General Illness Information Common Name: ANOREXIA NERVOSA Medical Term: None Specified Description: An eating disorder in young previously healthy women, who develop a paralyzing fear of becoming fat, and have a distorted body image. The patient refuses to eat adequately, and continues to want to lose weight even after a reasonable weight loss. Primarily affects teenage and young adult females. Occasionally young males are affected. There is also an absence of menstrual periods. Causes: Cause of Anorexia Nervosa is unknown. Suggested causes include family and internal conflicts (sexual conflicts). Patient develops a phobia about putting on weight, and is highly paranoid on changes in fashion (as slimness is identified with beauty). Patient suffers symptoms of depression or personality disorder. Prevention: Confront personal problems realistically. Try to correct or cope with problems with the help of counselors, therapists, family and friends. Patient must develop a rational attitude about weight. Signs & Symptoms Weight loss to 15% lower than ideal body weight. High energy levels despite body wasting. Intense fear of obesity. Depression. Hungry and preoccupied with food but refusing to eat for fear of gaining weight. They study diets and calories and tend to collect recipes and prepare elaborate meals for others. Constipation and abdominal pain often associated with the overuse of laxatives. Cold intolerance. Refusal to maintain a minimum standard weight for age and height. Distorted body image. The person continues to feel fat even when emaciated. Cessation of menstrual periods. Onset prior to age 25. No known medical illness to account for loss. No other known psychiatric disorder. Risk Factors Peer pressure to be thin. History of slight overweight. Perfectionist, compulsive or overachieving personalities. Psychological stress. Ballet dancer, models, cheerleaders, and athletes. Inadequate interpersonal relationships. Diagnosis & Treatment General Measures: The goal of treatment is for the patient to establish healthy eating patterns so as to regain normal weight. The patient can accomplish this with behavior-modification training supervised by qualified professionals. The appropriate treatment approach addresses underlying issues of control and self-perception. Treatment can usually be done on an outpatient basis. Psychotherapy or counseling for the patient and family. Hospitalization during crises for intravenous or tube feeding to correct electrolyte imbalance, or if patient is suicidal. Therapy may continue over several years. Relapses are common, especially when stressful situations occur. Medications: Antidepressants or anti-anxiety medications may be prescribed. Activity: Increased activity as weight is gained back. Diet: A controlled re-feeding program will be established. Vitamin and mineral supplements may be prescribed. Possible Complications : Chronic anorexia nervosa caused by patient's resistance to treatment. Electrolyte disturbances or irregular heartbeat. These may be lift-threatening. Osteoporosis. Suicide. Prognosis Treatable if the patient recognizes the emotional disturbance, wants help and cooperates in treatment. Without treatment, this can cause permanent disability and death. Persons with anorexia nervosa have a high rate of attempted suicide due to low self-esteem.