Anorexia nervosa is a Greek term for loss of appetite. There
are three aspects of anorexia nervosa.
1. Self-induced
starvation to significant degree.
2. Presence
of medical signs of starvation.
3. Morbid fear of fatness.
3. Morbid fear of fatness.
Above three features present for three months seal the
diagnosis.
There is body image misperception in these youth. To
achieve their goal they might reduce their food intake and may or may not
indulge in purging behavior.
It is reported in around 3.5% of adolescents mostly occurring
in teens with girls being 15 times more affected than boys. In professions such
as models and ballet dances, its prevalence is greatest.
Causes
of anorexia nervosa
Definite cause is not known to but a disturbance in
endogenous opioid production and neurotransmitter imbalance is known to play
role. Extra emphasis on thinness in society is also implicated.
Medical
complications associated with anorexia nervosa
1. Cardiac-
loss of heart muscle mass, arrhythmia, bradycardia or sudden death.
2. Reproductive- amenorrhea, sterlity.
3. Skin-
edema
4. Blood-
decrease in WBC
5. Dental-
caries
6. Skeletal-
osteoporosis
7. Metabolic-
electrolyte abnormalities
8. Cachexia- loss of muscle mass and fat.
9. Digestive- bloating, constipation and abdominal pain.
10. Neuropsychiatric- Depression, Seizures.
8. Cachexia- loss of muscle mass and fat.
9. Digestive- bloating, constipation and abdominal pain.
10. Neuropsychiatric- Depression, Seizures.
Course
of illness
An untreated illness has waxing and waning course and
outcome ranging from complete recovery to death.
Treatment of anorexia nervosa
Patients who are weighing 20% less than the expected
weight are recommended hospitalization for around 1 month but who are below 30%
require prolonged hospitalization to around 6 months.
During hospitalizations patient is weighed daily. Medical
complications are corrected and patient is force fed according to calories
calculated. Drugs such as fluoxetine and amitriptyline are beneficial. Cyproheptadine
is another useful drug for regaining weight.
Cognitive behavioral therapy may be useful in many cases.
Wishing you a very healthy and long life
Dr Hitesh Sharma
MBBS, MD (Psychiatry)
For asking a query or phone/video consultation with me visit- https://www.icliniq.com/hitesh
For asking a query or phone/video consultation with me visit- https://www.icliniq.com/hitesh
