Anorexia nervosa is an eating disorder that makes people lose more weight than is considered healthy for their age and height.
Persons with this disorder may have an intense fear of weight gain, even when they are underweight. They may diet or exercise too much, or use other methods to lose weight.
The exact causes of anorexia nervosa are unknown. Many factors probably are involved. Genes and hormones may play a role. Social attitudes promoting very thin body types may also be involved.
Family conflicts are no longer thought to contribute to this or other eating disorders.
Risk factors for anorexia include:
Anorexia usually begins during the teen years or young adulthood. It is more common in females, but may also be seen in males. The disorder is seen mainly in white women who are high academic achievers and who have a goal-oriented family or personality.
To be diagnosed with anorexia, a person must:
People with anorexia may severely limit the amount of food they eat, or eat and then make themselves throw up. Other behaviors include:
Other symptoms of anorexia may include:
Other causes of weight loss or muscle wasting must be ruled out with medical testing. Examples of other conditions that can cause these symptoms include:
Tests should be done to help find the cause of weight loss, or see what damage the weight loss has caused. Many of these tests will be repeated over time to monitor the patient.
These tests may include:
The biggest challenge in treating anorexia nervosa is making the person recognize that they have an illness. Most persons with anorexia nervosa deny that they have an eating disorder. People often enter treatment only once their condition is serious.
The goals of treatment are to restore normal body weight and eating habits. A weight gain of 1 - 3 pounds per week is considered a safe goal.
A number of different programs have been designed to treat anorexia. Sometimes the person can gain weight by:
Many patients start with a short hospital stay and continue to follow-up with a day treatment program.
A longer hospital stay may be needed if:
Care providers who are usually involved in these programs include:
Treatment is often very difficult, and patients and their families must work hard. Many therapies may be tried until the patient overcomes this disorder.
Patients may drop out of programs if they have unrealistic hopes of being "cured" with therapy alone.
Different kinds of talk therapy are used to treat people with anorexia:
Medications such as antidepressants, antipsychotics, and mood stabilizers may help some anorexic patients when given as part of a complete treatment program. Examples include:
These medicines can help treat depression or anxiety.
Although these drugs may help, no medication has been proven to decrease the desire to lose weight.
Anorexia nervosa is a serious condition that can be deadly. By some estimates, it leads to death in 10% of cases. Experienced treatment programs can help people with the condition return to a normal weight, but it is common for the disease to return.
Women who develop this eating disorder at an early age have a better chance of recovering completely. However, most people with anorexia will continue to prefer a lower body weight and be very focused on food and calories.
Weight management may be hard. Long-term treatment may be needed to stay at a healthy weight.
Complications can be severe. A hospital stay may be needed.
Complications may include:
Talk to your doctor if a loved one is:
Getting medical help right away can make an eating disorder less severe.
In some cases, prevention may not be possible. Encouraging healthy, realistic attitudes toward weight and diet may be helpful. Sometimes, talk therapy can help.
Eating disorder - anorexia
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Reviewed by: Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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