Anorexia nervosa (AN), a form of self-starvation, is an eating disorder characterized by low body weight (less than 85 percent of normal weight for height and age), a distorted body image, amenorrhea (absence of at least three consecutive menstrual cycles when otherwise expected to occur in women), and an intense fear of gaining weight. Anorexia nervosa is sometimes referred to as anorexia.
The cause of anorexia nervosa is not known. Anorexia usually begins as innocent dieting behavior, but gradually progresses to extreme and unhealthy weight loss. Social attitudes toward body appearance, family influences, genetics, and neurochemical and developmental factors are considered possible contributors to the cause of anorexia. Adolescents who develop anorexia are more likely to come from families with a history of weight problems, physical illness, and other mental health problems, such as depression or substance abuse. Further, often teens with the disorder come from families that are challenged by appropriate problem solving, being too rigid, overly-critical, intrusive, and overprotective. Teens may also be dependent, immature in their emotional development, and are likely to isolate themselves from others. Other mental health problems such as anxiety disorders or affective disorders are commonly found in teens with anorexia.
The occurrence of anorexia nervosa has increased over the past 20 years among adolescents. Approximately 90 percent are women between ages 12 and 25. Initially identified in upper- and middle-class families, anorexia is now known to be found in all socioeconomic groups and a variety of ethnic and racial groups.
There are two subgroups of anorexic behavior aimed at reducing caloric intake, including the following:
The following are the most common symptoms of anorexia. However, each child may experience signs differently.
Symptoms may include:
The following are the most common physical symptoms associated with anorexia--often that result from starvation and malnourishment. However, each child may experience symptoms differently. Symptoms may include:
Persons with anorexia may also be socially withdrawn, irritable, moody, and/or depressed. The symptoms of anorexia nervosa may resemble other medical problems or psychiatric conditions. Always consult your child's physician for a diagnosis.
Parents, teachers, coaches, or instructors may be able to identify the child or adolescent with anorexia, although many persons with the disorder initially keep their illness very private and hidden. However, a child psychiatrist or a qualified mental health professional usually diagnoses anorexia in children and adolescents. A detailed history of the child's behavior from parents and teachers, clinical observations of the child's behavior, and, sometimes, psychological testing contribute to the diagnosis. Parents who note symptoms of anorexia in their child or teen can help by seeking an evaluation and treatment early. Early treatment can often prevent future problems.
Anorexia, and the malnutrition that results, can adversely affect nearly every organ system in the body, increasing the importance of early diagnosis and treatment. Anorexia can be fatal. Consult your child's physician for more information.
Specific treatment for anorexia nervosa will be determined by your child's physician based on:
Anorexia is usually treated with a combination of individual therapy, family therapy, behavior modification, and nutritional rehabilitation. Treatment should always be based on a comprehensive evaluation of the adolescent and family. Individual therapy usually includes both cognitive and behavioral techniques. Medication (usually antidepressants) may be helpful if the adolescent with anorexia is also depressed. The frequent occurrence of medical complications and the possibility of death during the course of acute and rehabilitative treatment requires both your child's physician and a nutritionist to be active members of the management team. Parents play a vital supportive role in any treatment process. Hospitalization may be required for medical complications related to weight loss and malnutrition.
Medical complications that may result from anorexia include, but are not limited to, the following:
Preventive measures to reduce the incidence of anorexia are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the child's normal growth and development, and improve the quality of life experienced by children or adolescents with anorexia nervosa. Encouraging healthy eating habits and realistic attitudes toward weight and diet may also be helpful.
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