Anorexia nervosa is the most serious of the presently recognized eating disorders which also include bulimia nervosa and binge eating disorder.
While bulimia nervosa is characterized by eating binges that are followed by compensatory behavior such as vomiting or laxative abuse to prevent weight gain and binge eating disorder refers to eating binges without purging, anorexia nervosa involves maintaining a below minimally-normal body weight by restricting one’s intake of food.
About half of all people with anorexia nervosa also suffer from bulimia nervosa. Also, the eating disorders are often associated with other psychiatric conditions such as depression and substance abuse.
Anorexia affects females more than males; 85-95 percent of those that suffer from the condition are females. It is more common among teenagers than the other age groups and affects primarily those belonging to the middle and upper social classes. In Western societies, it is estimated that between 0.5 to 3.7 percent of females will suffer from anorexia nervosa within their lifetime.
People who develop anorexia nervosa have an extreme fear of obesity or gaining weight. They are obsessed with becoming and remaining thin. Worse, they believe themselves to be still fat even when they are already thin and emaciated.
People with anorexia literally starve themselves. They avoid highcalorie foods and pick out a few food items which they eat in small amounts. Curiously, among people with anorexia nervosa, eating small amounts of food often starts as a voluntary behavior aimed at maintaining one’s weight to what society considers being thin, but at some point, the behavior becomes pathologic.
The exact reason people develop anorexia isn’t known. It is generally believed that the eating disorder is an attempt to cope with emotional problems. Some experts link the disorder to hereditary factors. But social factors definitely also play a role in the occurrence of the disease because in most societies, being slim is more desirable than being fat. People with anorexia nervosa are usually perfectionists with above average intelligence.
Typically, people with anorexia are more than 15 percent underweight. They have dry skin and have a growth of fine hair all over their body. They have low heart rate, blood pressure and body temperature such that they feel cold all the time.
Some develop edema (manas, in Filipino), while girls with the disorder usually stop having menstrual periods.
The health problems associated with anorexia nervosa are essentially those that occur in malnutrition. Malnutrition affects practically all organs in the body. If severe, it causes life-threatening fluids and electrolytes imbalance, abnormal heart rhythms and heart failure. As many as 20 percent of people who have been diagnosed with anorexia nervosa die from either the complications of the disease (usually heart failure and electrolyte imbalance) or from suicide secondary to a co-existing depression.
The course of anorexia nervosa is very variable. Sometimes it is mild and transient with the person recovering completely after an episode. At other times, it is a recurring behavior. While still at other times, it becomes a chronic condition that sometimes ends tragically.
The treatment of anorexia nervosa consists of two parts. The first part is aimed at restoring body weight and is best done in a hospital setting where the person is encouraged to eat. If this fails, forced feeding via a nasogastric tube or intravenous line can be resorted to.
The second part of the treatment, which starts when body weight has been restored, consists of individual and family psychotherapy to prevent a relapse.
Address inquiries on health matters to Dr. Eduardo G. Gonzales, DLSU College of Medicine, Dasmariñas, Cavite 4114.
Note: I italicized some paragraphs because those were the answers in the questions asked last June 2006 exam on test 5 about anorexia nervosa. This eating disorder is commonly asked in the board exam.. Maybe this can give you a hint kahit papano..