Anorexia nervosa facts
What is anorexia nervosa?
Anorexia nervosa, commonly referred to simply as anorexia, is one type of eating disorder. It is also a psychological disorder. Anorexia is a condition that goes beyond concern about obesity or out-of-control dieting. A person with anorexia often initially begins dieting to lose weight. Over time, the weight loss becomes a sign of mastery and control. The drive to become thinner is actually secondary to concerns about control and/or fears relating to one's body. The individual continues the ongoing cycle of restrictive eating, often accompanied by other behaviors such as excessive exercising or the overuse of diet pills to induce loss of appetite, and/or diuretics, laxatives, or enemas in order to reduce body weight, often to a point close to starvation in order to feel a sense of control over his or her body. This cycle becomes an obsession and, in this way, is similar to an addiction.
Who is at risk for anorexia nervosa?
A majority of those affected by anorexia are female, most often teenage girls, but males can develop the disorder as well. While anorexia typically begins to manifest itself during early adolescence, it is also seen in young children and adults. Although the disorder has received a lot of media attention, it is an uncommon condition. Caucasians are more often affected than people of other racial backgrounds, and anorexia is more common in middle and upper socioeconomic groups.
Many experts consider people for whom thinness is especially desirable, or a professional requirement (such as athletes in sports like gymnastics, wrestling and jockeying, as well as models, dancers, and actors), to be at risk for eating disorders such as anorexia nervosa. Health-care professionals are usually encouraged to present the facts about the dangers of anorexia through education of their patients and of the general public as a means of preventing this and other eating disorders.
What causes anorexia nervosa?
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 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 called the hypothalamus (which regulates certain metabolic processes), as contributing to the development of anorexia. Other studies have suggested that imbalances in neurotransmitter (brain chemicals involved 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 than others 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 to such an extent that professional mental-health organizations no longer ascribe to that theory. Possible factors that protect against the development of anorexia include high maternal body mass index (BMI) as well as high self-esteem.
How is anorexia nervosa diagnosed?
Anorexia nervosa can be a difficult disorder to diagnose, since individuals with anorexia often attempt to hide the disorder. Denial and secrecy frequently accompany other symptoms. It is unusual for a person with anorexia to seek professional help because the individual typically does not accept that she or he has a problem (denial). In many cases, the actual diagnosis is not made until medical complications have developed. The individual is often brought to the attention of a professional by family members only after marked weight loss has occurred. When anorexics finally come to the attention of a health-care professional, they often lack insight into their problem despite being severely malnourished and may be unreliable in terms of providing accurate information. Therefore, it is often necessary to obtain information from parents, a spouse, or other family members in order to evaluate the degree of weight loss and extent of the disorder. Health professionals will sometimes administer symptom questionnaires as part of screening for the disorder.
Warning signs of developing anorexia or one of the other eating disorders include excessive interest in dieting or thinness. One example of such interest includes a movement called "thinspiration," which promotes extreme thinness as a lifestyle choice rather than as a symptom of illness. There are a variety of web sites that attempt to inspire others toward extreme thinness by featuring information on achieving that goal, photos of famous, extremely thin celebrities, and testimonials, as well as before and after pictures of individuals who ascribe to extreme thinness.
The actual criteria for anorexia nervosa are found in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V).
There are three basic criteria for the diagnosis of anorexia nervosa that are characteristic:
The DSM-V further identifies two subtypes of anorexia nervosa. In the binge-eating/purging type, the individual regularly engaged in binge eating or purging behavior in at least the past three months, which involves self-induced vomiting or the misuse of laxatives, diuretics, or enemas during the current episode of anorexia. In the restricting type, the individual has severely restricted food intake and/or excessively exercised for at least the past three months but does not regularly engage in the behaviors seen in the binge-eating type.
In order to diagnose anorexia, the health-care professional distinguishes this illness from being a symptom of an underlying medical disorder or of another eating disorder. As a symptom of a medical disorder, the term anorexia (in general, rather than anorexia nervosa, the condition discussed in this article) describes the considerable weight loss that may be the result of serious illness that may afflict terminally ill patients who are receiving hospice care.
Unlike the binge-eating/purging type of anorexia nervosa, bulimia nervosa does not result in weight reduction below the minimal normal weight. Bulimia nervosa is characterized by episodes of eating significantly excessive amounts of food that the individual feels they cannot stop themselves from engaging in (binges), alternating with episodes of attempts to counteract the binges using inappropriate behaviors (purging) like self-induced vomiting, misuse of medications, fasting, and/or excessive exercising. Most individuals with an eating disorder do not fit neatly into either the diagnosis of anorexia or bulimia and are therefore classified as either suffering from "other specified feeding or eating disorder" or "unspecified feeding or eating disorder." Examples of other specified feeding or eating disorders include people with binge-eating disorder who experience episodes of binge eating but do not regularly engage in purging or restricting behaviors; individuals with recurrent purging behaviors without binge eating and recurrent episodes of night eating that is not better explained by binge eating disorder or another mental-health disorder. Those eating disorders that do not meet diagnostic criteria for any specific eating disorder are classified as an "unspecified feeding or eating disorder."
What are anorexia symptoms and signs (psychological and behavioral)?
Anorexia can have dangerous psychological and behavioral effects on all aspects of an individual's life and can affect other family members as well.
In addition to the mental effects of anorexia, physical effects of this disorder in children and teens include a number of issues that are associated with growth and development inherent in this age group. Examples of symptoms and signs of anorexia in childhood and adolescence can include a slowing of the natural increase in height or a slowed development of other body functions like menses.
All of these features can negatively affect one's daily activities. Diminished interest in previously preferred activities can result or worsen. Some individuals also have symptoms that meet the diagnostic criteria for a major depressive disorder.
What are anorexia symptoms, signs, and complications (physical)?
Most of the medical complications of anorexia nervosa result from starvation. Few organs are spared the progressive deterioration brought about by anorexia.
What is the treatment for anorexia nervosa?
Anorexia 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. A gain of between 1 to 3 pounds per week is a safe and attainable goal when malnutrition must be corrected. Sometimes weight gain is achieved using schedules for eating, decreased physical activity, and increased social activity, either on an inpatient or outpatient basis. For individuals who have suffered from anorexia for several years, the goals of treatment may need to be achieved more slowly in order to prevent the anorexia sufferer from relapsing as a result of being overwhelmed by treatment.
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. Many patients find that a short hospitalization followed by participation in a day treatment program is an effective alternative to longer inpatient programs. Most individuals, however, initially seek outpatient treatment involving psychological as well as medical intervention. It is common to engage a multidisciplinary treatment team consisting of a medical-care professional, a dietician or nutritionist, and a mental-health-care professional.
Different kinds of psychological therapy are 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. In adolescents, research shows that the Maudsley model of family therapy can be particularly effective in treating this disorder in this population. In contrast to many past approaches to treatment, the Maudsley model approaches the family of the individual with anorexia as part of the solution rather than part of the reason their loved one has the disorder. With ongoing specific guidance from the professional mental-health team, this approach has the family actively help their loved one eat in a healthier manner.
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. Group counseling or support groups may assist the individual in the recovery process. The ultimate goal of treatment should be for the individual to accept herself/himself and lead a physically and emotionally healthy life.
While no medications have been identified that can definitively reduce the compulsion to starve oneself, olanzapine (Zyprexa, Zydis), risperidone (Risperdal), and quetiapine (Seroquel) are medications that are also used as mood stabilizers and to treat schizophrenia that may be useful in treating anorexia. These medications may also help increase weight and to manage some of the emotional symptoms like anxiety and depression that can accompany anorexia. Some of the selective serotonin reuptake inhibitor (SSRI) antidepressant drugs, like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro), have been shown to be helpful in weight maintenance after weight has been gained, as well as having beneficial effects on the mood and anxiety symptoms that may be associated with the condition.
Learn more about: Zyprexa | Risperdal | Seroquel
What is the prognosis (outcome) of anorexia nervosa?
Anorexia is among the psychiatric conditions that have the highest mortality rate, with an estimated mortality (death) rate of up to 6% due to the numerous complications of the disease. The most common causes of death in people with anorexia are medical complications of the condition, including cardiac arrest and electrolyte imbalances. Suicide is also a cause of death in people with anorexia. In the absence of any coexisting personality disorder, younger individuals with anorexia tend to do better over time than their older counterparts.
Early diagnosis and treatment can improve the overall prognosis in an individual with anorexia. Despite most psychiatric medications having little effect on the symptoms that are specific to anorexia, the improvement in associated symptoms (for example, anxiety and depression) can help anorexia sufferers engage more actively in treatment and otherwise have a powerful, positive effect on the improvement that individuals with anorexia show over time. With appropriate treatment, about half of those affected will make a full recovery. Some people experience a fluctuating pattern of periods of weight gain followed by relapses, while others experience a progressively deteriorating course of the illness over many years, and still others never fully recover. It is estimated that about 20% of people with anorexia remain chronically ill from the condition.
As with many other mental-health illnesses with addictive symptoms, it takes a day-to-day effort to control the urge to relapse. Many individuals will require ongoing treatment for anorexia over several years, and some may require treatment over their entire lifetime. Factors that seem to predict more difficult recovery from anorexia include vomiting and other purging behaviors, bulimia nervosa, and symptoms of obsessive personality disorder. The longer the disease goes on, the more difficult it is to treat as well.
What is anorexia nervosa?
Anorexia nervosa, commonly referred to simply as anorexia, is one type of eating disorder. It is also a psychological disorder. Anorexia is a condition that goes beyond concern about obesity or out-of-control dieting. A person with anorexia often initially begins dieting to lose weight. Over time, the weight loss becomes a sign of mastery and control. The drive to become thinner is actually secondary to concerns about control and/or fears relating to one's body. The individual continues the ongoing cycle of restrictive eating, often accompanied by other behaviors such as excessive exercising or the overuse of diet pills to induce loss of appetite, and/or diuretics, laxatives, or enemas in order to reduce body weight, often to a point close to starvation in order to feel a sense of control over his or her body. This cycle becomes an obsession and, in this way, is similar to an addiction.
Who is at risk for anorexia nervosa?
A majority of those affected by anorexia are female, most often teenage girls, but males can develop the disorder as well. While anorexia typically begins to manifest itself during early adolescence, it is also seen in young children and adults. Although the disorder has received a lot of media attention, it is an uncommon condition. Caucasians are more often affected than people of other racial backgrounds, and anorexia is more common in middle and upper socioeconomic groups.
Many experts consider people for whom thinness is especially desirable, or a professional requirement (such as athletes in sports like gymnastics, wrestling and jockeying, as well as models, dancers, and actors), to be at risk for eating disorders such as anorexia nervosa. Health-care professionals are usually encouraged to present the facts about the dangers of anorexia through education of their patients and of the general public as a means of preventing this and other eating disorders.
What causes anorexia nervosa?
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 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 called the hypothalamus (which regulates certain metabolic processes), as contributing to the development of anorexia. Other studies have suggested that imbalances in neurotransmitter (brain chemicals involved 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 than others 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 to such an extent that professional mental-health organizations no longer ascribe to that theory. Possible factors that protect against the development of anorexia include high maternal body mass index (BMI) as well as high self-esteem.
How is anorexia nervosa diagnosed?
Anorexia nervosa can be a difficult disorder to diagnose, since individuals with anorexia often attempt to hide the disorder. Denial and secrecy frequently accompany other symptoms. It is unusual for a person with anorexia to seek professional help because the individual typically does not accept that she or he has a problem (denial). In many cases, the actual diagnosis is not made until medical complications have developed. The individual is often brought to the attention of a professional by family members only after marked weight loss has occurred. When anorexics finally come to the attention of a health-care professional, they often lack insight into their problem despite being severely malnourished and may be unreliable in terms of providing accurate information. Therefore, it is often necessary to obtain information from parents, a spouse, or other family members in order to evaluate the degree of weight loss and extent of the disorder. Health professionals will sometimes administer symptom questionnaires as part of screening for the disorder.
Warning signs of developing anorexia or one of the other eating disorders include excessive interest in dieting or thinness. One example of such interest includes a movement called "thinspiration," which promotes extreme thinness as a lifestyle choice rather than as a symptom of illness. There are a variety of web sites that attempt to inspire others toward extreme thinness by featuring information on achieving that goal, photos of famous, extremely thin celebrities, and testimonials, as well as before and after pictures of individuals who ascribe to extreme thinness.
The actual criteria for anorexia nervosa are found in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V).
There are three basic criteria for the diagnosis of anorexia nervosa that are characteristic:
The DSM-V further identifies two subtypes of anorexia nervosa. In the binge-eating/purging type, the individual regularly engaged in binge eating or purging behavior in at least the past three months, which involves self-induced vomiting or the misuse of laxatives, diuretics, or enemas during the current episode of anorexia. In the restricting type, the individual has severely restricted food intake and/or excessively exercised for at least the past three months but does not regularly engage in the behaviors seen in the binge-eating type.
In order to diagnose anorexia, the health-care professional distinguishes this illness from being a symptom of an underlying medical disorder or of another eating disorder. As a symptom of a medical disorder, the term anorexia (in general, rather than anorexia nervosa, the condition discussed in this article) describes the considerable weight loss that may be the result of serious illness that may afflict terminally ill patients who are receiving hospice care.
Unlike the binge-eating/purging type of anorexia nervosa, bulimia nervosa does not result in weight reduction below the minimal normal weight. Bulimia nervosa is characterized by episodes of eating significantly excessive amounts of food that the individual feels they cannot stop themselves from engaging in (binges), alternating with episodes of attempts to counteract the binges using inappropriate behaviors (purging) like self-induced vomiting, misuse of medications, fasting, and/or excessive exercising. Most individuals with an eating disorder do not fit neatly into either the diagnosis of anorexia or bulimia and are therefore classified as either suffering from "other specified feeding or eating disorder" or "unspecified feeding or eating disorder." Examples of other specified feeding or eating disorders include people with binge-eating disorder who experience episodes of binge eating but do not regularly engage in purging or restricting behaviors; individuals with recurrent purging behaviors without binge eating and recurrent episodes of night eating that is not better explained by binge eating disorder or another mental-health disorder. Those eating disorders that do not meet diagnostic criteria for any specific eating disorder are classified as an "unspecified feeding or eating disorder."
What are anorexia symptoms and signs (psychological and behavioral)?
Anorexia can have dangerous psychological and behavioral effects on all aspects of an individual's life and can affect other family members as well.
In addition to the mental effects of anorexia, physical effects of this disorder in children and teens include a number of issues that are associated with growth and development inherent in this age group. Examples of symptoms and signs of anorexia in childhood and adolescence can include a slowing of the natural increase in height or a slowed development of other body functions like menses.
All of these features can negatively affect one's daily activities. Diminished interest in previously preferred activities can result or worsen. Some individuals also have symptoms that meet the diagnostic criteria for a major depressive disorder.
What are anorexia symptoms, signs, and complications (physical)?
Most of the medical complications of anorexia nervosa result from starvation. Few organs are spared the progressive deterioration brought about by anorexia.
What is the treatment for anorexia nervosa?
Anorexia 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. A gain of between 1 to 3 pounds per week is a safe and attainable goal when malnutrition must be corrected. Sometimes weight gain is achieved using schedules for eating, decreased physical activity, and increased social activity, either on an inpatient or outpatient basis. For individuals who have suffered from anorexia for several years, the goals of treatment may need to be achieved more slowly in order to prevent the anorexia sufferer from relapsing as a result of being overwhelmed by treatment.
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. Many patients find that a short hospitalization followed by participation in a day treatment program is an effective alternative to longer inpatient programs. Most individuals, however, initially seek outpatient treatment involving psychological as well as medical intervention. It is common to engage a multidisciplinary treatment team consisting of a medical-care professional, a dietician or nutritionist, and a mental-health-care professional.
Different kinds of psychological therapy are 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. In adolescents, research shows that the Maudsley model of family therapy can be particularly effective in treating this disorder in this population. In contrast to many past approaches to treatment, the Maudsley model approaches the family of the individual with anorexia as part of the solution rather than part of the reason their loved one has the disorder. With ongoing specific guidance from the professional mental-health team, this approach has the family actively help their loved one eat in a healthier manner.
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. Group counseling or support groups may assist the individual in the recovery process. The ultimate goal of treatment should be for the individual to accept herself/himself and lead a physically and emotionally healthy life.
While no medications have been identified that can definitively reduce the compulsion to starve oneself, olanzapine (Zyprexa, Zydis), risperidone (Risperdal), and quetiapine (Seroquel) are medications that are also used as mood stabilizers and to treat schizophrenia that may be useful in treating anorexia. These medications may also help increase weight and to manage some of the emotional symptoms like anxiety and depression that can accompany anorexia. Some of the selective serotonin reuptake inhibitor (SSRI) antidepressant drugs, like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro), have been shown to be helpful in weight maintenance after weight has been gained, as well as having beneficial effects on the mood and anxiety symptoms that may be associated with the condition.
Learn more about: Zyprexa | Risperdal | Seroquel
What is the prognosis (outcome) of anorexia nervosa?
Anorexia is among the psychiatric conditions that have the highest mortality rate, with an estimated mortality (death) rate of up to 6% due to the numerous complications of the disease. The most common causes of death in people with anorexia are medical complications of the condition, including cardiac arrest and electrolyte imbalances. Suicide is also a cause of death in people with anorexia. In the absence of any coexisting personality disorder, younger individuals with anorexia tend to do better over time than their older counterparts.
Early diagnosis and treatment can improve the overall prognosis in an individual with anorexia. Despite most psychiatric medications having little effect on the symptoms that are specific to anorexia, the improvement in associated symptoms (for example, anxiety and depression) can help anorexia sufferers engage more actively in treatment and otherwise have a powerful, positive effect on the improvement that individuals with anorexia show over time. With appropriate treatment, about half of those affected will make a full recovery. Some people experience a fluctuating pattern of periods of weight gain followed by relapses, while others experience a progressively deteriorating course of the illness over many years, and still others never fully recover. It is estimated that about 20% of people with anorexia remain chronically ill from the condition.
As with many other mental-health illnesses with addictive symptoms, it takes a day-to-day effort to control the urge to relapse. Many individuals will require ongoing treatment for anorexia over several years, and some may require treatment over their entire lifetime. Factors that seem to predict more difficult recovery from anorexia include vomiting and other purging behaviors, bulimia nervosa, and symptoms of obsessive personality disorder. The longer the disease goes on, the more difficult it is to treat as well.
Source: http://www.rxlist.com
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. Many patients find that a short hospitalization followed by participation in a day treatment program is an effective alternative to longer inpatient programs. Most individuals, however, initially seek outpatient treatment involving psychological as well as medical intervention. It is common to engage a multidisciplinary treatment team consisting of a medical-care professional, a dietician or nutritionist, and a mental-health-care professional.
Different kinds of psychological therapy are 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. In adolescents, research shows that the Maudsley model of family therapy can be particularly effective in treating this disorder in this population. In contrast to many past approaches to treatment, the Maudsley model approaches the family of the individual with anorexia as part of the solution rather than part of the reason their loved one has the disorder. With ongoing specific guidance from the professional mental-health team, this approach has the family actively help their loved one eat in a healthier manner.
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. Group counseling or support groups may assist the individual in the recovery process. The ultimate goal of treatment should be for the individual to accept herself/himself and lead a physically and emotionally healthy life.
While no medications have been identified that can definitively reduce the compulsion to starve oneself, olanzapine (Zyprexa, Zydis), risperidone (Risperdal), and quetiapine (Seroquel) are medications that are also used as mood stabilizers and to treat schizophrenia that may be useful in treating anorexia. These medications may also help increase weight and to manage some of the emotional symptoms like anxiety and depression that can accompany anorexia. Some of the selective serotonin reuptake inhibitor (SSRI) antidepressant drugs, like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro), have been shown to be helpful in weight maintenance after weight has been gained, as well as having beneficial effects on the mood and anxiety symptoms that may be associated with the condition.
Source: http://www.rxlist.com
We respect your privacy and aim for the best website experience in compliance with local laws. Allowing cookies enables a tailored experience, while disabling them may reduce personalization. For more information, please read our Privacy Policy and Cookie Policy.