Anorexia Nervosa: An Eating Disorder

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Anorexia Nervosa (AN) is not as uncommon as is usually believed.
1 in 200 women suffer from the eating disorder. 90 percent of anorexia nervose are young girls in between 12 and 30 years of age; the peak incidence being at 16 to 17 years of age.

Right from 13 years of age, anorexia nervose is noted to be more common in girls. And as children progress through their teens, girls are found to be 3 times more frequently affected. This could possibly be, because puberty associated body structure changes in teenage girls, make them more prone to negative body image than the boys at that age.

Causative factors

Psycho-social, genetic, biological and environmental factors make children prone to grossly distorted concept of their body image and unrealistic fear of weight gain that leads to self-starvation.

Type1 Diabetes like chronic illnesses further disturb the psychological balance of the adolescents who are socially and genetically predisposed to the eating disorder; many of them remain at sub threshold level for clinical diagnosis of anorexia nervosa.

Studies show that up to 40% of the young female diabetics even fiddle with their prescribed Insulin dose to control their body weight. 

Presenting features

Calling the affected children anorectics would be wrong!
There never is any loss of appetite, nor are they disinterested in food; at least not in the initial stage of the disorder. Anorexia nervosa teenagers impose severe restrictions on self for fear of becoming obese. Yet others go through the cycle of binge eating, bulimia and exercising.

50% of anorexic nervose also suffer from teenage depression, but are not inclined to substance abuse, alcoholism or suicidal tendencies. However, the death rate if not intervened early and efficiently is high. Death occurs due to disturbed body metabolism, hormonal imbalance and compromised heart functions.   

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Telltale signs of AN

Anorexia Nervosa: Telltale Signs
  • Anorexia nervosa dread obesity.

  • Fear of being obese haunts them even when they are grossly underweight.

  • Disturbed body image distorts AN affected teenagers' perception of self and damages their self concept.

    Consequently, their fear of being obese gets reinforced and perpetuated even when they fall far below the normal expected weight on their age and sex specific BMI and growth chart. 

  • At puberty, girls suffering from anorexia nervose do not develop normal menstrual cycles, or they develop amenorrhea (absence of monthly menses) subsequently as the disease advances.

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Behavioral patterns in cases of anorexia nervose

Anorexia Nervosa: Behavior Pattern
  • Behavior pattern of anorexia nervose youths is typically that of obsessive compulsive personality: Rigid in views, intellectualizing, perfectionists, suspicious, manipulative and dominating.

  • Poor ability to balance the right and the wrong hinders them to accept that both could exist together in a normal society.

  • Idealistic expectations of exacting behavior and their mood swings deprive them of the much needed companionship.

  • Depression, stress, social isolation along with hormonal imbalance mask their sexual drive.

  • Many women with AN are unable to accept the female role and fear pregnancy.

  • Anorectics usually deny the fact that they are suffering, and continue to remain cheerful, alert and active till their body begins to fail them. 

Common physical signs

  • Anxious look

  • Emaciated body

  • Sunken eyes

  • Scanty thin hair on scalp

  • Lanugo hair on body

  • Dry skin

  • Cold intolerance

  • Signs of cardiac dysfunction

Progression of the disease

75% of anorexia nervosa cases go into remission of the disease, and one third even attain expected normal weight. However, 25% continue to be chronic anorectics.

The prognosis is jeopardized by medical complications and coexisting psychiatric disorders like substance abuse, anxiety, depression, mood disorder, obsessive compulsive disorder and psychosis. Consequently, 10% cases of anorexia nervose succumb to the disease.

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