Sign and Symptoms of Anorexia Nervosa

Anorexia nervosa is an eating disorder characterized by excessive weight loss, and irrational fear of gaining weight and distorted body self-perception. Anorexia nervosa usually developes during adolescence and early adulthood.Due to the fear of gaining weight, people with this disorder restrict the amount of food they intake. This restriction of food intake causes metabolic and hormonal disorders.The terms anorexia nervosa and anorexia are often used interchangeably, however anorexia is simply a medical term for lack of appetite. Anorexia nervosa has many complicated implications and may be thought of as a lifelong illness that may never be truly cured, but only managed over time. Anorexia nervosa is characterized by low body weight, inappropriate eating and obsession with thin figure.

Anorexia nervosa is often coupled with a distorted self image which may be maintained by various cognitive biases that alter how the affected individual evaluates and thinks about her or his body, food and eating. Persons with anorexia nervosa continue to feel hunger, but deny themselves all but very small quantities of food. The average caloric intake of a person with anorexia nervosa is 600–800 calories per day, but extreme cases of complete self-starvation are known.It is a serious mental illness with a high incidence of comorbidity and similarly high mortality rates to serious psychiatric disorders.[7]

Anorexia most often has its onset in adolescence and is most prevalent among adolescent girls. However, more recent studies show that the onset age of anorexia has decreased from an average of 13 to 17 years of age to 9 to 12. While it can affect men and women of any age, race, and socioeconomic and cultural background,Anorexia nervosa occurs in females 10 times more than in males. While anorexia nervosa is quite commonly (in lay circles) believed to be a woman ‘s illness, it should not be forgotten than ten per cent of people with anorexia nervosa are male.

The term anorexia nervosa was established in 1873 by Sir William Gull, one of Queen Victoria’s personal physicians.The term is of Greek origin: an- (ἀν-, prefix denoting negation) and orexis (ὄρεξις, “appetite”), thus meaning a lack of desire to eat.However, while the term “anorexia nervosa” literally means “neurotic loss of appetite” the literal meaning of the term is somewhat misleading. Many anorexics do enjoy eating and have certainly not lost their appetite as the term “loss of appetite” is normally understood; it is better to regard anorexia nervosa as a self-punitive addiction to fasting, rather than a literal loss of appetite.

Signs and symptoms

A person with anorexia nervosa may exhibit a number of signs and symptoms, some of which are listed below. The type and severity vary in each case and may be present but not readily apparent. Anorexia nervosa and the associated malnutrition that results from self-imposed starvation, can cause severe complications in every major organ system in the body.

  • Refusal to maintain a normal BMI for their age
  • amenorrhea: The absence of 3 consecutive menstrual cycles
  • Fearful of even the slightest weight gain and takes all precautionary measures to avoid weight gain and becoming overweight
  • obvious, rapid, dramatic weight loss
  • lanugo: soft, fine hair grows on face and body
  • obsession with calories and fat content
  • preoccupation with food, recipes, or cooking; may cook elaborate dinners for others but not eat themselves
  • dieting despite being thin or dangerously underweight
  • rituals: cuts food into tiny pieces; refuses to eat around others; hides or discards food
  • purging: uses laxatives, diet pills, ipecac syrup, or water pills; may engage in self-induced vomiting; may run to the bathroom after eating in order to vomit and quickly get rid of the calories
  • may engage in frequent, strenuous exercise
  • perception: perceives self to be overweight despite being told by others they are too thin
  • becomes intolerant to cold: frequently complains of being cold from loss of insulating body fat or poor circulation resulting from extremely low blood pressure; body temperature lowers (hypothermia) in effort to conserve energy
  • depression: may frequently be in a sad, lethargic state
  • solitude: may avoid friends and family; becomes withdrawn and secretive
  • cheeks may become swollen because of enlargement of the salivary glands caused by excessive vomiting
  • swollen joints
  • abdominal distension
  • bad breath
  • hair loss or thinning
Dermatologic signs of anorexia nervosa
telogen effluvium
seborrheic dermatitis
livedo reticularis
interdigital intertrigo
generalized pruritus
acquired striae distensae
angular stomatitis
prurigo pigmentosa
linear erythema craquele
acrodermatitis enteropathica
Possible medical complications of anorexia nervosa
electrolyte imbalance[
tooth loss
cardiac arrest
optic neuropathy
brain atrophy

Medical Complications in Children and Adolescents with Anorexia Nervosa Anorexia nervosa can have serious implications when onset occurs before the completion of growth, pubertal maturation and prior to attaining peak bone mass.Complications specific to adolescents and children with anorexia nervosa can include:

  • growth retardation height gain slows and can stop completely with severe weight loss. Growth in height can commence a few months after weight restoration.
  • Pubertal Delay or Arrest both height gain and pubertal development are dependent on the release of growth hormone and gonadotrophins (LH and FSH) from the pituitary gland. Suppression of gonadotrophins in patients with anorexia nervosa has been frequently documented.
  • Reduction of Peak Bone Mass Bone accretion is the highest during adolescence, and if onset of anorexia nervosa occurs during this time and stalls puberty, bone mass may remain low
  • Hepatic Steatosis fatty infiltration of the liver, an indicator of malnutrition in children

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