Introductory Remarks

Anorexia refers to loss of appetite and inability to eat food and this can be due to an illness. Anorexia nervosa is an eating disorder characterized by intentional restricted food intake and deliberate loss of weight. It is a mental health disorder.

This disorder can affect any person, regardless of age, sex, race or financial status. These disorder can occur alongside various mental health disorders such as:

• Anxiety.
• Obsessive-compulsive disorder (OCD).
• Post-traumatic stress disorder (PTSD).
• Borderline personality disorder.

 

 Essential Statistics and Key Facts

Facts and  figures

• Anorexia nervosa commonly affects people assigned female at birth (AFAB). Female to male ratio of individuals with anorexia nervosa is 10:1.
• Approximately up to 1% of the United States population is affected by this condition.
• It is estimated that about 9% of individuals living in the US will have an eating disorder at some point of their lives.
• Effects of anorexia nervosa are highly likely to threaten lives of male individuals as compared to their female counterparts.
• A study carried out in 2015 found out that individuals suffering from anorexia nervosa might actually have gut microbiota that is different as compared to normal individuals.
• Another study was conducted which found than less than 6% of persons with eating disorders were underweight.

 

Risk Elements & Causal Factors

Risk factors

• A history of dieting.
• Past trauma such as racism.
• Being bullied about body figure and weight.
• Anxiety.
• Pressure and influence to fit within trends or fashions.
• Type 1 diabetes.
• Family history, where a close relative or family member has been previously diagnosed with the condition.
• Sexual orientation and gender identity. Individuals who identify with LGBTQ+ community have higher likelihood of having an eating disorder as compared to their fellow heterosexual persons.

 

Causes

• According to research, a mixture of several factors might be responsible for anorexia nervosa. These can be:

1.  Genetics.
2.  Changes in brain chemicals.
3. Peer pressure.
4. Trauma such as physical abuse.

 

 Signs & Symptoms

• There are 3 common groups of signs and symptoms in anorexia nervosa. They are:

1. Physical signs and symptoms.
2. Mental signs and symptoms.
3. Behavioral signs and symptoms.

Physical signs and symptoms:

• Significant loss of weight over weeks or various months.
• Unexplained changes in body mass index (BMI) in children and adults.
• Inability to maintain appropriate body weight in relation to height, age and sex of the individual.

 

Other physical signs and symptoms which are side effects of starving and malnutrition are:

• Arrhythmia.
• Hypotension.
• Dry skin.
• Poor wound healing.
• Frequent disease episodes.

 

Mental and emotional manifestations:

• Distorted body image.
• Being highly obsessed with foods and other calorific stuff.
• Fear of gaining weight.

 

Behavioral signs and symptoms:

• Excessive engagement in physical exercises.
• Putting on baggy clothing to hide loss of weight.
• Unhealthy limiting of calories.
• Feeling fat despite having lost sufficient weight.
• Changes in eating behaviors.
• Misuse of appetite suppressant drugs.

 

Types

• 2 types of anorexia nervosa are:

1.  Restrictive anorexia.
2.  Binge-purge anorexia.

 

 Diagnostic Procedures

• Anorexia nervosa is a mental disorder.
• It is diagnosed according to three criteria for anorexia nervosa which are listed in the Diagnostic and Statistical Manual of Mental Disorders. These are:

1.  Intense fear to become fat or gain additional weight.
2.  Having a distorted self-image.
3.  Unhealthy restriction of calorie intake which leads to weight loss and low body weight for respective age, height and sex.

 

• Individuals that present with signs and symptoms of anorexia must undergo a:

1.  Full review of medical history.
2. Physical examination.
3. Lab tests. Laboratory testing can be conducted to rule out health conditions which could cause loss of weight.

 

Treatment & Management

Goals of treatment:

1. To stabilize loss of weight.
2. To restore weight.
3. Treat psychological problems such as low self-esteem

 

Treatment strategies:

1. Talk therapy (psychotherapy).
2. Medications.
3. Hospitalization.

 

Talk therapy (psychotherapy) forms;

1.  Cognitive behavioral therapy (CBT).
2.  Dialectical behavioral therapy (DBT).
3.  Interpsersonal psychotherapy (IPT).

Medications. Drugs such as olanzapine (an anti-pschotic drug) can aid in weight gain.

Hospitalization. This is recommended to treat severe loss of weight which has le to malnutrition and other complications such as heart disorders and sever depression.