(Anorexia Nervosa—Adult)
Definition
Definition
Anorexia is an eating disorder. It occurs when a person’s obsession with diet and exercise leads to extreme weight loss. The disorder is considered if a person refuses to maintain a body weight at or above 85% of their ideal body weight. Anorexia can be fatal.
Causes
Causes
The cause of anorexia is not known. It appears to be a combination of genetics and environment.
Risk Factors
Risk Factors
Anorexia is more common in women. Factors that increase your risk for anorexia include:
- Low self-esteem
- Feelings of helplessness
- Perfectionism
- Fear of becoming overweight
- Pressure to be thin
- Family history of eating disorders
- Emotional stress
- Mood disorders, such as depression or generalized anxiety disorder
- Personality disorders
- Influenced by social and fashion trends emphasizing or glamorizing thinness
Symptoms
Symptoms
Symptoms may include:
- Excessive weight loss
- Obsession with food, calories, and fat content
- Dieting even when thin
- Intense fear of gaining weight, even when underweight
- Body dysmorphia—distorted self-image of being overweight despite evidence of the opposite
- Basing self-evaluation heavily on body weight or shape
- Loss of menstrual periods
- Excessive exercising
- Feeling cold, especially hands and feet
- Being secretive about food
- Hair loss and/or growth of fine hair on the body
- Fainting or severe light-headedness
- Constipation
- Depression and/or anxiety
- Heart palpitations
Anorexia often leads to a number of serious medical problems including:
- Osteoporosis
- Cardiac problems, which can be fatal if an arrhythmia develops
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Diagnosis
Diagnosis
You will be asked about your symptoms and medical history. A physical exam and psychological evaluation will be done.
Other tests may include:
- Blood tests to look for chemical imbalances
- Electrocardiogram (EKG)—to check your heart’s electrical activity
- Bone density tests
Treatment
Treatment
The goal of treatment is to return to and maintain a healthy weight. A healthy weight is above 85% of your ideal weight. To achieve this, the intake of calories is gradually increased. This can be accomplished through a number of interventions, including the following:
Nutritional Consultation
A dietitian may be consulted to help you learn more about the components of a healthy diet. The dietitian will also talk to you about reasonable weight and calorie goals.
Therapy
Therapy can help address harmful thought patterns, improve eating behavior, and increase self-esteem. There are many different types of therapy. Work with your doctor and therapists to determine which therapy may be best for you. You may use more than one therapy or try different therapies before you find one that works best for you. Some therapy options include:
- Cognitive behavioral therapists —To help you develop a healthier and more realistic self-image. The therapist will help you find new ways to think about your body and your diet.
- Interpersonal therapy —To help you understand and cope with concerns about your relationships.
- Family therapy—Families often play a role in eating disorders. Many people cannot recover unless their families are involved in the changes. All families need to understand the disorder to provide the appropriate support.
Antidepressants
In some cases, people with anorexia benefit from a combination of psychotherapy and antidepressant medication. In particular, selective serotonin reuptake inhibitors (SSRIs) are used. Used alone, antidepressant therapy is not an effective treatment for anorexia.
Addressing Nutritional Status and Loss of Bone Density
Medications and supplements may include:
- Vitamins and minerals to maintain adequate nutrition
- Hormone replacement to resume periods and prevent bone loss
Hospitalization
Hospitalization may be necessary if:
- Weight is more than 25% below ideal body weight
- There are signs of serious physical or emotional deterioration
Prevention
Prevention
There are no current guidelines to prevent anorexia. Early detection and treatment is the best option.
RESOURCES:
National Eating Disorders Association http://www.nationaleatingdisorders.org
CANADIAN RESOURCES:
National Eating Disorder Information Center http://www.nedic.ca
References:
http://www.ebscohost.com/dynamed
Updated February 20, 2013. Accessed July 22, 2013.
Anorexia nervosa fact sheet. Office on Women’s Health website. Available at:
http://www.womenshealth.gov/publications/our-publications/fact-sheet/anorexia-nervosa.html
Updated July 16, 2012. Accessed July 22, 2013.
Casper RC. How useful are pharmacological treatments in eating disorders? Psychopharmacol Bull. 2002;36(2):88-104.
Last Updated: 10/13/2014