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.