Written by Dr.M.D.Mazumdar, MD
Anorexia Nervosa is a complex psychological disorder which affects the entire body including the reproductive tract.
What is Anorexia nervosa?
Anorexia Nervosa is a potentially life-threatening disorder in which a person does not take enough nutrition to maintain the minimum body weight necessary for a healthy body. The body weight is usually 15% or more below the normal weight for that age.
It is characterized by
- Extreme dietary restrictions
- An intense fear of gaining weight
- A distorted body image.
People with this disorder may have an intense fear of weight gain, even when they are underweight. They may diet or exercise too much or use other ways to lose weight.
Food and weight gain becomes obsessions. Most people with anorexia nervosa develop strange eating habits. They like cooking large and elaborate meals for others which they themselves do not eat.
They refuse to eat in public and hide food when they do so. They cut their food into small particles and nibble at only a little of it while giving the impression of eating well.
Loss of weight is achieved mainly by eating only low calorie food like lettuce, spinach and popcorns and excessive exercising. The daily calorie intake may be less than 1000 calories.
Persons especially at risk for developing Anorexia Nervosa:It is commonly seen in young girls in their teens or in the early twenties. But it can affect men as well as older women.
- Aspiring models
- Film stars
- Dancers,especially ballet dancers who need to keep a very slender figure.
- TV personalities and athletes for whom being thin is an important necessity.
- Young girls and boys, especially teenagers, who are under a lot of peer pressure to be thin, and who equate thinness with beauty, can also suffer from anorexia.
- People having an anxiety disorder or eating problem during infancy or early childhood.
- People with a negative self-image.
- People who live in societies with certain social or cultural ideas about health and beauty
Causes of Anorexia NervosaThe exact causes of anorexia are not known. Many factors may be involved. Genes and hormones may play a role. Social attitudes that promote very thin body types may also be involved. The cause is thought to be a mix of genetic, biochemical, psychological, and social factors.
Causes of Anorexia Nervosa
- Genetic - Studies suggest that anorexia may be partially inherited, as many people in the family have the same condition. Individuals with a first-degree relative that struggled with anorexia nervosa are more likely to develop it. Anorexia is also associated with certain genetic mutations that affect the metabolism of neurotransmitters (chemicals in the brain that help regulate mood and appetite).
- Biological - Excessive dieting and staving can trigger anorexia nervosa. There is strong evidence that many of the symptoms of anorexia are actually symptoms of starvation. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction in appetite.
- Psychological - Individuals with previous mental health diagnoses are more likely to develop eating disorders in general. Anorexia is commonly seen to co-occur with anxiety disorders as well as obsessive-compulsive disorders. Psychological traits such as perfectionism, low self-esteem, and difficulty expressing emotions can contribute to the development of anorexia.
- Social - Social attitudes that promote very thin body types may be an important cause, especially in young girls who look up to models and film actresses as role models.
Types of Anorexia nervosa
There are two types of Anorexia Nervosa:
Severity of Anorexia according to the BMI
Body Mass Index (BMI) is commonly used to determine the severity of anorexia nervosa. But it is not the only criterion - other criteria such as behavioral, psychological and medical conditions should also be considered.
The BMI or Body Mass Indicator indicates the weight status of an individual. It varies according to the severity of Anorexia nervosa:
Symptoms of Anorexia Nervosa
Anorexia Nervosa affects all the systems of the body, producing a number of symptoms.
Symptoms of Anorexia Nervosa
Complications of Anorexia Nervosa
The severe lack of nutrition and calories causes a number of medical problems.
Treatment of Anorexia Nervosa
Treatment of anorexia nervosa is very difficult. The main goals of treatment are (1) regain a healthy weight,(2) improve mental health and (3)reduce or eliminate symptoms of the disorder. The aim should be a weight gain of at least 1 to 3 pounds per week
Fortunately, much of the medical complications like amenorrhea and heart palpitations revert back to normal with an improvement in the body weight.
Treatment of anorexia nervosa usually involves a combination of approaches tailored to individual needs. Below are some common treatment options for anorexia nervosa.
- Psychotherapy: This is often the first line of treatment for anorexia nervosa. Different types of psychotherapy can be used, such as Cognitive-behavioral therapy (CBT), DBT, and Family-Based therapy to help change negative thoughts and behaviours. Family based therapy is essential as it involves family members in the treatment process and has been shown to be more successful than individual therapy.
- Medical Treatment: People with anorexia nervosa often require medical treatment to manage the physical complications of the condition. This may include refeeding or force feeding and monitoring of vital signs. Treatment of underlying medical conditions are also needed. Recent studies has shown medical marijuana can help stimulate appetite and decrease depression in these individuals.
Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) may be prescribed to relieve symptoms of depression, anxiety and obsessive-compulsive disorder associated with anorexia nervosa.
- Nutrition Advice: Diet is the most essential factor to work on in people with anorexia nervosa, and must be tailored to each person's needs. A dietician or nutritionist can work with patients to develop a healthy eating plan with foods that are higher in energy density and educate the family about nutritional needs.
- Hospitalization: In some cases, people with anorexia nervosa require hospitalization to treat serious medical complications and ensure adequate nutrition. It is important to note that recovery from anorexia nervosa is a lengthy process, often involving multiple stages and relapses.
If anorexia nervosa is not treated, serious complications such as heart conditions and kidney failure can arise and eventually lead to death. The average number of years from onset to remission of Anorexia Nervosa is seven for women and three for men.
Can anorexia nervosa be prevented?
Preventing the development of anorexia nervosa can be difficult because the exact cause of the disorder is not fully understood. However, there are some steps that can be taken to reduce the risk of developing anorexia nervosa and to catch the disorder early when it is more treatable.
Anorexia Nervosa is a complex psychological and behavioural disorder which needs empathy and understanding from family and medical practitioners. It is important to remember that it is treatable. An individual can struggle yet receive appropriate treatment and live a life free from food rules, dieting, and restrictions.
Anorexia nervosa has the highest mortality rate of any psychological disorder. The mortality rate is 11 to 12 times greater than in the general population, and the suicide risk is 56 times higher. The mortality rate or the rate of death of Anorexia nervosa is quite high at 7 - 10%.
Half of women with AN achieve a full recovery, while an additional 20-30% may partially recover. Not all people with anorexia recover completely: about 20% develop anorexia nervosa as a chronic disorder.
- Female Reproductive Anatomy.
- Birth Control Methods.
- Vaginal Discharge with Itching .
- Different Sexually Transmitted Diseases.