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Anorexia Nervosa

Overview

The term anorexia literally means loss of appetite and nervosa indicates that the loss is due to emotional reasons. Considering this, the term is actually somewhat of a misnomer because patients suffering from this disorder do not loose their interest in food or suffer from a loss in appetite. In contrary, they might actually become increasingly preoccupied with food, for example, preparing gourmet meals for others. A patient suffering from this disorder refuses to maintain normal body weight, always fears that he/she will become obese and feels fat no matter how thin they actually maybe. Anorexia nervosa can be a life threatening situation. Gymnast Christy Henrich died from this disorder in the year 1994.

An anorexic has the tendency to consistently starve oneself in order to maintain a thin frame. They refuse to maintain a healthy body weight and despite weighing extremely less, they perceive themselves as fat. They constantly look for ways to reduce their perceived ‘excessive’ fat such as heavy use of laxatives, excessive exercise; self-induced vomiting etc. people with this disorder also always fear that they might be putting on too much weight and a reduction in their body weight doesn’t change this false belief. Also, these patients have an imprecise view of their body shape. Despite being razor thin, they might feel that certain parts of their bodies are excessively out of proportion or too fat. For example, they think that certain parts such as their thighs, buttocks or abdomen are too fat. They evaluate their reflections critically and their self esteems are highly related to their belief of maintaining thinness. In females, extreme weight loss during such a condition is usually linked with the loss of the menstrual period. However, this criterion is not usually considered of much importance in diagnosing the disorder.


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Causes

The disorder is said to be highly genetic – running in families. First degree relatives of anorexic women are over ten times more likely than average women to have this disorder. Also, a study of the brain with relation to anorexia reveals that patients with anorexia are found to have abnormal levels of hormones released by the hypothalamus (for example, cortisol, which is released into the body by the hypothalamus). However, these hormonal abnormalities are due to the self starvation induced by the patient and return to normal levels following weight gain.

On very important cause of anorexia is the sociocultural influence mainly involving the perception of what women think is the right body structure. Over time the standards of body shape and size considered desirable and attractive have been changing. No matter how much the think the models on the ramp these days appear, for many women, that figure is surely desirable. This strong desire to stick to what the society appreciates and admires have led many young women into starving themselves to worryingly dangerous extents. Another indication of our society’s preoccupied with thinness is what happened with Miss Universe of 1996, Alicia Machado. When after winning the title, she gained a few pounds; some people became outraged and suggested that she give up her crown.


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Signs & Symptoms

There are commonly two types of anorexia nervosa – the restricting type and the binge-eating-purging type. The restricting type applies to those who limit their intake of food in order to lower body weight. The binge-eating-purging type are those who indulge in excessive (or binge) eating and then purposely indulge in purging. These types of patients are usually associated with other psychopathological symptoms such as personality disorders, social withdrawal, alcohol and drug abuse, impulsive behavior, stealing and suicidal attempts than patients of the restricting type. Patients with anorexia nervosa have been usually diagnosed with depression, mood disorders, phobias, panic disorder and various personality disorders. It is found to be ten times as more common in women than in men. In men, anorexia is associated with mood disorders, substance disorders and schizophrenia.

Owing to excessive use of laxatives and starvation, there are numerous undesirable physical changes that may take place in the patient. These include loss of hair from the scalp, brittle nails, declining of the bone mass, drying of the skin, slowing of heart rate, gastrointestinal and kidney problems and a fall in blood pressure. There may also be some excessive loss of salts and structural changes in the brain may also occur.

It is found that almost 70 percent of the patients recover from this disorder, however, owing to the excessively severe physical complications anorexia nervosa is highly likely to turn into a life threatening disorder.

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Prevention

Anorexia nervosa is a psychological disorder which cannot be prevented, but to stop the condition from becoming worse, early detection of the symptoms, followed by psychological counselling can be beneficial.


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Treatments
Family Therapy Psychotherapy

Treating an eating disorder is usually very difficult because the patient refuses to acknowledge the fact that he or she has a problem. Owing to this almost 90 percent of people with this disorder are not in treatment. Hospitalization is usually necessary as it is the most appropriate way to ingest food in monitored conditions. Drugs have been used to treat to the disorder but they have proved highly unsuccessful. Family therapies seem to be the preferred way of the psychological treatment of anorexia. The family therapy aim at the following:
1.    Changing the patient role of the patient with anorexia.
2.    Redefining the eating problem as an interpersonal problem.
3.    Preventing the parents from using their child’s anorexia as a means of avoiding conflict.
Family therapy like else have been constantly under scanner but is proved to be quite successful.

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