Anorexia Nervosa

Mental Health, Nutritional

Anorexia nervosa is one of a group of eating disorders characterized by excessive weight loss and an extreme fixation upon shape and weight. More than 30 million men and women suffer from an eating disorder in the United States and anorexia has the highest death rate among them all. The fatalities due to anorexia nervosa are 12 times higher than any other cause of death among fifteen- to twenty-four-year-olds. Anorexia nervosa occurs when people have a distorted body image and feel they need to lose weight. They may lose too much weight through starvation or excessive exercise. They may be too thin for their height and weight, yet they still think they need to lose more. Sufferers have a fear of gaining weight and can suffer severe malnutrition and electrolyte loss which can lead to fatalities.

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Symptoms

The signs of anorexia nervosa have to do with food and weight issues. The following are common signs and symptoms:

Emotional signs include:

  • Fear of weight gain
  • Keeping body weight 15% below normal BMI (body mass index)
  • Distorted body image (thinking they are fat, even when too thin)
  • Picking at food, eating only tiny amounts
  • Excessive exercising and non-stop
  • Unable to share meals with family or friends
  • Taking diet pills, laxatives, or diuretics

Physical signs include:

  • Muscle and fat wasting/skeletal appearance
  • Loss of muscle and bone strength
  • Sensitivity to cold
  • Depressionand anxiety
  • Yellowing skin
  • Fine downy hair all over the body
  • Confusion
  • Poor memory
  • Dry Mouth
  • Dizzinessor fainting spells

Risk Factors

The risk factors for anorexia are usually attributed to the following factors:

Age group. Teenagers are more at risk for anorexia because they are dealing with changes in puberty and growth. Emotionally teens are more sensitive to peer pressure and negative comments about their bodies.

Females. Boys are at risk for anorexia, but there is a higher rate of females that suffer from eating disorders.

Genetic tendencies. There may be genetic links to eating disorders and it may run in families.

Weight changes. Even small weight gains can cause someone to go on an extreme diet. When someone goes into starvation mode, they may change their brain’s response to food. It has been found that people with long-standing anorexia cannot go back into normal eating patterns without intense therapy.

Life trauma andchanges. Moves, new schools, new jobs, or relationship issues can trigger an eating disorder.

Athletes or performing artists. Being in a position where you are expected to maintain a certain weight can trigger an eating disorder. This is common among models, dancers, ice skaters, and gymnasts.

Diagnosis

The signs of anorexia can be hidden until the disorder has become advanced. The following tests can be done to check for an eating disorder and if any damage is occurring to the body:

Medical history and physical examination. The doctor conducts a thorough medical examination. They will check height and weight and compare to the BMI (body mass index). Vital signs will be checked, as well as skin and nails.

Blood tests. Routine bloodwork for anorexia measures the electrolytes, the liver, kidneys, thyroid, and complete blood count. These tests can show the state of nutritional status and if the organs are affected.

Mental examination. A psychological exam can evaluate thoughts about eating, emotional status, and history of emotional trauma that may be linked to the disorder.

Electrocardiogram (ECG) andradiology studies. Bone density scans may be performed to assess the loss of calcium and/or bone density. ECGs will reveal if there are any abnormal heart rhythms due to electrolyte loss.

Treatments

Anorexia nervosa is successfully treated with therapy, medication, and dietary modifications. Treatment often is lifelong, and sufferers are prone to relapse if therapy is not continued. There needs to be an adequate support group and behavioral therapy about food issues.

Medications typically prescribed are anti-depressants, anti-anxiety medications, and sometimes appetite stimulants. In serious cases where there is significant malnutrition, sufferers may need inpatient hospitalization with tube feedings, intravenous nutrition, and vitamin supplementation. There are instances where the body is unable to tolerate solid foods after long periods of self-starvation.

Prevention

Unfortunately, there is no one way to prevent the onset of anorexia but early intervention may be helpful. If you can spot the signs and symptoms early enough treatment can be aimed at preventing its progression.
Here are a few tips to use with kids and teens:

Encourage healthy eating and exercise. Keep a positive outlook when talking about eating healthily and exercising. Stress that it is for good health and not looks.

Promote a healthy self-image. Never call a child fat or say they will get fat. Teach them they are beautiful no matter what and what is inside is most important

Do not use food as a reward or punishment. Never take away food if a child does something wrong or offer food if they are good.

Model healthy behaviors. The best way to teach our kids is by doing. When they see us healthily thinking about ourselves, eating, and exercising right they will hopefully follow our lead.

Lifestyle Changes

There are a few lifestyle changes that can help with anorexia nervosa:

  • Keep a strong support system or join a support group
  • Remove bathroom scales and do not weigh more than once a week
  • Reduce exercise until the proper weight is reached
  • Stick with any treatment plans, therapy appointments, and meal plans
  • Have dietary back-up such as protein or meal replacement shakes
  • Refrain from reading materials that promote an unhealthy self-image

References

Hudson, J. I, et. al. (2007, February 01). The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biological Psychiatry, 61(3), 348-358. Retrieved from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892232/

Mayo Clinic Staff. (2018, February 20). Anorexia nervosa. Retrieved from:https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/symptoms-causes/syc-20353591

Morris, J. & Twaddle, S. (2007, April 28). Anorexia nervosa. BMJ, 334(7599), 894-898. Retrieved from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1857759/

Pike, E. (2020, February 28). Eating disorder statistics: NEDA week 2020. Retrieved from: https://www.eatingrecoverycenter.com/blog/advocacy/Eating-Disorder-Statistics-NEDA-Week-2020

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