Overview

Anorexia nervosa is an eating disorder. It occurs when a person's obsession with dieting and exercise leads to excessive weight loss. People are generally considered anorexic when they refuse to maintain their body weight at or above 85 percent of their ideal body weight. Anorexia can be fatal. Anorexia often leads to a number of serious medical problems including amenorrhea (loss of periods) and osteoporosis.

Title
Anorexia nervosa

Types

Symptoms may include:

  • Excessive weight loss
  • Obsession with food, calories, and fat content
  • Dieting even when thin
  • Intense fear of gaining weight, even when underweight
  • Distorted self-image of being overweight despite evidence to the contrary
  • Basing self-evaluation heavily on body weight or shape
  • Loss of menstrual periods (secondary amenorrhea) or delay in menarche (onset of periods)
  • Excessive exercising
  • Feeling cold, especially hands and feet
  • Being secretive about food
  • Hair loss and/or growth of fine hair on the body
  • Fainting or severe lightheadedness
  • Constipation
  • Depression and/or anxiety 
  • Heart palpitations
Causes

The cause of anorexia nervosa is not known. It appears that hereditary and environmental factors play a role.

Diagnosis

Symptoms and medical history are important, as well as a physical exam. There will also be psychological tests, and possibly lab tests. Findings may include:

  • Excessive loss of body fat
  • Loss of muscle mass
  • Low heart rate
  • Low blood pressure, particularly when standing
  • Decreased bone density  
  • Signs of sluggish metabolism
Treatment

The goal of treatment is to get you back to a healthy weight and keep you there. A healthy weight is above 85 percent, but not necessarily to 100 percent, of the ideal weight. To achieve this, the intake of calories is gradually increased to between 1,500 and 3,500 per day. This can be accomplished through a number of interventions, including cognitive-behavioral therapy (CBT) to help to develop a healthier and more realistic self-image; interpersonal therapy to help to understand and cope with concerns about your relationship; family therapy and antidepressants.
Hospitalization may be necessary if weight is 25–30% below ideal body weight or if there are signs of serious physical or emotional deterioration.

Prevention

There are no guidelines for preventing anorexia nervosa. Early detection and treatment has been more successful than prevention.

Complications

- Anemia

- Constipation

- Dehydration

- Electrolyte imbalances

Orthostatic hypotension

Risks

Risk factors for anorexia nervosa include the following:

  • Sex: Female
  • Age: Adolescence or early adulthood
  • Low self-esteem
  • Feelings of helplessness
  • Perfectionism
  • Fear of becoming overweight
  • Familial pressure to be thin
  • Families that are overprotective, rigid, under-involved, or in conflict
  • Family history of eating disorders
  • Emotional stress
  • Mood disorders such as depression or generalized anxiety disorder
  • Personality disorders  
  • Susceptibility to social and fashion trends emphasizing or glamorizing thinness