Each year millions of people in the United States are affected by serious and sometimes life-threatening eating disorders. More than 90 percent of those afflicted are adolescent and young adult women. It is suggested that the reason women in this age group are particularly vulnerable to eating disorders is because of their tendency to go on strict diets to achieve an "ideal" figure. Researchers have found that such stringent dieting can play a key role in triggering eating disorders.
The consequences of eating disorders can be severe - 5 percent to 20 percent of cases of anorexia nervosa leads to death from starvation, cardiac arrest, other medical complications, or suicide.
Increasing awareness of the dangers of eating disorders - sparked by medical studies and extensive media coverage of the illness - has led many people to seek help. Nevertheless, some people with eating disorders refuse to admit they have a problem and refuse treatment.
Anorexia nervosa (or simply anorexia) is an eating disorder in which people intentionally starve themselves. It causes extreme weight loss, which the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH), defines as at least 15 percent below the individual's normal body weight.
Food and weight become obsessions. Compulsiveness may cause strange eating rituals or the refusal to eat in front of others. It is not uncommon for people with anorexia to collect recipes and prepare gourmet feasts for family and friends, but not partake in the meals themselves. They may also adhere to strict exercise routines to keep off weight.
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. Persons 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 persons with the disorder come from families that are challenged by appropriate problem solving, being too rigid, overly-critical, intrusive, and overprotective. Persons with anorexia 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 persons with anorexia.
The occurrence of anorexia nervosa has increased over the past 20 years. Approximately 90 percent are women between ages 12 and 25. Initially found mostly in upper- and middle-class families, anorexia is now found in all socioeconomic groups and a variety of ethnic and racial groups.
Most people with eating disorders share certain personality traits and use abnormal eating rituals as a means of handling stress and anxiety. These personality traits often include, but are not limited to, the following:
People with anorexia nervosa:
It is believed that they restrict food - particularly carbohydrates - to gain a sense of control in some/one area of their lives. Controlling their weight appears to offer two advantages:
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 individual may experience symptoms differently. Symptoms may include:
The following are the most common physical symptoms associated with anorexia - often that result from starvation and malnourishment. However, each individual 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 physician for a diagnosis.
Parents, family members, spouses, teachers, coaches, and instructors may be able to identify an individual with anorexia, although many persons with the disorder initially keep their illness very private and hidden. A detailed history of the individual's behavior from family, parents, and teachers, clinical observations of the person's behavior, and, sometimes, psychological testing contribute to the diagnosis. Family members who note symptoms of anorexia in a loved one 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 physician for more information.
Specific treatment for anorexia nervosa will be determined by your 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 individual and family. Individual therapy usually includes both cognitive and behavioral techniques. Medication (usually antidepressants) may be helpful if the person 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 physician and a nutritionist to be active members of the management team. Families play a vital supportive role in any treatment process.
Medical complications that may result from anorexia include, but are not limited to, the following:
To understand eating disorders, researchers have studied the neuroendocrine system, which is made up of a combination of the central nervous and hormonal systems.
The neuroendocrine system regulates multiple functions of the mind and body. It has been found that many of the following regulatory mechanisms may be, to some degree, disturbed in persons with eating disorders:
Many people with eating disorders also appear to suffer from depression, and is believed that there may be a link between these two disorders. For example:
Because eating disorders tend to run in families, and female relatives are the most often affected, genetic factors are believed to play a role in the disorders.
But, other influences, both behavioral and environmental, may also play a role. Consider these facts from the National Institute of Mental Health:
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 individual's normal growth and development, and improve the quality of life experienced by persons with anorexia nervosa. Encouraging healthy eating habits and realistic attitudes toward weight and diet may also be helpful.
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