Anorexia: Description:Anorexia is an eating disorder where people starve themselves. Anorexia usually begins in young people around the onset of puberty. Individuals suffering from anorexia have extreme weight loss. Weight loss is usually 15% below the person's normal body weight. People suffering from anorexia are very skinny but are convinced that they are overweight. Weight loss is obtained by many ways. Some of the common techniques used are excessive exercise, intake of laxatives and not eating.Anorexics have an intense fear of becoming fat. Their dieting habits develop from this fear. Anorexia mainly affects adolescent girls.People with anorexia continue to think they are overweight even after they become extremely thin, are very ill or near death. Often they will develop strange eating habits such as refusing to eat in front of other people. Sometimes the individuals will prepare big meals for others while refusing to eat any of it.The disorder is thought to be most common among people of higher socioeconomic classes and people involved in activities where thinness is especially looked upon, such as dancing, theater, and distance running.Symptoms:There are many symptoms for anorexia, some individuals may not experience all of they symptoms. The symptoms include: Body weight that is inconsistent with age, build and height (usually 15% below normal weight).Some other symptoms of anorexia are:1. Loss of at least 3 consecutive menstrual periods (in women).2. Not wanting or refusing to eat in public.3. Anxiety.4. Weakness.5. Brittle skin.6. Shortness of breath.7. Obsessiveness about calorie intake.Causes and Riskfactors:At this time, no definite cause of anorexia nervosa has been determined. However, research within the medical and psychological fields continues to explore possible causes.Some experts feel that demands from society and families could possibly be underlying causes for anorexia. For many individuals with anorexia, the destructive cycle begins with the pressure to be thin and attractive. A poor self-image compounds the problem.Other researchers feel that this disorder can stem from a particular dysfunction often seen in families of anorexia patients. In one particular type of dysfunction, family members become so interdependent that each cannot achieve their identity as an individual. Thus, family members are unable to function as healthy individuals and are dependent on other family members for their identity. In children, part of this dysfunction includes a fear of growing up (especially girls). Restrictive dieting may prevent their bodies from developing in a normal manner, and in their thinking, restricts the maturational process and maintains the parent-child relationship that the family has come to rely on. Other family situations that have been suggested, but not proved, as possibly being related to the development of anorexia nervosa include high parental expectations, poor communications skills, and problems with conflict management.Some studies also suggest that a genetic (inherited) component may play a role in determining a person's susceptibility to anorexia. Researchers are currently attempting to identify the particular gene or genes that might affect a person's tendency to develop this disorder.Although no organic cause for anorexia has been identified, some evidence points to a dysfunction in the part of the brain (hypothalamus) which regulates certain metabolic processes. Other studies have suggested that imbalances in neurotransmitter levels in the brain may occur in people suffering from anorexia.Diagnosis:Anorexia nervosa is a complicated disorder to diagnose. Individuals with anorexia often attempt to hide the disorder. Denial and secrecy frequently accompany other symptoms. It is unusual for an individual with anorexia to seek professional help because the individual typically does not accept that she or he has a problem (denial). In many cases, the actual diagnosis is not made until there are other medical complications. The individual is often brought to the attention of a professional by family members only after a marked weight loss has occurred. When anorexics finally come to the attention of the health professional, they often lack insight into their problem despite being severely malnourished and may be unreliable in terms of providing accurate information. Therefore, it is often necessary to obtain information from parents or other family members in order to evaluate the degree of weight loss and extent of the disorder.The actual criteria for anorexia nervosa are found in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).There are four basic criteria for the diagnosis of anorexia nervosa that are characteristic:The refusal to maintain body weight at or above a minimally normal weight for age and height. Body weight less than 85% of the expected weight is considered minimal.An intense fear of gaining weight or becoming fat, even though the person is underweight.Self-perception that is grossly distorted and weight loss that is not acknowledged.In women who have already begun their menstrual cycle, at least three consecutive periods are missed (amenorrhea), or menstrual periods occur only after a hormone is administered.The DSM-IV further identifies two subtypes of anorexia nervosa. In the binge-eating/purging type, the individual regularly engages in binge eating or purging behavior which involves self-induced vomiting or the misuse of laxatives, diuretics, or enemas during the current episode of anorexia. In the restricting type, the individual severely restricts food intake but does not engage in the behaviors seen in the binge eating type.Treatment:Anorexia may be treated in an outpatient setting, or hospitalization may be necessary. For an individual with severe weight loss that has impaired organ function, hospital treatment must initially focus on correction of malnutrition, and intravenous feeding may be required. A gain of between one to three pounds per week is a safe an attainable goal when malnutrition must be corrected.The overall treatment of anorexia, however, must focus on more than weight gain. There are a variety of treatment approaches dependent upon the resources available to the individual. Because of increasing insurance restrictions, many patients find that a short hospitalization followed by a day treatment program is an effective alternative to longer inpatient programs. Most individuals, however, initially seek outpatient treatment involving psychological as well as medical intervention.Different kinds of psychological therapy have been employed to treat people with anorexia. Individual therapy, cognitive behavior therapy, group therapy, and family therapy have all been successful in treatment of anorexia. Those with anorexia can be treated by a medical doctor, a clinical psychologist, or both, depending upon the progression of the disorder. A psychiatrist with both medical and psychological training is perhaps the best treatment provider. An appropriate treatment approach addresses underlying issues of control and self-perception. Family dynamics are explored, and often the family is included in the treatment plan. Nutritional education provides a healthy alternative to weight management for the patient. Group counseling or support groups often assist the individual in the recovery process. The ultimate goal of treatment should be for the individual to accept herself/himself and lead a physically and emotionally healthy life.While no medications have been identified that can definitively reduce the compulsion to starve themselves, some of the selective serotonin reuptake inhibitor (SSRI) antidepressant drugs have been shown to be helpful in weight maintenance after weight has been gained, and in controlling mood and anxiety symptoms that may be associated with the condition.Medicine and medications:The best medicine for anorexia nervosa in underweight patients is food. What researchers are wondering, though, is whether there are medications that can help the process along.Most of the promising research that exists for treatment of anorexia while in the weight-gain stage of recovery focuses on atypical antipsychotics. These drugs are normally prescribed for schizophrenia and bipolar disorder, but seem to have potential when it comes to eating disorders, as well.Zyprexa (olanzapine) has been shown effective in at least one small study for the obsessional thoughts that accompany anorexia. Limiting these thoughts can make gaining weight easier. Once a patient reaches a normal weight, she or he may not need the drug, as obsessional thoughts may decrease substantially simply through good nutrition.Further, one of Zyprexa's potential side effects is weight gain. In the case of anorexia, extra help in reaching a more healthy weight is a good thing.Seroquel is another atypical antipsychotic drug that shows promise, but very little research has been done so far.Prozac (fluoxetine) is the medication most often discussed in medical literature. But its usefulness is debatable. Some studies show a reduction in relapse rates when using Prozac, while others suggest that it's no better than a placebo.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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