Eating Disorder : Symptoms and Treatment
Anorexia nervosa is a psychiatric diagnosis that describes an eating disorder characterized by low body weight and body image distortion with an obsessive fear of gaining weight. Individuals with anorexia often control body weight by voluntary starvation, purging, vomiting, excessive exercise, or other weight control measures, such as diet pills or diuretic drugs. It primarily affects adolescent females in America. Anorexia nervosa is a complex condition, involving psychological, neurobiological, and sociological components.
Anorexia Nervosa is a disease condition that can put a serious strain on many of the body’s organs and physiological resources. Anorexia puts a particular strain on the structure and function of the heart and cardiovascular system, with slow heart rate (bradycardia) and elongation of the QT interval seen early on. People with anorexia typically have a disturbed electrolyte balance, particularly low levels of phosphate, which has been linked to heart failure, muscle weakness, immune dysfunction, and ultimately death. Those who develop anorexia before adulthood may suffer stunted growth and subsequent low levels of essential hormones (including sex hormones) and chronically increased cortisol levels. Osteoporosis can also develop as a result of anorexia in 38-50% of cases, as poor nutrition leads to the retarded growth of essential bone structure and low bone mineral density. Anorexia does not harm everyone in the same way. For example, evidence suggests that the results of the disease in adolescents may differ from those in adults.
Changes in brain structure and function are early signs of the condition. Enlargement of the ventricles of the brain is thought to be associated with starvation, and is partially reversed when normal weight is regained. Anorexia is also linked to reduced blood flow in the temporal lobes, although since this finding does not correlate with current weight, it is possible that it is a risk trait rather than an effect of starvation.
The term anorexia is of Greek origin: an (privation or lack of) and orexis (appetite) thus meaning a lack of desire to eat. A person who is diagnosed with anorexia nervosa is most commonly referred to with the adjectival form anorexic. The noun form, as in ‘he is an anorectic’, is used less commonly. The term “anorectic” can also refer to any drug that suppresses appetite.
“Anorexia nervosa” is frequently shortened to “anorexia” in both the popular media and scientific literature. This is technically incorrect, as strictly speaking “anorexia” refers to the medical symptom of reduced appetite.
In popular culture, and especially with anorectics themselves, the term is often shortened to “ana” to avoid sounding clinical and impersonal. “Pro-ana” groups often use the terms “ana” and “mia” (referring to bulimia nervosa) to describe their conditions, as it has less negative connotations than the full medical term. Some pro-ana groups discourage or deride the use of colloquial abbreviations.
The most commonly used criteria for diagnosing anorexia are from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems (ICD).
Although biological tests can aid the diagnosis of anorexia, the diagnosis is based on a combination of behaviour, reported beliefs and experiences, and physical characteristics of the patient. Anorexia is typically diagnosed by a clinical psychologist, psychiatrist or other suitably qualified clinician.
Notably, diagnostic criteria are intended to assist clinicians, and are not intended to be representative of what an individual sufferer feels or experiences in living with the illness.