Anorexia is a psychiatric diagnosis that defines an eating disorder. The disorder is complex involving low body weight, self-starvation, purging, excessive exercise, and poor body image.
Symptoms for Anorexia Nervosa are:
• Perfectionism (psychology)|Perfectionism
• Distorted body image
• Poor insight
• Self-evaluation largely, or even exclusively, in terms of their shape and weight
• Pre-occupation or obsessive-compulsive disorder|obsessive thoughts about food and weight
• OCD (obsessive compulsive disorder)
Emotional Symptoms associated with Anorexia Nervosa:
• Low self-esteem and self-efficacy
• Clinical depression or chronically low mood
• Intense fear about becoming overweight
Social symptoms associated with Anorexia Nervosa:
• Deterioration in relationships with the family
• Poor or deteriorating school performance
• Withdrawal from previous friendships and other peer-relationships
The structure and function of the heart are severely affected
Disturbed electrolyte balance
Low levels of phosphate leading to heart failure, muscle weakness, immune dysfunction and possibly death
Amenorrhea – cessation of menstruation
Osteoporosis – up to fifty percent of patients
Secondary Symptoms are:
• Endocrine disorder Starvation symptoms, such as reduced metabolism, slow heart rate (bradycardia), hypotension, hypothermia and anemia.
• Growth of lanugos hair (fine black hair) over the body
• Abnormalities of mineral and electrolyte levels in the body
• Zinc deficiency
• Often a reduction in white blood cell count
• Reduced immune system function
• Body mass index less than 17.5 in adults, or 85% of expected weight in children
• Possibly with pallid complexion and sunken eyes
• Creaking joints and bones
• Collection of fluid in ankles during the day and around eyes during the night
• Very dry/chapped lips due to malnutrition
• Poor circulation, resulting in common attacks of 'pins and needles' and purple extremities
• In cases of extreme weight loss, there can be nerve deterioration, leading to difficulty in moving the feet
Behavior Symptoms of Anorexia are:
* Excessive exercise, food restriction
* Secretive behavior about eating or exercise
* Possible self-harm, substance abuse or suicide attempts
Diagnosis is commonly made using the criteria from the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders – DSM-IV-TR.
Biological tests may aid in diagnosis, but most commonly it is made based on a combination of reported self-image and experiences, physical characteristics and behavior of the patient.
According to the DSM-IV-TR, a person must display:
• Refusal to maintain weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
• Intense fear of gaining weight or becoming overweight|fat.
• Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
• In females (women who have had their first menstrual period but have not yet experienced menopause) amenorrhea (the absence of at least three consecutive menstrual cycles).
There are two subtypes of Anorexia, according to the DSM-IV-TR. The first subtype is known as the Restrictive Type. Restrictive type defines a person with Anorexia as not regularly binge-eating or purging – using laxatives, diuretics or enemas. The second type is Binge-Eating or Purging Type. This type defines a patient as regularly binge-eating OR purging. the misuse of laxatives, diuretics, or enemas).
There is no single cause for Anorexia Nervosa. Anorexia Nervosa is a combination of social, psychological and biological factors.
Anorexia Nervosa is usually found in Western Cultures. Non-Western cultures that are exposed to Western media may have a higher number of cases.
When a patient has a serious condition that requires hospitalization, the first focus of treatment is to gain weight. This may be achieved via residential programs. Depending on the state mental health law, involuntary commitment may be used. Most patients with Anorexia Nervosa are treated on an outpatient basis.
Psychotherapy is the prime method of treatment, including family therapy. There are non-profit and community groups that offer support and advice. Drug treatments have not been found to be particularly effective.
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