“Controlling Lives Around the World”

1. Anorexia Nervosa “Controlling Lives Around the World”

2. What is Anorexia Nervosa? • Anorexia nervosa is an eating disorder characterized by self-starvation, unrealistic fear of weight gain, and conspicuous distortion of body image.

3. Description • The term anorexia nervosa comes from two Latin words that mean "nervous inability to eat." Anorexics have the following characteristics in common: • inability to maintain weight at or above what is normally expected for age or height • intense fear of becoming fat • distorted body image • in females who have begun to menstruate, the absence of at least three menstrual periods in a row, a condition called amenorrhea

4. Description • There are two subtypes of anorexia nervosa: a restricting type, characterized by strict dieting and exercise without binge eating; and a binge-eating/purging type, marked by episodes of compulsive eating with or without self-induced vomiting and/or the use of laxatives or enemas. A binge is defined as a time-limited (usually under two hours) episode of compulsive eating in which the individual consumes a significantly larger amount of food than most people would eat in similar circumstances.

5. Causes and Symptoms • While the precise cause of the disease is not known, anorexia is a disorder that results from the interaction of cultural and interpersonal as well as biological factors.

6. Anorexia Nervosa Influences • Social • The rising incidence of anorexia is thought to reflect the present idealization of thinness as a badge of upper-class status as well as of female beauty. The onset of anorexia in adolescence is attributed to a developmental crisis caused by girls' changing bodies coupled with society's overemphasis on female appearance. • Occupational goals • The risk of developing anorexia is higher among adolescents preparing for careers that require attention to weight and/or appearance. Some example are: dancers, fashion models, professional athletes and actresses.

7. Genetic and Biological Influences • Girls whose biological mothers or sisters have or have had anorexia nervosa appear to be at increased risk of developing the disorder. • Psychological Factors A number of theories have been advanced to explain the psychological aspects of the disorder. No single explanation covers all cases. Anorexia nervosa has been given the following interpretations: -Overemphasis on control, autonomy, and independence: Some anorexics come from achievement-oriented families that stress physical fitness and dieting. Many anorexics are perfectionists who are driven about schoolwork and other matters in addition to weight control. -Evidence of family dysfunction: In some families, a daughter's eating disorder serves as a distraction from marital discord or other family tensions.

8. Diagnosis • Diagnosis of anorexia nervosa is complicated by a number of factors. One is that the disorder varies somewhat in severity from patient to patient. A second factor is denial, which is regarded as an early sign of the disorder. Many anorexics deny that they are ill and are usually brought to treatment by a family member. • Anorexia nervosa is a serious public health problem not only because of its rising incidence, but also because it has one of the highest mortality rates of any psychiatric disorder. Moreover, the disorder may cause serious long-term health complications, including congestive heart failure, sudden death, growth retardation, dental problems, constipation, stomach rupture, swelling of the salivary glands, anemia and other abnormalities of the blood, loss of kidney function, and osteoporosis.

9. Treatment Treatment of anorexia nervosa includes both short- and long-term measures and requires assessment by dietitians and psychiatrists as well as medical specialists. Therapy is often complicated by the patient's resistance or failure to carry out a treatment plan.

10. Figures for long-term recovery vary from study to study, but reliable estimates are that 40 to 60 percent of anorexics make a good physical and social recovery, and 75 percent gain weight. The long-term mortality rate for anorexia is estimated at around 10 percent, although some studies give a lower figure of 3 to 4 percent. The most frequent causes of death associated with anorexia are starvation, electrolyte imbalance, heart failure, and suicide. Prognosis

11. Key Terms • Amenorrhea—The absence or abnormal stoppage of menstrual periods. • Binge—A pattern of eating marked by episodes of rapid consumption of large amounts of food; usually food that is high in calories. • Body dysmorphic disorder—A psychiatric disorder marked by preoccupation with an imagined physical defect. • Hyperalimentation—A method of refeeding anorexics by infusing liquid nutrients and electrolytes directly into central veins through a catheter. • Lanugo—A soft, downy body hair that covers a normal fetus beginning in the fifth month and usually shed by the ninth month. Also refers to the fine, soft hair that develops on the chest and arms of anorexic women. Also called vellus hair.

12. More Key Terms • Purging—The use of vomiting, diuretics, or laxatives to clear the stomach and intestines after a binge. • Russell's sign—A scraped or raw area on the patient's knuckles, caused by self-induced vomiting. • Superior mesenteric artery syndrome—A condition in which a person vomits after meals due to blockage of the blood supply to the intestine.

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