Anorexia Nervosa

EATING DISORDER

When I weighed 120 lbs. I thought that if I weighed 110 lbs. I would be thin. When I weighed 110 lbs I thought I would feel better if I weighed 100. Now I weigh 99 lbs. and I still feel fat. - 18 year-old anorexic

What is Anorexia Nervosa?

goes beyond concern about obesity or out-of-control dieting initially begins dieting to lose weight This cycle becomes an obsession and, in this way, is similar to an addiction.

What causes Anorexia Nervosa?

no definite cause Studies suggest :
Genetic dysfunction in the part of the brain
Hypothalamus Imbalances in Neurotransmitter

Feeding problems as an infant

Additional possible causes include:

high level of negative feelings perfectionism victim of childhood abuse

Who is at risk for Anorexia Nervosa?

Female (95%)
most often teenage girls

Caucasians People for whom thinness is especially desirable, or a professional requirement

Athletes models dancers actors

How is Anorexia Nervosa Diagnosed?

History taking Administer questionnaires for anorexia as part of screening for the disorder.

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Four basic criteria:
The refusal to maintain body weight at or above a minimally normal weight for age and height (maintaining a body weight less than 85% of the expected weight)

An intense fear of gaining weight or becoming fat, even though the person is underweight

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Self-perception that is grossly distorted, excessive emphasis on body weight in selfassessment, and weight loss that is either minimized or not acknowledged completely In women who have already begun their menstrual cycle, at least three consecutive periods are missed, or menstrual periods occur only after a hormone is administered.

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two subtypes of anorexia nervosa:
the binge-eating/purging type restricting type

Signs and Symptoms (psychological and behavioral)

seriously underweight -> depression and social withdrawal. become irritable and easily Disrupted -> fatigue Decreased attention and concentration obsessed with food and thoughts of food Other psychiatric problems such as affective (mood) disorders, anxiety disorders, and personality disorders.

 compliant in every other aspect of their life except for their relationship with food perfection are critical issues men tend to co-occur with other psychological problems and more commonly follow a period of being overweight than in women. Men with anorexia also tend to be more likely to have a distorted body image.

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women tend to more frequently include a general displeasure with their body and a possibly stronger desire to be thin. Women with anorexia also tend to experience more perfectionism and cooperativeness. Due to the growth and development inherent during childhood and adolescence->slowing of the natural increase in height or a slowed increase in development of other body functions

Signs and Symptoms (Physical)

Heart and Circulatory:
Bradicardia Hypotension Arrythmia Reduction in work capacity of the heart

GI Complications
Constipation and abdominal pain Decreased food absorption Changes in liver enzymes (some)

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Glandular (endocrine) system
Disturbances in the menstrual cycle are frequent, and secondary amenorrhea Hormonal imbalances restrictive eating can trick the thyroid into thinking that the body is starving, causing it to slow down in an attempt to preserve calories When anorexia occurs in a person who also has diabetes mellitus (a tendency toward very high blood sugar levels), the risk of death is higher than in people who have either anorexia or diabetes mellitus alone.

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Kidney (renal) function
increased or decreased urination or potentially fatal potassium deficiency Diabetes insipidus

Bone density loss electrolyte imbalance Anemia high total cholesterol levels.

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Physical symptoms
obvious loss of weight (>BMI) dry, flaky skin that takes on a yellow tinge Brittle nails Erosion of Dental enamel -> loss of tooth Trouble maintaining consistent body temp

How is Anorexia Nervosa Treated?

Most medications treat symptoms that are associated with anorexia much better than they address the specific symptoms of anorexia themselves. Maudsley model of family therapy focus on more than just weight gain and often involves a combination of individual, group, and family psychotherapies in addition to nutritional counseling.

Medical Management
olanzapine (Zyprexa, Zydis), risperidone(Risperdal), and quetiapine (Seroquel)
selective serotonin reuptake inhibitor (SSRI) antidepressant drugs

Isabelle Caro
BEFORE AFTER

ISABELLE CARO 12 September 1982 to 17 November 2010)