ANOREXIA NERVOSA, symptoms, sing, risk factor, treatment

ANOREXIA NERVOSA

Q. What is anorexia nervosa?

 Ans: - The term anorexia is greek origin, ‘an’ means prevention or lack of and ‘orexia’ means appetite. It is very common eating disorder of childhood ages of boy and girls. But more common in puberty and adolescence girls. It appears to be more prevalent in industrialized countries or developed countries.

The reasons behind the development of Anorexia will differ from person to person; known causes include genetic predisposition and a combination of environmental, social and cultural factors.

Anorexia nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.

Anorexia nervosa is a complex eating disorder with three key features:

• refusal to maintain a healthy body weight
• an intense fear of gaining weight
• a distorted body image

Q. Write the features of anorexia nervosa./ What are the warning signs of Anorexia?

Ans: -There is a number of features present in this eating disorder----

Physical Signs

• Rapid weight loss or frequent weight changes
• Loss or disturbance of menstruation in girls and women and decreased libido in men
• Fainting or dizziness
• Feeling cold most of the time, even in warm weather (caused by poor circulation)
• Feeling bloated, constipated, or the development of intolerances to food
• Feeling tired and not sleeping well
• Lethargy and low energy
• Facial changes (e.g. looking pale, sunken eyes)
• Fine hair appearing on face and body

Psychological Signs

• Preoccupation with eating, food, body shape and weight
• Feeling anxious and/or irritable around meal times
• Intense fear of gaining weight
• Unable to maintain a normal body weight for their age and height
• Depression and anxiety
• Reduced capacity for thinking and increased difficulty concentrating
• ‘Black and white’ thinking (e.g. rigid thoughts about food being ‘good’ or ‘bad’)
• Having a distorted body image (e.g. seeing themselves as overweight when they are actually underweight)
• Low self esteem and perfectionism
• Increased sensitivity to comments relating to food, weight, body shape, exercise
• Extreme body image dissatisfaction

Behavioural Signs

• Dieting behaviour (e.g. fasting, counting calories/kilojoules, avoiding food groups such as fats and carbohydrates)
• Deliberate misuse of laxatives, appetite suppressants, enemas and diuretics
• Repetitive or obsessive behaviours relating to body shape and weight (e.g. repeated weighing, looking in the mirror obsessively and pinching waist or wrists)
• Evidence of binge eating (e.g. disappearance or hoarding of food)
• Eating in private and avoiding meals with other people
• Anti-social behaviour (spending more and more time alone)
• Secrecy around eating (e.g. saying they have eaten when they haven’t, hiding uneaten food)
• Compulsive or excessive exercising (e.g. exercising in bad weather, continuing to exercise when sick or injured, and experiencing distress if exercise is not possible)
• Radical changes in food preferences (e.g. suddenly disliking food they have always enjoyed in the past, reporting of food allergies or intolerances, becoming vegetarian)
• Obsessive rituals around food preparation and eating (e.g. eating very slowly, cutting food into very small pieces, insisting that meals are served at exactly the same time everyday)
• Preoccupation with preparing food for others, recipes and nutrition
• Self harm, substance abuse or suicide attempts

Enotional

• Self efficiency
• Clinical depression
• Moodiness or ‘mood swing’

Social and interpersonal

• Deterioration in relationship with the family
• Deterioration in school performance
• Withdraw from previous friendship

Q. What are the risks associated with Anorexia?

The risks associated with Anorexia are severe and can be life threatening. They include:

• Anaemia (iron deficiency)
• Compromised immune system (e.g. getting sick more often)
• Intestinal problems (e.g. abdominal pain, constipation, diarrhoea)
• Loss or disturbance of menstruation in girls and women
• Increased risk of infertility in men and women
• Kidney failure
• Osteoporosis– a condition that leads to bones becoming fragile and easily fractured
• Heart problems (e.g. cardiac abnormalities, sudden cardiac arrest)

Body dissatisfaction Strict dieting Low self-esteem Difficulty expressing feelings

• Perfectionism
• Troubled family relationships
• History of physical or sexual abuse
• Family history of eating disorders
• Death

                                                          Or

Certain risk factors increase the risk of anorexia nervosa, including:

• Being female:  Anorexia is more common in girls and women. However, boys and men have been increasingly developing eating disorders, perhaps because of growing social pressures.
• Young age:  Anorexia is more common among teenagers. Still, people of any age can develop this eating disorder, though it's rare in those over 40. Teens may be more susceptible because of all the changes their bodies go through during puberty. They also may face increased peer pressure and be more sensitive to criticism or even casual comments about weight or body shape.
• Genetics: Changes in certain genes may make people more susceptible to anorexia.
• Family history: Those with a first-degree relative — a parent, sibling or child — who had the disease have a much higher risk of anorexia.
• Weight changes: When people change weight — on purpose or unintentionally — those changes may be reinforced by positive comments from others for losing weight or by negative remarks for gaining weight. Such changes and comments may trigger someone to start dieting to an extreme. In addition, starvation and weight loss may change the way the brain works in vulnerable individuals, which may perpetuate restrictive eating behaviors and make it difficult to return to normal eating habits.
• Transitions: Whether it's a new school, home or job; a relationship breakup; or the death or illness of a loved one, change can bring emotional stress and increase the risk of anorexia.
• Sports, work and artistic activities: Athletes, actors, dancers and models are at higher risk of anorexia. Coaches and parents may inadvertently raise the risk by suggesting that young athletes lose weight.
• Media and society: The media, such as TV and fashion magazines, frequently feature a parade of skinny models and actors. These images may seem to equate thinness with success and popularity. But whether the media merely reflect social values or actually drive them isn't clear-cut.

Q. Write the treatment and therapy of anorexia.

Since anorexia involves both mind and body, a team approach to treatment is often best. Those who may be involved in anorexia treatment include medical doctors, psychologists, counselors, and dieticians. The participation and support of family members also makes a big difference in treatment success. Having a team around you that you can trust and rely on will make recovery easier.

Treating anorexia involves three steps:

• Getting back to a healthy weight
• Starting to eat more food
• Changing how you think about yourself and food

Medical treatment for anorexia

The first priority in anorexia treatment is addressing and stabilizing any serious health issues. Hospitalization may be necessary if you are dangerously malnourished or so distressed that you no longer want to live. You may also need to be hospitalized until you reach a less critical weight. Outpatient treatment is an option when you’re not in immediate medical danger.

Nutritional treatment for anorexia

A second component of anorexia treatment is nutritional counseling. A nutritionist or dietician will teach you about healthy eating and proper nutrition. The nutritionist will also help you develop and follow meal plans that include enough calories to reach or maintain a normal, healthy weight.

Counseling and therapy for anorexia

Counseling is crucial to anorexia treatment. Its goal is to identify the negative thoughts and feelings that fuel your eating disorder and replace them with healthier, less distorted beliefs. Another important goal of counseling is to teach you how to deal with difficult emotions, relationship problems, and stress in a productive, rather than a self-destructive, way.

Getting past your fear of gaining weight

Try to understand that your fear of gaining weight is a symptom of your anorexia. Reading about anorexia or talking to other people who have lived with it can help. It also helps to be honest about your feelings and fears—including your family and your treatment team. The better they understand what you’re going through, the better support you’ll receive.

Psychological Treatments

• Behavioural therapy
• Cognitive analytic therapy
• Cognitive behavioural therapy
• Ego-oriented therapy-adolescent focused individual therapy (for children and adolescents)
• Focal psychodynamic therapy
• Family interventions focused explicitly on eating disorders
• Maudsley family-based treatment (for children and adolescents)
• Interpersonal psychotherapy
• Specialist supportive clinical management

Other treatments

Antidepressants (specifically selective serotonin re-uptake inhibitors; e.g. SSRI) or antipsychotics can also be used to treat Anorexia Nervosa.

Please note: Medication should not be used as the sole or primary treatment for Anorexia Nervosa; rather, it should be used in conjunction with therapy appropriate for the treatment of Anorexia Nervosa.

Q. Write the Effects of anorexia.

One thing is certain about anorexia. Severe calorie restriction has dire physical effects. When your body doesn’t get the fuel it needs to function normally, it goes into starvation mode and slows down to conserve energy. Essentially, your body begins to consume itself. If self-starvation continues and more body fat is lost, medical complications pile up and your body and mind pay the price.

• Severe mood swings; depression
• Lack of energy and weakness
• Slowed thinking; poor memory

• Constipation and bloating
• Tooth decay and gum damage
• Dizziness, fainting, and headaches

                                      Source: National Women's Health Information Center

Q. Write the Complications of anorexia.

Anorexia nervosa can have numerous complications. At its most severe, it can be fatal. Death may occur suddenly — even when someone is not severely underweight. This may result from abnormal heart rhythms (arrhythmias) or an imbalance of electrolytes — minerals such as sodium, potassium and calcium that maintain the balance of fluids in your body.

Other complications of anorexia include:

• Anemia
• Heart problems, such as mitral valve prolapse, abnormal heart rhythms or heart failure
• Bone loss, increasing risk of fractures later in life
• In females, absence of a period
• In males, decreased testosterone
• Gastrointestinal problems, such as constipation, bloating or nausea
• Electrolyte abnormalities, such as low blood potassium, sodium and chloride
• Kidney problems
• Suicide

If a person with anorexia becomes severely malnourished, every organ in the body can be damaged, including the brain, heart and kidneys. This damage may not be fully reversible, even when the anorexia is under control.

In addition to the host of physical complications, people with anorexia also commonly have other mental disorders as well. They may include:

• Depression, anxiety and other mood disorders
• Personality disorders
• Obsessive-compulsive disorders
• Alcohol and substance misuse

Q. Write the Causes of Anorexia.

Anorexia is not a simple disorder. It has many symptoms and effects, and its causes are complex as well. Currently, it is thought that anorexia nervosa develops as a result of multiple factors, both biological and environmental.

Examples of environmental factors that would contribute to the occurrence of anorexia nervosa are:

• The effects of the thinnessculture in media, that constantly reinforce thin people as ideal stereotypes
• Professions and careers that promote being thin and weight loss, such as ballet and modeling
• Family and childhood traumas: childhood sexual abuse, severe trauma
• Peer pressure among friends and co-workers to be thin or be sexy.

Examples of biological factors include:

• Irregular hormone functions
• Genetics (the tie between anorexia and one’s genes is still being heavily researched, but we know that genetics is a part of the story).
• Nutritional deficiencies

Psychological. Some emotional characteristics may contribute to anorexia. Young women may have obsessive-compulsive personality traits that make it easier to stick to strict diets and forgo food despite being hungry. They may have an extreme drive for perfectionism, causing them to think they're never thin enough. They may have high levels of anxiety and restrict their eating to reduce it.

Q. Write the Types of Anorexia.

There are two common types of anorexia, which are as follows:

• Anorexia Nervosa Binge / Purge Type – The individual suffering from anorexia nervosa binge / purge type, will purge when he or she eats. This is typically a result of the overwhelming feelings of guilt a sufferer would experience in relation to eating; they compensate by vomiting, abusing laxatives, or excessively exercising.
• Restrictive Anorexia Nervosa – In this form of anorexia nervosa, the individual will fiercely limit the quantity of food consumed, characteristically ingesting a minimal amount that is well below their body’s caloric needs, effectively slowly starving him or herself.

Though two classifications of anorexia nervosa exist, both types exhibit similar symptoms, such as irrational fear of weight gain and abnormal eating patterns.

Bulimia Nervosa

Bulimia Nervosa

Q. What is bulimia nervosa?

Bulimia Nervosa is a psychological and severe life-threatening eating disorder described by the ingestion of an abnormally large amount of food in short time period, followed by an attempt to avoid gaining weight by purging what was consumed. 

Bulimia nervosa is an eating disorder characterized by frequent episodes of binge eating, followed by frantic efforts to avoid gaining weight. It affects women and men of all ages.

Q. Write the types of bulimia nervosa.

There are two common types of bulimia nervosa, which are as follows:

• Bulimia Nervosa Purging type -This type of bulimia nervosa accounts for the majority of cases of those suffering from this eating disorder.  In this form, individuals will regularly engage in self-induced vomiting or abuse of laxatives, diuretics, or enemas after a period of bingeing.
• Bulimia Nervosa Non-purging type -In this form of bulimia nervosa, the individual will use other inappropriate methods of compensation for binge episodes, such as excessive exercising or fasting.  In these cases, the typical forms of purging, such as self-induced vomiting, are not regularly utilized.

Q. What is binge eating?

Binge eating involves two key features:

• Eating a very large amount of food within a relatively short period of time (e.g. within two hours)
• Feeling a sense of loss of control while eating (e.g. feeling unable to stop yourself from eating)

Q. What are the warning signs of Bulimia?

Having awareness about Bulimia and its warning signs and symptoms can make a marked difference to the severity and duration of the illness. Seeking help at the first warning sign is much more effective than waiting until the illness is in full swing. If you or someone you know is exhibiting some or a combination of these signs it is vital to seek help and support as soon as possible.

The warning signs of Bulimia can be physical, psychological and behavioural. It is possible for someone with Bulimia to display a combination of these symptoms.

Physical signs:

• Frequent changes in weight (loss or gains)
• Signs of damage due to vomiting including swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath
• Feeling bloated, constipated or developing intolerances to food
• Loss of or disturbance of menstrual periods in girls and women
• Fainting or dizziness
• Feeling tired and not sleeping well

Psychological Signs:

• Preoccupation with eating, food, body shape and weight
• Sensitivity to comments relating to food, weight, body shape or exercise
• Low self esteem and feelings of shame, self loathing or guilt, particularly after eating
• Having a distorted body image (e.g. seeing themselves as overweight even if they are in a healthy weight range for their age and height)
• Obsession with food and need for control
• Depression, anxiety or irritability
• Extreme body dissatisfaction

Behavioural Signs:

• Evidence of binge eating (e.g. disappearance or hoarding of food)
• Vomiting or using laxatives, enemas, appetite suppressants or diuretics
• Eating in private and avoiding meals with other people
• Anti social behaviour, spending more and more time alone
• Repetitive or obsessive behaviours relating to body shape and weight (e.g. weighing themselves repeatedly, looking in the mirror obsessively and pinching waist or wrists)
• Secretive behaviour around food (e.g. saying they have eaten when they haven’t, hiding uneaten food in their rooms)
• Compulsive or excessive exercising (e.g. exercising in bad weather, continuing to exercise when sick or injured, and experiencing distress if exercise is not possible)
• Dieting behaviour (e.g. fasting, counting calories/kilojoules, avoiding food groups such as fats and carbohydrates)
• Frequent trips to the bathroom during or shortly after meals which could be evidence of vomiting or laxative use
• Erratic behaviour (e.g. spending large amounts of money on food)
• Self harm, substance abuse or suicide attempts

Q. What are the risks associated with Bulimia?

The risks associated with Bulimia are severe. People with Bulimia may experience:

• Chronic sore throat, indigestion, heartburn and reflux
• Inflammation and rupture of the oesophagus and stomach from frequent vomiting
• Stomach and intestinal ulcers
• Chronic irregular bowel movements, constipation and/or diarrhoea due to deliberate misuse of laxatives
• Osteoporosis– a condition that leads to bones becoming fragile and easily fractured
• Loss of or disturbance of menstrual periods in girls and women
• Increased risk of infertility in men and women
• Irregular or slow heart beat which can lead to an increased risk of heart failure

Q. Write the treatment of bulimia nervosa.

Therapies to be considered for the treatment of Bulimia Nervosa include:

• Psychological Treatments
• Evidence-based self-help programs
• Cognitive behavioural therapy for Bulimia Nervosa
• Interpersonal psychotherapy
• Maudsley family-based treatment (for children and adolescents)
• Dialectical behaviour therapy
• Guided imagery
• Crisis intervention
• Stress management

Other treatments

Antidepressants (specifically selective serotonin reuptake inhibitors; e.g. SSRI) may also be prescribed for someone who is suffering from Bulimia Nervosa.

Q. Write the Complications of bulimia nervosa.

Bulimia may cause numerous serious and even life-threatening complications. Possible complications include:

• Dehydration, which can lead to major medical problems, such as kidney failure
• Heart problems, such as an irregular heartbeat or heart failure
• Severe tooth decay and gum disease
• Absent or irregular periods in females
• Digestive problems, and possibly a dependence on laxatives to have bowel movements
• Anxiety and depression
• Misuse of alcohol or drugs
• Suicide

Q. Write the risk factors of bulimia nervosa.

Factors that increase your risk of bulimia may include:

• Being female:  Girls and women are more likely to have bulimia than boys and men are.
• Age: Bulimia often begins in the late teens or early adulthood.
• Biology: People with first-degree relatives (siblings, parents or children) with an eating disorder may be more likely to develop an eating disorder, suggesting a possible genetic link. It's also possible that a deficiency in the brain chemical serotonin may play a role. And, being overweight as a child or teen may increase the risk.
• Psychological and emotional issues:  Psychological and emotional problems, such as anxiety disorder or low self-esteem, can contribute to eating disorders. Triggers for bingeing may include stress, poor body self-image, food, restrictive dieting or boredom. In some cases, traumatic events and environmental stress may be contributing factors.
• Media and societal pressure: The media, such as TV and fashion magazines, frequently feature a parade of skinny models and actors. These images seem to equate thinness with success and popularity. But whether the media merely reflect social values or actually drive them isn't clear.
• Sports, work or artistic pressures: Athletes, actors, dancers and models are at a higher risk of eating disorders. Coaches and parents may inadvertently raise the risk by encouraging young athletes to lose weight, maintain a low weight and restrict eating for better performance.

Q. What are the Effects of Bulimia Nervosa?

Bulimia complications are potentially life-threatening, and the disease requires medical attention from an experienced eating disorder treatment professional. Bulimia treatment centers often see women facing severe effects from advanced bulimia nervosa. These may include:

• Extreme social isolation
• Inability to sleep
• Fractured relationships with family and friends
• Loss of spiritual connection to one’s faith, religion, or higher power
• Forced withdrawal from school or college
• Job loss
• Bankruptcy, often resulting from excessive spending on binge foods
• Infertility
• Internal bleeding
• Drug and alcohol addiction, especially if these substances are used to self-medicate for uncontrolled emotions or deal with physical complications
• Suicide
• Self-injury behavior
• Heart attack
• Death

Q. Write the symptoms of bulimia nervosa.

1. Purging

2. eating uncontrollably

3. strict dieting

4. fasting

5. indigestion

6. dental problem

7. constipation

8. heart burn

9. using the bathroom frequently after meal.

10. irregular menstruation

Is it possible to recover? 

Yes. It is possible to recover from Bulimia Nervosa, even if you have been living with the illness for many years. The path to recovery can be very challenging. People with Bulimia Nervosa can become entangled in a vicious cycle of eating and exercise behaviours that can impact their ability to think clearly and make decisions. However, with the right team and a high level of personal commitment, recovery is an achievable goal. Treatments for Bulimia Nervosa are available; seek help from a professional with specialised knowledge in eating disorders.

Steps to bulimia recovery

• Admit you have a problem. Up until now, you’ve been invested in the idea that life will be better—that you’ll finally feel good—if you lose more weight and control what you eat. The first step in bulimia recovery is admitting that your relationship to food is distorted and out of control.
• Talk to someone. It can be hard to talk about what you’re going through, especially if you’ve kept your bulimia a secret for a long time. You may be ashamed, ambivalent, or afraid of what others will think. But it’s important to understand that you’re not alone. Find a good listener—someone who will support you as you try to get better.
• Stay away from people, places, and activities that trigger the temptation to binge or purge. You may need to avoid looking at fashion or fitness magazines, spend less time with friends who constantly diet and talk about losing weight, and stay away from weight loss web sites and “pro-mia” sites that promote bulimia. You may also need to be careful when it comes to meal planning and cooking magazines and shows.
• Seek professional help. The advice and support of trained eating disorder professionals can help you regain your health, learn to eat normally again, and develop healthier attitudes about food and your body.