What Is Anorexia Nervosa?
Anorexia nervosa is a type of
eating disorder in which people can literally starve themselves to death. People with anorexia nervosa eat very little even though they are already thin. They have an intense and overpowering fear of body fat and weight gain, with repeated dieting attempts and excessive weight loss.
People with anorexia nervosa are often characterized as overachievers and perfectionists who appear to be in control. In reality, they suffer from low self-esteem and overly criticize themselves. They are also very concerned about pleasing others.
Anorexia nervosa affects from 0.5 to 1 percent of the female adolescent population, with an average age of onset between 14 and 18 years. An estimated 0.5 to 3.7 percent of females suffer from anorexia nervosa in their lifetime.
Symptoms of Anorexia Nervosa
Anorexia nervosa is identified, in part, by refusal to eat, an intense desire to be thin, repeated dieting attempts, and excessive weight loss.
To maintain an abnormally low weight, people with anorexia nervosa may diet, fast, or over-exercise. They often engage in behaviors such as self-induced vomiting or the misuse of laxatives, diuretics, or enemas. People with anorexia nervosa believe that they are overweight even when they are extremely thin.
Anorexia nervosa will often develop after a stressful life event, such as the beginning of puberty or moving out of the parents' home.
Diagnosing Anorexia Nervosa
A diagnosis of
anorexia nervosa occurs if the following are present:
- The person weighs at least 15 percent below what is considered normal for others of the same height and age
- The person misses at least three consecutive menstrual cycles (if a female of childbearing age)
- There is an intense fear of gaining weight
- The person refuses to maintain the minimal normal body weight
- There is a belief that he or she is overweight, although, in reality, this person is dangerously thin.
Treating Anorexia Nervosa
The first goal for the treatment of anorexia nervosa is to ensure the person's physical health, which involves restoring a healthy weight. Reaching this goal may require hospitalization. Once a person's physical condition is stable,
treatment for anorexia usually involves individual psychotherapy and family therapy, during which parents help their child learn to eat again and maintain healthy eating habits on his or her own. Behavioral therapy also has been effective for helping a person with anorexia return to healthy eating habits. Supportive group therapy may follow, and self-help groups within communities may provide ongoing support.
Health Risks With Anorexia Nervosa
Anorexia nervosa can slow the heart rate and
lower blood pressure, increasing the chance of
heart failure. Those who use drugs to stimulate vomiting, bowel movements, or urination are also at a high risk for heart failure. Starvation resulting from anorexia nervosa can lead to heart failure, as well as damage to the brain.
Anorexia nervosa may also cause hair and nails to grow brittle.
Skin may dry out, become yellow, and develop a covering of soft hair called lanugo.
Mild anemia, swollen joints, reduced muscle mass, and light-headedness also commonly occur as a consequence of anorexia nervosa.
Severe cases of anorexia nervosa can lead to brittle bones that break easily as a result of calcium loss.
Anorexia Nervosa: Prognosis
The course and outcome of
anorexia nervosa vary among individuals: some fully recover after a single episode; some have a fluctuating pattern of weight gain and relapse. Others experience a chronically deteriorating course of the illness over many years.
The mortality rate among people with anorexia nervosa has been estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15 to 24 in the general population. The most common causes of death are complications of the disorder, such as cardiac arrest or electrolyte imbalance, and suicide.
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