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Anorexia Nervosa

A psychiatric disorder characterized by a distorted body image leading the person to believe that she is overweight even when she is dangerously underweight.

Anorexia nervosa is a psychiatric disorder in which a person's (usually a girl's) distorted body image leads her to believe that she is overweight even when she is dangerously underweight. Anorectics employ a number of weight-loss strategies, including fasting, dieting, exercise, induced vomiting, and laxative abuse. A girl is considered anorexic when her weight drops below 85% of what is expected for her height and age. Anorexia typically affects adolescent girls; the average age of onset is 13.7 years. Girls with anorexia tend to be perfectionists with a deep-seated need to feel in control. Environmental factors may play a role in the development of anorexia. Although not all anorectics' family situations will fit these generalizations, parents of anorectics tend to be rigid and overprotective, and they often avoid open discussion of problems and tensions.

Physical effects

Anorexia, which is technically starvation, has serious physical effects on a growing adolescent's body. These effects include:

Growth problems. In a young girl who has not finished growing, anorexia can increase the risk of bone deformities or limit eventual adult height.

Delay of sexual maturation. When the percentage of a girl's body fat drops below a certain critical level, a girl will not ovulate or menstruate, and puberty will not progress normally.

Gastrointestinal problems. Diarrhea brought about by laxative use can cause dehydration and electrolyte imbalance. Vomiting can cause pancreatic, esophageal, glandular, and dental problems.

Endocrine and metabolic problems. Hypoglycemia (low blood sugar) can cause dizziness and confusion. Malnutrition may result in weakness, fatigue, or muscle cramps. Dehydration is possible.

Skin and hair abnormalities. Anorectics' skin is typically dry and mottled. A fine hair called lanugo grows on the shoulders, back, arms, and face, and pubic and underarm hair becomes thin.

Cardiovascular problems. Anorexia affects heart rate, blood pressure, body temperature, blood volume, and heart size.

Psychological effects

The biological effects of anorexia can compound existing psychological problems as well as contribute to new ones. Depression, for example, is a common effect of starvation. As malnutrition depletes a girl's energy stores, her anxiety level may increase because the lethargy she's experiencing makes her feel a loss of control over her body. The anorectic responds to this anxiety by imposing even more stringent restrictions on her diet, which leads to further malnutrition.

Treatment and prognosis

Anorexia nervosa is a life-threatening disease and should be taken seriously. If an adolescent girl exhibits any signs of anorexia, a doctor should be alerted without delay. Effective treatment for anorexia incorporates psychotherapy, medical monitoring, and nutrition education. In extreme cases, hospitalization may be necessary.

In many people, abnormal behaviors associated with anorexia (induced vomiting and laxative abuse, for example) will continue in adulthood. More than one quarter of adolescent anorectics will continue to experience anxiety or depression as adults, and one in five will continue to be underweight. Anorexia nervosa has one of the highest suicide rates of any psychiatric disorder.

See also Bulimia, Eating Disorders

For Further Study

Books

Jablow, Martha M. A Parent's Guide to Eating Disorders and Obesity. New York: Delta Publishing, 1992.

Maloney, Michael, and Rachel Kranz. Straight Talk About Eating Disorders. New York: Facts on File, 1991.

Organizations

National Eating Disorders Organization
Address: 6655 Yale Avenue
Tulsa, OK 74136
Telephone: (918) 481-4044

National Association of Anorexia Nervosa and Associated
Disorders (ANAD)
Address: P.O. Box 7
Highland Park, IL 60035
Telephone: (847) 831-3438