Causative & risk factors
Teenagers are the most commonly affected age group. Most of the patients are females. Those affected have a distorted body image and hence see themselves as fat; whereas in reality, they are extremely thin. The etiology of anorexia nervosa is complex and may be due to a combination of factors like genetics, personality traits, social environment and family history.
Any form of chronic emotional stress can predispose to developing anorexia nervosa. People in occupations which revolve around physical appearance may feel much more pressure to look perfect and are thus at a higher risk of becoming anorexic.
Clinical presentation
Anorexic people do not realize they have a problem. It’s the friends and family who need to watch out for the signs.
These patients usually have a distorted body image. Body weight becomes the focus of their lives. In spite of being severely underweight, they think that they are overweight. They are extremely critical of their appearance and keep looking at themselves in the mirror.
They eat in severely restricted amounts and usually exercise a lot. They may also induce vomiting to expel the food eaten. They tend to lie about how much they eat and excessively count calories. They tend to use medications like diuretics, appetite suppressants and laxatives to lose further weight.
Since they aren’t getting sufficient nutrients from food, these patients usually develop several physical symptoms. They feel tired or dizzy and have frequent headaches. They have dry skin, brittle nails and start losing hair. Abdominal pain and sleeping difficulties are common findings in anorexic patients. Women may develop amenorrhea.
Investigations
Anorexia nervosa is diagnosed on the basis of assessment of the symptoms and feelings of the patient. Blood tests, X-rays or other investigations may be carried out to ensure that all body systems are functioning well.
Treatment
The primary goal of treatment is to offer psychotherapy in order to normalize the patient’s understanding of his/her body and eating habits. A dietician must work towards improving the patient’s food habits to fulfill nutritional requirements. Support from friends and family helps aid recovery.
Statistics
Approximately half the people who have had anorexia develop bulimia or bulimic patterns. The mortality rate of anorexia nervosa is about 4%.
