Anorexia is a general loss of appetite or no interest in food.  Many times Anorexia Nervosa is simply referred to as anorexia, but Anorexia Nervosa is defined as a psychological disorder.  The patient has a distorted body image and an irrational fear of becoming overweight – so he/she deliberately attempts to lose weight.  It is a somber eating disorder.  Even though the majority of patients are female, men can also suffer from the disorder.  According to DSM-IV-TR® Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, a person with Anorexia Nervosa:

• weighs much less than he/she should – 15% or more below their ideal weight

• normally has a BMI of 17.5 or less

• has missed three consecutive menstrual periods

• has a preoccupation with body shape and weight

• has a severe fear of putting on weight

          76% of reported Anorexia Nervosa onsets start between the ages 11-20.  About 6% of patients diagnosed with Anorexia Nervosa die – approximately half of the deaths are a result of suicide.  It has the highest mortality rate for any mental illness.  A person who suffers from this disease is often a perfectionist who sets herself/himself targets beyond his/her reach.  When they are not achieved the patient begins to control parts of his/her life that he feels he/she can, such as food intake and weight.  An exaggerated fear of losing control is mainly driven by low self-esteem and constant self-criticism.  It is not uncommon for patients to feel loss of control after consuming a tiny amount of food.  Bulimia Nervosa is another eating disorder, but it is different in that patients experience regular bouts of serious overeating, which are always followed by a feeling of guilt, which can then lead to extreme reactions such as crash dieting, doing lots of exercise and purging (deliberately vomiting).

          At this time, no definite cause of anorexia nervosa has been determined.  However, research within the medical and psychological fields continues to explore possible causes.  Studies suggest that a genetic (inherited) component may play a more significant role in determining a person’s susceptibility to anorexia than was previously thought.  Researchers are currently attempting to identify the particular gene or genes that might affect a person’s tendency to develop this disorder, and preliminary studies suggest that a gene located at chromosome 1p seems to be involved in determining a person’s susceptibility to anorexia nervosa.  Other evidence had pinpointed a dysfunction in the part of the brain, the hypothalamus (which regulates certain metabolic processes), as contributing to the development of anorexia.  And yet other studies have suggested that imbalances in neurotransmitter (brain chemicals involves in signaling and regulatory processes) levels in the brain may occur in people suffering from anorexia.

          Feeding problems as an infant, a general history of under eating and maternal depressive symptoms tend to be risk factors for developing anorexia.  Other personal characteristics that can predispose an individual to the development of anorexia include a high level of negative feelings and perfectionism.  For many individuals with anorexia, the destructive cycle begins with the pressure to be thin and attractive.  A poor self-image compounds the problem.  People who suffer from any eating disorder are more likely to have been the victim of childhood abuse.  While some professionals remain of the opinion that family discord and high demands from parents can put a person at risk for developing this disorder, the increasing evidence against the idea that families cause anorexia has mounted such that professional mental-health organizations no longer ascribe to that theory.

          The extreme dieting and weight loss with Anorexia Nervosa can lead to a potentially fatal degree of malnutrition.  Other possible consequences of anorexia include heart-rhythm disturbances, digestive abnormalities, bone density loss, anemia, hormonal and electrolyte imbalances.  This disease can also affect pregnancy.  In order to have a healthy child, the average pregnant woman should gain between 25 and 35 pounds.  Telling this to a person with anorexia is like telling a normal person to gain 100 pounds.  If you are anorexic, you may have trouble conceiving a baby and carrying it to term.  Irregular menstrual cycles and weak bones make it more difficult to conceive.  If you are underweight and do not eat the proper variety of foods, you and your baby could be in danger.  Women with eating disorders have higher rates of miscarriages and your baby might be born prematurely which puts them at risk for many medical problems.

          Anorexia Nervosa is truly a somber eating disorder.  It may be treated in an outpatient setting or hospitalization may be necessary.  For an individual with severe weight loss that has impaired organ function, hospital treatment must initially focus on correction of malnutrition, and intravenous feeding or tube feeding that goes past the mouth may be required.  The overall treatment of anorexia, however, must focus on more than weight gain.  There are a variety of treatment approaches dependent upon the resources available to the individual.  Different kinds of psychological therapy have been employed to treat people with anorexia.  Individual therapy, cognitive behavior therapy, group therapy and family therapy have all been successful in the treatment of anorexia.  Any appropriate treatment approach addresses underlying issues of control, perfectionism and self-perception.  Family dynamics are explored.  Nutritional education provides a healthy alternative to weight management for the patient.  The ultimate goal of treatment should be for the individual to accept herself/himself and lead a physically and emotionally healthy life.



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