Anorexia Nervosa Information
(from the National Alliance for the Mentally Ill)

Anorexia nervosa is a life-threatening eating disorder defined by a refusal to maintain body weight within 15 percent of an individual's minimal normal weight.

Other essential features of this disorder include an intense fear of gaining weight, a distorted body image, and amenorrhea (absence of at least three consecutive menstrual cycles when otherwise expected to occur) in women.

Sometimes people starve and binge-purge, depending on the extent of weight loss. This can be physically very dangerous. People who present an on-going preoccupation with food and weight even at lesser weight reductions would benefit from exploring their cognitive and relationship skills.

The term anorexia literally means loss of appetite, but this isn't a true symptom of the disorder. In fact, people with anorexia are usually hungry, but they control their eating. This is frequently sublimated through cooking for others or hiding food in their personal space which they will not eat.

Who develops anorexia?

Like all eating disorders, it tends to occur in pre or post puberty, but can develop at any life change. Anorexia nervosa predominately affects adolescent girls, although it can also occur in men and older women.

One reason younger women are particularly vulnerable to eating disorders is their tendency to go on strict diets to achieve an "ideal" figure. This obsessive dieting behavior reflects a great deal of today's societal pressure to be thin, which is seen in advertising and the media.

Others especially at risk for eating disorders include athletes, actors, and models for whom thinness has become a professional requirement.

How many people suffer from anorexia?

Conservative estimates suggest that one-half to one percent of females in the U.S. develop anorexia. Because more than 90 percent of all those who are affected are adolescent and young women, the disorder can be characterized as primarily a women's illness.

It should be noted, however, that children as young as 7 have been diagnosed, and women 50, 60, 70, and even 80 fit the diagnosis.

How is the weight lost?

People with anorexia usually lose weight by reducing their total food intake and exercising excessively. Many persons with anorexia nervosa restrict their intake to 1,000 calories a day or less. Most avoid fattening, high-calorie foods and eliminate red meat or meat altogether.

The diet of persons with anorexia may consist almost completely of low-calorie vegetables like lettuce and carrots or popcorn.

What are the common signs of anorexia?

The hallmark of anorexia nervosa is denial and preoccupation with food and weight. In fact, all eating disorders share this trait including binge eating disorder and compulsive eating.

One of the most frightening aspects of the disorder is that people with anorexia continue to think they look fat, even when they are bone-thin. Their nails and hair become brittle, and their skin may become dry and yellow. Depression is common in patients suffering from this disorder.

People with anorexia often complain of feeling cold (hypothermia) because their body temperature drops. They may develop long, fine hair on their body as a way of trying to conserve heat.

Persons with anorexia develop strange eating habits such as cutting their food into tiny pieces, refusing to eat in front of others, or fixing elaborate meals for others that they themselves don't eat. Food and weight become obsessions as people with this illness constantly think about their next encounter with food.

Generally, if a person fears she may have anorexia, she should see a doctor to rule out other physical disorders.

What are the causes of anorexia?

Knowledge about the causes of anorexia is inconclusive, and the causes may be varied. In an attempt to understand and uncover the origins of eating disorders, scientists have studied the personalities, genetics, environments, and biochemistry of people with these illnesses.

Certain personality traits common in persons with anorexia are low self-esteem, social isolation, and a perfectionist attitude. These people tend to be good students and excellent athletes.

Eating disorders also tend to run in families, with female relatives most often affected. A girl has a 10- to 20-times higher risk of developing anorexia, for instance, if she has a sibling with the disease.

This finding suggests that genetic factors may predispose some people to eating disorders or acceptance of the social ideal of thinness by selves and parents.

Behavioral and environmental influences may also play a role. Eating disorders are seen primarily in Western and industrialized countries, where slimness is a model of attractiveness.

Stressful events are likely to increase the risk of eating disorders as well, but this is the case for psychiatric disorders in general.

In studies of the biochemical functions of people with eating disorders, scientists have found that the neurotransmitters serotonin and norepinephrine are decreased in those with anorexia, which links them with patients suffering from depression. This link is supported by studies showing that certain antidepressants can be used to successfully treat some people with eating disorders.

People with anorexia also tend to have higher than normal levels of cortisol (a brain hormone released in response to stress) and vasopressin (a brain chemical found to be abnormal in patients with obsessive-compulsive disorder).

Other psychiatric disorders can occur together with anorexia, such as OCD, self mutilation, or bipolar disorder.

In general, people with anorexia nervosa have responded minimally to antidepressants. The most effective strategy for treating a patient has been weight restoration within 10% of normal and individual and family therapy.

Are there medical complications?

The starvation experienced by persons with anorexia nervosa can cause damage to vital organs such as the heart and brain. Breathing, pulse, and blood pressure rates drop, and those suffering from this illness may experience irregular heart rhythms or heart failure.

Nutritional deprivation causes calcium loss from bones, which become brittle and prone to breakage. In the worst-case scenario, people with anorexia can starve themselves to death. Eating disorders have among the highest mortality rates of all mental disorders, killing up to 6 percent of their victims.

Is there treatment available?

Luckily, most of the complications experienced by persons with anorexia nervosa are reversible when they gain weight. It is important that people with this disorder be diagnosed and treated as soon as possible because eating disorders are most successfully treated when diagnosed early

Some patients can be treated as outpatients, but some may need hospitalization to stabilize their dangerously low weight. Most patients will regain the weight at a rate of 1-3 pounds per week.

To help people with anorexia overcome their disorder, a variety of approaches are used. Some form of psychotherapy is needed to deal with underlying emotional issues. Cognitive-behavioral therapy is sometimes used to change abnormal thoughts and behaviors.

Group or family therapy is often advised so people can share their experiences with others. A physician is needed to prescribe medications useful in treating the disorder.

Finally, a nutritionist may be necessary to advise the patient about proper diet and eating regimens.

For more information about eating disorders call the National Association of Anorexia Nervosa and Associated Disorders at (847) 831-3438.

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