Alternative names: Anorexia nervosa
Anorexia is a serious eating disorder in which people deliberately starve themselves to lose weight. No matter how thin they become, they still see themselves as being overweight.
Although eventual outcomes of anorexia and starvation are very similar, it is important to rule out one or the other. Anorexia is primarily psychological and not simply due to appetite loss whereas starvation may be due to physical, environmental or other factors.
Although here we will discuss only anorexia, several of the recommendations will also help overcome the effects of starvation.
There are two types of anorexia, both sharing essentially the same symptoms. Binge/purge anorexia involves self-induced vomiting, laxative abuse, or excessive exercise after eating. Restrictive anorexia involves severe calorie intake restriction, well below the body's needs.
More than 90% of people with anorexia are females, though a growing number of males now have the disorder. In Western countries, anorexia is estimated to affect between 1-in-100 and 1-in-20 women, and between 1-in-500 and 1-in-300 men at some point during their lives. The most common age of onset is between the ages of 13 and 18.
Although the exact cause is not known, anorexia can be triggered by a severe emotional shock.
Common risk factors include:
Common signs and symptoms of starvation in general include:
Common signs and symptoms of anorexia specifically include:
A health care provider will generally ask questions about eating habits (how much and what is being eaten), current circumstances, family history, and exercise patterns. A psychological evaluation is often performed.
Further possible tests are generally used to look for malnutrition-related health deterioration and other possible explanations for the excess weight loss:
If anorexia nervosa is suspected then the patient should be referred to a therapist or psychiatrist who understands eating disorders.
The severity of anorexia can be roughly gauged in adults by the patient's Body Mass Index (BMI):
The BMI metric is unreliable for those under 18, so a BMI-for-age percentile can be used instead.
Treatment involves bringing the patient back up to a healthy weight, while at the same time identifying and treating any underlying psychological disorder.
It is best to get treatment as soon as the symptoms appear, from a psychiatrist specially trained both in treating the disorder and in nutritional counseling. The patient may receive cognitive-behavioral, group, relaxation, or psychodynamic therapy, and be shown how to "relearn" correct eating habits. In severe cases, hospitalization may be needed. Long-term monitoring and support is necessary.
For some patients anorexia will be a one-off episode, whereas for others it may will recur over the years. Many of the complications of anorexia will resolve or improve once a healthy weight has been regained.
Starvation can cause complications in every major organ system of the body: without proper treatment, the disorder can be fatal, with anorexia having the highest mortality rate of any psychiatric disorder.
Low potassium levels can cause arrhythmia, constipation, fatigue, muscle damage, and even paralysis. Other possible consequences of extreme weight loss include osteoporosis, infertility, heart damage, and not having menstrual periods. Those with eating disorders are at increased risk for premature death from a variety of causes, including suicide.
Underweight people often feel cold due to having less fat and muscle mass. Body fat acts as insulation to keep the body warm; muscle activity generates heat.
Semi-starvation can cause edema. People with eating disorders may interpret the puffiness of edema or any changes on the scale as weight gain or getting "fat" and may panic and purge or take laxatives even more.
The common medical complications of being severely underweight include kidney damage.
Early symptoms of magnesium deficiency can include fatigue, anorexia, irritability, insomnia, and muscle tremors or twitching.
Metformin is used to treat type II diabetes, but several studies show that it helps people to lose weight by reducing hunger in people whether they have diabetes or not. Metformin reduces sugar release from your liver to prevent blood sugar levels from rising too high, so your body doesn't need to produce as much insulin. Insulin makes you hungry and causes fat cells in your abdomen to fill with fat. If you are very underweight, see your doctor about lowering your dose or force yourself to eat more food.
Frequent dieters stand an 8-times greater chance of developing anorexia.
Anorexia or starvation causes difficulties in conceiving and carrying a baby to term.
Anorexia or starvation causes difficulties in conceiving and carrying a baby to term.
Women with anorexia and/or bulimia often experience amenorrhea as a result of maintaining a body weight that would be too low to sustain a pregnancy. As a result, as a form of protection for the body, the reproductive system shuts down because it is severely malnourished.
The common medical complications of anorexia/starvation include osteoporosis.
The common medical complications of being severely underweight include kidney damage.
Goldenseal, a strong digestive stimulant and tonic to the digestive tract, is especially useful for anorexia nervosa.
A mild sedative, spasmolytic, it may also gently help regulate thyroid-stimulating hormone and thyroid function.
Condurango is a digestive stimulant for diminished appetite or dietary abuse; is a specific to anorexia nervosa.
A nerve tonic and antidepressant, it also relieves irritation of mucous membranes. This herb is slow to start acting but is long-lasting.
A nutritive and digestive tonic used where there is digestive debility and poor nutrition.
Protein supplements at 1 to 3 servings per day will help ensure sufficient amino acids and help prevent wasting.
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