The Skinny on Anorexia
It's got a fancy Latin name: anorexia nervosa, "nervous want of appetite." It's a killer. One in 10 cases ends in death. People with anorexia starve themselves by eating far too little food. Eventually they become dangerously thin -- yet they still see themselves as fat. People with this eating disorder may become so undernourished that they have to be hospitalized. Even then they often deny that anything is wrong with them. Anorexia usually begins around the time of puberty. Nine out of 10 people with anorexia are female; one in 100 U.S. women is anorexic. Technically, anorexia is when a person eats so little that their weight drops at least 15% below normal body weight. Often anorexia is linked to another eating disorder, bulimia, in which people periodically go on eating binges and then forces themselves to vomit the food they have eaten. A person with anorexia becomes obsessed about food and weight. Some people develop strange eating rituals and may refuse to eat in front of other people. Many people with anorexia seem to care a lot about food. They may collect cookbooks and prepare sumptuous meals for their friends and families -- but they don't join in. Often the refusal to eat is paired wi
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) (Raeburn, 2002). Behavioral and environmental influences may also play a role. Are there medical complications?The starvation experienced by persons with anorexia nervosa can cause damage to vital organs such as the heart and brain. Nutritional deprivation causes calcium loss from bones, which become brittle and prone to breakage (Grinspoon, 2001). 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. Doctors should pay attention to bone loss and heart function. Other psychiatric disorders can occur together with anorexia, such as OCD, self-mutilation, or bipolar disorder. Stressful events are likely to increase the risk of eating disorders as well, but this is the case for psychiatric disorders in general. A girl has a 10- to 20-times higher risk of developing anorexia, for instance, if she has a sibling with the disease. Health care providers should have specific experience in treating eating disorders as well as expertise in working with adolescents and their families. Physical problems can include anemia, heart palpitations, bone loss, and tooth decay. The treatment team should include a mental-health professional and a primary care doctor. This link is supported by studies showing that certain antidepressants can be used to successfully treat some people with eating disorders. These people tend to be good students and excellent athletes (Polivy, 2002). Anorexia nervosa predominately affects adolescent girls, although it can also occur in men and older women.
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