Laboratory results often reveal
quite abnormal values. These values are often caused by dehydration and severe
electrolyte imbalances which can be life threatening. Amenorrhea, or absence of
menstruation occurs in post menarchal girls who lose more than 20% of their
expected body weight (Blackman, 1996; Rock, 1996). Amenorrhea, in fact is
another one of the diagnostic criteria for anorexia nervosa (for females)
according to the DSM IV (Blackman, 1996). The absence of menarche is related to
the bodies reaction to extreme fat loss and the non viability of pregnancy under
these conditions (Blackman, 1996). Starvation itself as been shown to induce
many hormonal changes in the body as well as inducing mental states such as
anxiety, depression, and even psychosis (Kershenbaum, 1997). These are just a
few of the consequences associated with anorexia nervosa. There are many others
ranging from things as obscure as bilateral foot drop, which was observed in one
15 year old girl (Kershenbaum, 1997), to something as serious as sudden death
and even suicide (Neumrken, 1997). Sudden death is defined as the sudden,
unexpected, and unexplainable occurrence of death. Some of those who died
suddenly, did show abnormalities in ECG recordings days prior to death. As well,
upon autopsy, changes in brain structure and cardia muscles (such as atrophy)
were sometimes found (Neumrken, 1997). One would question with all of the
adverse consequences, why anorexics still diet. Anorexia produces a *runners
high= as does exercise. This is a result of opiate release in the brain which in
turn suppresses appetite and promotes increased levels of activity. Once
anorexic behavior begins and becomes established, it promotes this endorphin
secretion and becomes pleasurable and self reinforcing. The sufferer then is
bound to self starve and the established cycle is no longer deliberate or easily
stopped (Blackman,1996). Treatment Treatment comes in the form of psychotherapy,
nutritional education, and refeeding. Nutritional education takes time however
as the farther a person is below their healthy weight, the more their cognitive
ability is impaired (Merriman, 1996). The first of the higher mental functions
to be lost is the capacity for abstract thinking. As the condition progresses,
the anorexic may not even be able to assimilate information (Merriman, 1996).

The nutritionist then must carefully plan nutrition education sessions to make
them as meaningful to the person as is possible. Refeeding is also not a
straightforward process as anorexics often find it quite difficult to gain
weight. This is due to an increased diet induced thermogenesis and a lower
metabolic efficiency. Anorexic patients can waste about 50% of the energy of
their food due to this inefficient metabolism at the start of refeeding, making
the maintenance of any gain in weight difficult (Moukadden, 1997). Another study
concluded that even with weight gain after 3 months to a year, it was not enough
to maintain a desirable nutritional status. This was because patients did not
reach an adequate body mass index and their immunological indexes were lower
than in control subjects during an entire one year follow-up (Marcos, 1997).

Conclusions From the information presented, one can only imagine just how
complex the issues really are that the anorexic attempts to deal with via
dieting. The anorexic may be dealing with substance abuse, depression, sexual
abuse, confusion about their sexual orientation, or bodily dissatisfaction to
name a few. The individual anorexic may be suffering from a combination of such
issues in varying degrees. To what extent, psychological, societal, and
biological factors affect the onset of the disorder is, as of yet, too complex
to determine. It appears to vary from individual to individual, although there
are some features seen more commonly than others. The variability seen with the
disorder on an individual basis is why the anorexic sufferer can not be
categorized into a particular stereotypical group. It is not just the white
adolescent girl who is affected. The disorder affects various other groups as
well and is being seen more frequently in groups it did not typically affect. It
has been mentioned how the disorder is becoming more prevalent among immigrants
who move to westernized cultures; yet, the disorder is rarely ever seen in less
developed countries. Males also are being seen more frequently to be sufferers
of this traditionally female disorder. This data seems not to point to a
particular group as being more prone to developing anorexia, but instead points
to society=s unrealistic and unachievable ideals, as encouraging more sensitive,
insecure, or emotionally disturbed individual members of society to lose weight.

Weight loss often provides these people with short lived confidence, and for a
while they feel good about their weight loss and in control of something in
their life. They inevitably desire to feel like this again so they set out to
lose more weight. This cycle continues until someone steps in and helps the
sufferer by convincing them to seek help. This can be hard as the anorexic is
usually so far in denial that they are the last to realize just what shape they
are in. The road to recovery is difficult and the body seems to resist any
weight gain during the initial refeeding period. Even after an entire year of
treatment, evidence suggests that recovery has not been achieved and many
anorexics still continue to suffer from their disorder. There are so many
complications that anorexia can be attributed to that it would appear that the
quicker a person complies with treatment and can be recovered, the better. It is
quite obvious that anorexia is a complex disorder that partly involves how one
perceives his or her self and what physical standard society dictates they
should live up to. The topic has many areas that require further research as
society has been shown not to be the entire causative factor for the development
of the disorder. It has been shown to be one of them however; so until society
becomes more realistic in the ideals it endorses, it is responsible, at least in
part, for the prevalence of this disorder.

Blackman, M. A Anorexia Nervosa: Diagnosis and Management, @ Medical Scope
Monthly, July/August, 1996 (or see

Carlat, D. J. ; Camargo Jr. , C. A. ; and Herzog, D. B. AEating Disorders in
Males: A Report on 135 Patients, A American Journal of Psychiatry, 154, August
1997, 1127-1132. Council on Size and Weight Discrimination. Facts and Figures.

New York: Council on Size and Weight Discrimination, Inc. , 1996. Eating
Disorder Resource Centre of British Columbia. Do I Have an Eating Disorder? .

Vancouver: Working Design, 1997. Kershenbaum, A. ; Jaffa, T. ; Zeman, A. ; and
Boniface, S. A Bilateral Foot Drop in a Patient With Anorexia Nervosa, A
International Journal of Eating Disorders, 22, November 1997, 335-337. Kinzl, J.

F. ; Mangwelth, B. ; Traweger, C. M. ; and Biebl, W. A Eating-Disordered
Behavior in Males: The Impact of Adverse Childhood Experiences, A International
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P. ; Toro, O. ; Lpez-Vidriero, I. ; Nova, E. ; Madruga, J. C. ; and Morand,
G. AInteractions between nutrition and immunity in anorexia nervosa: a 1-y
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485-490. Merriman, S. H. A Nutrition education in the treatment of eating
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6, October 1996, 377-380. Moukadden, M. ; Bouler, A. ; Apfelbaum, M. ; and
Rigaud, D. A Increase in diet-induced thermogenesis at the start of refeeding in
severely malnourished anorexia nervosa patients, A American Journal of Clinical
Nutrition, 66, July 1997, 133-140. Murnen, S. K. ; and Smolak, L. A Feminity,
Masculinity, and Disordered Eating: A Meta-Analytic Review, A International
Journal of Eating Disorders, 22, November 1997, 231-242. Neumrker, K. A
Mortality and Sudden Death in Anorexia Nervosa, A International Journal of
Eating Disorders, 21, April 1997, 205-212. Nimmons, D. A Sex and the Brain, A
Discover, March 1994, 64-68, 70-71. Rock, C. L. ; Gorenflo, D. W. ; Drewnowski,
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October 1996, 566-571
Health Care

Anorexia nervosa

Anorexia nervosa
Overview | Treatment | Images
An eating disorder associated with a distorted body image that may be caused by a mental disorder. Inadequate calorie intake results in severe weight loss (see also bulimia and intentional weight loss).
Alternative names
Eating disorder – anorexia nervosa
Causes, incidences, and risk factors
The exact cause of this disorder is not known, but social attitudes towards body appearance and family factors play a role in its development. The condition affects females more frequently, usually in adolescence or young adulthood. Gorging followed by vomiting (spontaneous or self-induced) and inappropriate use of laxatives or diuretics are behaviors that may accompany this disorder. Risk factors are being Caucasian, having an upper or middle economic background, being female, and having a goal-oriented family or personality. The incidence is 4 out of 100,000 people.
In some cases, prevention may not be possible. Encouraging healthy, realistic attitudes toward weight and diet may be helpful. Sometimes, counselling can help.
weight loss of 25% or greater cold intolerance constipation menstruation, absent skeletal muscle atrophy loss of fatty tissue low blood pressure dental cavities increased susceptibility to infection blotchy or yellow skin dry hair, hair loss depression (may be present
Anorexia Nervosa
Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.
Anorexia Nervosa has five primary symptoms:
Refusal to maintain body weight at or above a minimally normal weight for height, body type, age, and activity level.

Intense fear of weight gain or being “fat.”
Feeling “fat” or overweight despite dramatic weight loss.

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Loss of menstrual periods in girls and women post-puberty.

Extreme concern with body weight and shape.
The chances for recovery increase the earlier anorexia nervosa is detected. Therefore, it is important to be aware of some of the warning signs of anorexia nervosa.
Warning Signs of Anorexia Nervosa:
Dramatic weight loss.

Preoccupation with weight, food, calories, fat grams, and dieting .

Refusal to eat certain foods, progressing to restrictions against whole categories of food (i.e., no carbohydrates, etc.).

Frequent comments about feeling “fat” or overweight despite weight loss.

Anxiety about gaining weight or being “fat.”
Denial of hunger.

Development of food rituals (i.e., eating foods in certain orders, excessive chewing, rearranging food on a plate).

Consistent excuses to avoid mealtimes or situations involving food.

Excessive, rigid exercise regimen–despite weather, fatigue, illness, or injury, the need to “burn off” calories taken in.

Withdrawal from usual friends and activities.

In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.
Health Consequences of Anorexia Nervosa:
Anorexia nervosa involves self-starvation. The body is denied the essential nutrients it needs to function normally, so it is forced to slow down all of its processes to conserve energy. This “slowing down” can have serious medical consequences:
Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower.

Reduction of bone density (osteoporosis), which results in dry, brittle bones.

Muscle loss and weakness.

Severe dehydration, which can result in kidney failure.

Fainting, fatigue, and overall weakness.

Dry hair and skin, hair loss is common.

Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.
About Anorexia Nervosa:
Approximately 90-95% of anorexia nervosa sufferers are girls and women (Gidwani, 1997).

Between 1-2% of American women suffer from anorexia nervosa (Zerbe, 1995).

Anorexia nervosa is one of the most common psychiatric diagnoses in young women (Hsu, 1996).

Between 5-20% of individuals struggling with anorexia nervosa will die. The probabilities of death increases within that range depending on the length of the condition (Zerbe, 1995).

Anorexia nervosa has one of the highest death rates of any mental health condition.
Anorexia nervosa typically appears in early to mid-adolescence.

Gidwani, G.P. and Rome, E.S. (1997). Eating Disorders. Clinical Obstetrics and Gynecology, 40(3), 601-615.

Hsu, G.L.K. (1996). Epidemiology of the Eating Disorders. Psychiatric Clinics of North America, 19(4), 681-697.

Zerbe, K.J. (1995). The Body Betrayed. Carlsbad, CA: Grze Books.

Anorexia Nervosa

Anorexia Nervosa Anorexia Nervosa is a very serious disease that is plaguing many young people in our society. This is something that is becoming more and more prevalent. It is something that should not be taken lightly. I have chosen to do my Science report on this topic, because it is something intriguing and it is found in many teens. This is a topic that is too foreign to many people and they need to be educated on the subject.

I hope to help that in anyway I can. In the following paragraphs I will discuss the warning signs of anorexia, the people affected by the disease, the disease itself, and certain types of treatments for the disorder. Firstly, I would like to discuss the warning signs of an eating disorder. The physical symptoms are much easier to identify, so I will start with them. The first and most obvious sign is extreme weight loss, which you can easily identify.

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To try and conceal this the anorexic will start to wear baggy clothing in an attempt to conceal the weight loss. An anorexic will also make every attempt to avoid a situation where food or meals are served. Times like this will be very uncomfortable to them, because it leaves them vulnerable to questions about their eating habits. This is something they want to avoid at all costs. Another part of avoiding meals is to prepare big meals for groups of people and eat very little.

The anorexic will give excuses like, “I’m to tired to eat,” or, “No, that’s okay you should just eat. I prepared it for you.” This let’s them off the hook in their own mind. They make it look as they are too tired after all the hard work they have put in and usually nobody draws attention to it. An anorexic may also start to lose hair on their head or begin to grow finer hair on the body. This is one sign that you will want to look for if you have the opportunity.

It will be a very accurate sign of an eating disorder. Also, a person with an eating disorder will show different types of emotional and mental symptoms. A few of the more obvious symptoms are depression, being grouchy, temperamental, and withdrawal. These are the most common signs of a person with anorexia. However, you must be very careful when assuming that a person has an eating disorder.

It should not be confused with mood swings caused by trouble with friends or at home. These symptoms are usually with the person most of the time, not just periodically. They are usually accompanied by some of the physical signs. There are a few other signs that an anorexic person may have but are hard to identify with such as fear of gaining weight and perfectionist tendencies. These are harder to identify because they can be confused with other feelings or easily concealed. You should not confuse goal setting and high aspirations with perfectionist tendencies and if the person exercises daily it does not mean they are afraid of weight gain. By using common sense you can easily identify if a person has signs that are serious.

That is the time you need to take action. In closing, there are many ways to identify an eating disorder, but you must do it with carefulness and thinking. Next, I will talk about the people that are most commonly affected by anorexia and who is most likely to get it. So far, I have talked about the different warning signs that you will find in anorexia. Now I will talk about what type of people to look for it in and it will give you a better idea of a person that could have it.

The first thing I would like to make clear, is that any person can have an eating disorder. Statistics show different groups with anorexia, but the truth is that anyone can develop anorexia. After surveys, doctors have found that the age group where you will most commonly find anorexic people is between the ages of 13 to 21. Doctor’s believe that these people are more at risk because of being exposed to people that are very judgmental and analyze them. This makes the person feel that they have to stay a certain way for the people around them. In other words, these people are afraid of being rejected by their peers for being too fat.

The age groups can vary from as young as six years of age to as old as seventy-six years old. This is very uncommon, but it will happen on occasion. Anorexia will be found in younger people most of the time. The sex of the person also plays a great role in what type of person will develop anorexia. Anorexia is found in women more than men. There is one theory behind this. Doctors and psychologists believe that the media has a lot to do with the fact that women get anorexia more often.

Magazines show people pictures of women that are practically skeletons and then people start to believe that this the way to look. People do not realize that this is physically impossible without teetering on the edge of death. Women see this in their magazines so it affects them more. Some men are affected when they strive to have thin muscular bodies, because it can lead to the disease called Anorexia athletica. It is compulsive exercising and is most commonly found in males.

It is still very serious, because the person can become so caught up in physical fitness that they lose control of their lives and everything else. Anorexia athletica is the pursuit for the perfect body and like anorexia nervosa, it can be deadly. The background of an anorexic person can vary from situation to situation. Many times they develop the disease because of problems with their family or social life. It is usually the people around them that “force” them to become anorexic. They will insult them or pick on them to the point where they feel the need to be perfect. People from dysfunctional families also develop eating disorders more frequently.

In closing, any person of any background of any age can develop an eating disorder. There is not set characteristic of an anorexic person, but you should always keep your eye on a person that you suspect may have the disease. Thirdly, I would like to talk more about the disease itself and the future things it can lead to. Causes of anorexia are usually star …


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