Anorexia Nervosa

To prevent weight gain or to continue losing weight, people with anorexia usually severely restrict the amount of food they eat. They may control calorie intake by vomiting after eating or by misusing laxatives, diet aids, diuretics or enemas. They may also try to lose weight by exercising excessively. No matter how much weight is lost, the person continues to fear weight gain.

anorexia nervosa

Anorexia isn't really about food. It's an extremely unhealthy and sometimes life-threatening way to try to cope with emotional problems. When you have anorexia, you often equate thinness with self-worth.

Anorexia, like other eating disorders, can take over your life and can be very difficult to overcome. But with treatment, you can gain a better sense of who you are, return to healthier eating habits and reverse some of anorexia's serious complications.

The physical signs and symptoms of anorexia nervosa are related to starvation. Anorexia also includes emotional and behavioral issues involving an unrealistic perception of body weight and an extremely strong fear of gaining weight or becoming fat.

It may be difficult to notice signs and symptoms because what is considered a low body weight is different for each person, and some individuals may not appear extremely thin. Also, people with anorexia often disguise their thinness, eating habits or physical problems.

Some people who have anorexia binge and purge, similar to individuals who have bulimia. But people with anorexia generally struggle with an abnormally low body weight, while individuals with bulimia typically are normal to above normal weight.

Unfortunately, many people with anorexia don't want treatment, at least initially. Their desire to remain thin overrides concerns about their health. If you have a loved one you're worried about, urge her or him to talk to a doctor.

If you're experiencing any of the problems listed above, or if you think you may have an eating disorder, get help. If you're hiding your anorexia from loved ones, try to find a person you trust to talk to about what's going on.

If a person with anorexia becomes severely malnourished, every organ in the body can be damaged, including the brain, heart and kidneys. This damage may not be fully reversible, even when the anorexia is under control.

There's no guaranteed way to prevent anorexia nervosa. Primary care physicians (pediatricians, family physicians and internists) may be in a good position to identify early indicators of anorexia and prevent the development of full-blown illness. For instance, they can ask questions about eating habits and satisfaction with appearance during routine medical appointments.

Individuals with anorexia nervosa have a fear of being overweight or being seen as such, although they are in fact underweight.[1][3] The DSM-5 describes this perceptual symptom as "disturbance in the way in which one's body weight or shape is experienced".[8] In research and clinical settings, this symptom is called "body image disturbance".[14] Individuals with anorexia nervosa also often deny that they have a problem with low weight.[4] They may weigh themselves frequently, eat small amounts, and only eat certain foods.[1] Some exercise excessively, force themselves to vomit (in the "anorexia purging" subtype), or use laxatives to lose weight and control body shapes, and/or binge eat.[1] Medical complications may include osteoporosis, infertility, and heart damage,[1] along with the cessation of menstrual periods.[4] In extreme cases, patients with anorexia nervosa who continually refuse significant dietary intake and weight restoration interventions, and are declared incompetent to make decisions by a psychiatrist, may be fed by force under restraint via nasogastric tube[15] after asking their parents or proxies[16] to make the decision for them.[17]

The cause of anorexia is currently unknown.[3] There appear to be some genetic components with identical twins more often affected than fraternal twins.[3] Cultural factors also appear to play a role, with societies that value thinness having higher rates of the disease.[4] Additionally, it occurs more commonly among those involved in activities that value thinness, such as high-level athletics, modeling, and dancing.[4][5] Anorexia often begins following a major life-change or stress-inducing event.[4] The diagnosis requires a significantly low weight[4] and the severity of disease is based on body mass index (BMI) in adults with mild disease having a BMI of greater than 17, moderate a BMI of 16 to 17, severe a BMI of 15 to 16, and extreme a BMI less than 15.[4] In children, a BMI for age percentile of less than the 5th percentile is often used.[4]

Treatment of anorexia involves restoring the patient back to a healthy weight, treating their underlying psychological problems, and addressing behaviors that promote the problem.[1] While medications do not help with weight gain, they may be used to help with associated anxiety or depression.[1] Different therapy methods may be useful, such as cognitive behavioral therapy or an approach where parents assume responsibility for feeding their child, known as Maudsley family therapy.[1][18] Sometimes people require admission to a hospital to restore weight.[8] Evidence for benefit from nasogastric tube feeding is unclear;[19] such an intervention may be highly distressing for both anorexia patients and healthcare staff when administered against the patient's will under restraint.[15] Some people with anorexia will have a single episode and recover while others may have recurring episodes over years.[8] Many complications improve or resolve with the regaining of weight.[8]

Globally, anorexia is estimated to affect 2.9 million people as of 2015[update].[10] It is estimated to occur in 0.3% to 4.3% of women and 0.2% to 1% of men in Western countries at some point in their life.[20] About 0.4% of young women are affected in a given year and it is estimated to occur ten times more commonly among women than men.[4][20] Rates in most of the developing world are unclear.[4] Often it begins during the teen years or young adulthood.[1] While anorexia became more commonly diagnosed during the 20th century it is unclear if this was due to an increase in its frequency or simply better diagnosis.[3] In 2013, it directly resulted in about 600 deaths globally, up from 400 deaths in 1990.[21] Eating disorders also increase a person's risk of death from a wide range of other causes, including suicide.[1][20] About 5% of people with anorexia die from complications over a ten-year period, a nearly six times increased risk.[4][9] According to a study conducted in 2020, it was observed that the unadjusted odds ratio of mortality among male (6.1%) patients was more than twice the ratio for female patients (2.6%) in Japan (Edakubo & Fushimi).[22]

In recent years, evolutionary psychiatry as an emerging scientific discipline has been studying mental disorders from an evolutionary perspective. It is still debated whether eating disorders such as anorexia have evolutionary functions or if they are problems resulting from a modern lifestyle.[23][24][25].mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 uldisplay:none

Anorexia nervosa is an eating disorder characterized by attempts to lose weight to the point of starvation. A person with anorexia nervosa may exhibit a number of signs and symptoms, the type and severity of which may vary and be present but not readily apparent.[26]

Anorexia nervosa, and the associated malnutrition that results from self-imposed starvation, can cause complications in every major organ system in the body.[27] Hypokalaemia, a drop in the level of potassium in the blood, is a sign of anorexia nervosa.[28][29] A significant drop in potassium can cause abnormal heart rhythms, constipation, fatigue, muscle damage, and paralysis.[30]

Interoception involves the conscious and unconscious sense of the internal state of the body, and it has an important role in homeostasis and regulation of emotions.[39] Aside from noticeable physiological dysfunction, interoceptive deficits also prompt individuals with anorexia to concentrate on distorted perceptions of multiple elements of their body image.[40] This exists in both people with anorexia and in healthy individuals due to impairment in interoceptive sensitivity and interoceptive awareness.[40]

Aside from weight gain and outer appearance, people with anorexia also report abnormal bodily functions such as indistinct feelings of fullness.[41] This provides an example of miscommunication between internal signals of the body and the brain. Due to impaired interoceptive sensitivity, powerful cues of fullness may be detected prematurely in highly sensitive individuals, which can result in decreased calorie consumption and generate anxiety surrounding food intake in anorexia patients.[42] People with anorexia also report difficulty identifying and describing their emotional feelings and the inability to distinguish emotions from bodily sensations in general, called alexithymia.[41]

Interoceptive awareness and emotion are deeply intertwined, and could mutually impact each other in abnormalities.[42] Anorexia patients also exhibit emotional regulation difficulties that ignite emotionally-cued eating behaviors, such as restricting food or excessive exercising.[42] Impaired interoceptive sensitivity and interoceptive awareness can lead anorexia patients to adapt distorted interpretations of weight gain that are cued by physical sensations related to digestion (e.g., fullness).[42] Combined, these interoceptive and emotional elements could together trigger maladaptive and negatively reinforced behavioral responses that assist in the maintenance of anorexia.[42] In addition to metacognition, people with anorexia also have difficulty with social cognition including interpreting others' emotions, and demonstrating empathy.[43] Abnormal interoceptive awareness and interoceptive sensitivity shown through all of these examples have been observed so frequently in anorexia that they have become key characteristics of the illness.[41] 041b061a72