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Anorexia nervosa

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Anorexia nervosa

What is anorexia nervosa?

Anorexia nervosa is an eating disorder characterised by an obsessive desire to lose weight and dissatisfaction with body weight and shape. Extreme weight loss is achieved by excessive dieting including avoiding fattening foods, use of laxatives or diuretics, self-induced vomiting and exercise.

Body weight is maintained at least 15% below that expected for the person's height. The condition usually starts in the teenage years and tends to affect girls more often, although boys can also suffer from it. Because the weight loss can cause hormonal disturbances, girls with anorexia nervosa may stop having periods.

The disease is seen mainly in the West and is more common among women in professions such as modelling and ballet. Anorexia can last for months or years and it can take a long time before normal weight is regained.

Serious long-term risks associated with anorexia include osteoporosis (fragile bones) and damage the heart, liver, kidneys and brain. It can also impede growth in the young and cause difficulties in concentration. Tooth decay and damage due to prolonged self-induced vomiting is also commonly seen. People who do not receive treatment may become chronically ill or even die.

What causes anorexia nervosa?

Anorexia nervosa is related to a number of risk factors. It is thought that psychological factors such as low self esteem contribute to the problem. Cultural factors such as peer pressure to be thin and the emphasis placed on the relationship between thinness and beauty in our society are also factors. Other risk factors include:

  • Body image disturbances.
  • Family history of eating disorders, alcoholism, affective (mood) disorders.
  • Lack of conflict resolution.
  • Sense of ineffectiveness.
  • Over-protectiveness.
  • Rigidity.
  • Obesity.
  • Puberty.
  • Death in the family.
  • Other life stresses.

What are the signs of anorexia nervosa?

  • Weighing 15 per cent below the normal ideal body weight for age and height.
  • In females, periods may stop.
  • There may be delayed development in puberty.
  • Weight loss is self-induced.
  • A constant fear of gaining weight, as well as a feeling of being fat, even when weight is much less than that of other people of the same height.
  • No interest in socialising.
  • A feeling of being bloated, even after a small meal.

How is anorexia nervosa treated?

Treatment may be carried out by your GP, although sometimes referral to a psychologist or psychiatrist is necessary. Treatment varies according to the individual person and the root cause of the problem.

Generally, it aims to enable the person to achieve a healthy weight and eat more healthily. Mental health problems may also need to be addressed, especially concerning food and body image. In some cases, medication may be necessary, especially where the person is also experiencing depression.

In cases where the person’s weight is more than 20%-25% below total normal body weight, admission to hospital may be required. Treatments include individual psychological therapy, family therapy and drug therapy using antidepressants.

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