Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Anorexia
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. It can be fatal.
The cause of anorexia is not known. It appears that genetics and environment play a role.
A risk factor increases your chance of getting a disease or condition. Risk factors for anorexia include the following:
- Mood disorders, such as depression or generalized anxiety disorder
- Age: adolescence or early adulthood
- Emotional stress
- Familial pressure to be thin
- Families that are overprotective, rigid, not involved, or in conflict
- Family history of eating disorders
- Fear of becoming overweight
- Feelings of helplessness
- Low self-esteem
- Perfectionism
- Personality disorders
- Sex: female
- Susceptibility to social and fashion trends emphasizing or glamorizing thinness
Symptoms may include:
- Constipation
- Depression and/or anxiety
- Loss of menstrual periods (secondary amenorrhea ) or delay in menarche (onset of periods)
- Basing self-evaluation heavily on body weight or shape
- Being secretive about food
- Body dysmorphia—distorted self-image of being overweight despite evidence to the contrary
- Dieting even when thin
- Excessive exercising
- Excessive weight loss
- Fainting or severe light-headedness
- Feeling cold, especially hands and feet
- Hair loss and/or growth of fine hair on the body
- Heart palpitations
- Intense fear of gaining weight, even when underweight
- Obsession with food, calories, and fat content
Anorexia often leads to a number of serious medical problems including:
- Osteoporosis
- Amenorrhea (loss of periods)
- Cardiac problems—can be fatal
The doctor will ask about your symptoms and medical history. A physical exam will be done. There will also be psychological tests. There may be lab tests. Findings may include:
- Decreased bone density
- Excessive loss of body fat
- Loss of muscle mass
- Low blood pressure, particularly when standing
- Low heart rate
- Signs of sluggish metabolism
The goal of treatment is to get you back to a healthy weight and keep you there. A healthy weight is above 85% of your ideal weight. To achieve this, your intake of calories is gradually increased. This can be accomplished through a number of interventions, including the following:
A dietician may be consulted to help you learn more about the components of a healthy diet. The dietician will also talk to you about reasonable weight goals and calorie goals.
Cognitive-behavioral therapists 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.
Therapy can help you understand and cope with concerns about your relationships.
Families often play a role in eating disorders. Many patients cannot recover unless their families are involved in the changes. All families need to understand the disorder and provide support.
In some cases, anorexic patients benefit from a combination of psychotherapy and antidepressant medication. In particular, selective serotonin reuptake inhibitors (such as sertraline [ Zoloft ] or fluoxetine [ Prozac ]) are used. Used alone, antidepressant therapy is not an effective treatment for anorexia.
Medications and supplements may include:
- Hormone replacement to resume menstruation and prevent bone loss
- Vitamins and minerals to maintain adequate nutrition
Hospitalization may be necessary if:
- There are signs of serious physical or emotional deterioration
- Weight is 25%-30% below ideal body weight
If you are diagnosed with anorexia, follow your doctor's instructions .
There are no guidelines for preventing anorexia. Early detection and treatment is the best option.
Last reviewed: November 2009 by Rosalyn Carson-DeWitt, MD .
- National Association of Anorexia Nervosa and Associated Disorders
http://www.anad.org/ - National Eating Disorders Association
http://www.nationaleatingdisorders.org/
- Canadian Mental Health Association
http://www.ontario.cmha.ca/ - National Eating Disorder Information Center
http://www.nedic.ca/
- Anorexia nervosa. National Eating Disorders Association website. Available at: http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286 . Accessed June 19, 2008.
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