Anorexia Nervosa

An eating disorder characterized by inappropriate eating habits, anorexia nervosa is a diagnosed most often in women. Nine times more females than males are affected by this disorder.

Usually it involves serious weight loss caused by the restricted amount of food consumed by people affected but this disorder as they are terribly frightened about possible weight loss. Anorexia and anorexia nervosa are two distinct terms that outside the medical literature are misused interchangeably by many people.

Anorexia refers to the simple lack of appetite while people with anorexia nervosa are not losing their appetite. Actually people with anorexia nervosa are very hungry. The levels of ghrelin in their blood is really high which means their body is making them very hungry in a desperate effort to make them eat. Their body needs more nutrients than it gets.

But the people with anorexia will do anything to suppress, override or ignore that hunger call. Sometimes they will harm themselves just to override that hunger call.

The risks involved by anorexia nervosa are serious and the incidence of comorbidity is really high. Cases of extreme self-starvation are known.

People with anorexia nervosa are usually obsessed with having a thin figure and a distorted self-perception of their body.

Due to the lack of nutrition people with anorexia nervosa often experience fever, dizziness, drowsiness, headache and lack of energy. In order to compensate people might resort to harmful behaviors like smoking, excessive use of diet pills or excessive consumption of caffeine.

Though they might already be underweight, people with anorexia think of themselves as “big” or overweight.

Anorexia nervosa is not leading to physical complications only but mental health complications too.

The DSM V criteria include:

  • Continuous restriction of nutritional intake that leads to significant weight loss, below the minimal weight expected for the patient
  • Disturbed perspective of the patient over her own weight or body shape
  • Intense fear of becoming fat or gaining weight

There are two important subtypes for anorexia nervosa: those who resort to binge eating and purging behavior for weight loss and those who don’t use the aforementioned methods.

According to the DSM V the levels of severity are measured by the BMI (body mass index):

  • Mild: 17-17.99 (BMI)
  • Moderate: 16-16.99 (BMI)
  • Severe: 15-15.99 (BMI)
  • Extreme: anything less than 15 (BMI)

Anyway, people with no medical training should not use DSM V to diagnose anorexia nervosa in themselves or others. In order to get a correct diagnosis people should seek the specialist help of a trained doctor.

There are many tests that might help a trained physician to diagnose anorexia nervosa correctly, including: complete blood count, urinalysis, ELISA, western blot analysis, glucose tolerance test, liver function test, Chem-20, serum chilinesterase test, creatine kinase test, blood urea nitrogen, barium enema, EKG, thyroid screen, parathyroid hormone test, upper GI series.

The signs and symptoms of anorexia nervosa might include:

  • Amenorrhea
  • Fear of any weight gain, even the slightest
  • Lanugo
  • Refusal of to maintain a BMI that is normal for the age of the patient
  • Rapid weight loss
  • Obsession with calories content of the food
  • Swollen cheeks
  • Swollen joints
  • Hypotension
  • Purging
  • Food rituals
  • Food restrictions
  • Intolerance to cold
  • Tachycardia and Bradycardia
  • Solitude
  • Halitosis
  • Fatigue
  • Depression

Complications of anorexia nervosa might include pubertal arrest or delay, hepatic steatosis, growth retardation, acute gastric dilation, seizures, tremors, reduction of peak bone mass and death.

The treatment most often involves regular counseling sessions and in case of severe malnutrition resulting from anorexia nervosa a hospital stay might be necessary.

Anorexia Nervosa: Being Too Thin – An Inside Story