Click Here

Wednesday, March 19, 2008

Anorexia nervosa

Anorexia nervosa is a psychiatric diagnosis that describes an eating disorder characterized by low body weight and body image distortion with an obsessive fear of gaining weight. Individuals with anorexia are known to commonly control body weight through the means of voluntary starvation, purging, vomiting, excessive exercise, or other weight control measures, such as diet pills or diuretic drugs. It primarily affects adolescent females, however approximately 10% of people with the diagnosis are male. Anorexia nervosa is a complex condition, involving psychological, neurobiological, and sociological components.

The term anorexia is of Greek origin: an (αν, privation or lack of) and orexis (ορεξις, appetite) thus meaning a lack of desire to eat. A person who is diagnosed with anorexia nervosa is most commonly referred to with the adjectival form anorexic. The noun form, "anorectic" is generally not used in this context and usually refers to drugs that suppress appetite.

"Anorexia nervosa" is frequently shortened to "anorexia" in both the popular media and television reports. This is technically incorrect, as the term "anorexia" used separately refers to the medical symptom of reduced appetite (which therefore is distinguishable from anorexia nervosa in being non-psychiatric).

Diagnosis:
To be diagnosed as having anorexia nervosa, according to the DSM-IV-TR, a person must display:
*Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
*Intense fear of gaining weight or becoming obese.
*Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
*The absence of at least three consecutive menstrual cycles (amenorrhea), in women who have had their first menstrual period but have not yet gone through menopause (postmenarcheal, premenopausal females).
*Or other eating related disorders.

Symptoms:
Extreme weight loss, Body mass index less than 17.5 in adults, or 85% of expected weight in children, Endocrine disorder leading to cessation of periods in girls (amenorrhoea), Decreased libido; impotence in males , Stunted growth, Starvation symptoms, such as reduced metabolism, slow heart rate (bradycardia), hypotension, hypothermia and anemia, Abnormalities of mineral and electrolyte levels in the body, thinning of the hair, growth of lanugo hair over the body, Constantly feeling "cold", Zinc deficiency, Reduction in white blood cell count, Reduced immune system function, Pallid complexion and sunken eyes, Creaking joints and bones, Collection of fluid in ankles during the day and around eyes during the night, Tooth decay, Constipation, Dry skin, Dry or chapped lips, poor circulation, resulting in common attacks of 'pins and needles' and purple extremities, In cases of extreme weight loss, there can be nerve deterioration, leading to difficulty in moving the feet, Headaches, Brittle fingernails, Bruising easily etc.

Treatment:
The first line treatment for anorexia is usually focused on immediate weight gain, especially with those who have particularly serious conditions that require hospitalization. In particularly serious cases, this may be done as an involuntary hospital treatment under mental health law, where such legislation exists. In the majority of cases, however, people with anorexia are treated as outpatients, with input from physicians, psychiatrists, clinical psychologists and other mental health professionals.
Drug treatments, such as SSRI or other antidepressant medication, have not been found to be generally effective for either treating anorexia, or preventing relapse although it has also been noted that there is a lack of adequate research in this area. It is common, however, for antidepressants to be prescribed, often with the intent of trying to treat the associated anxiety and depression.
Supplementation with 14mg/day of zinc is recommended as routine treatment for anorexia nervosa due to a study showing a doubling of weight regain after treatment with zinc was begun.


No comments: