Anorexia Nervosa

What Is It?

[url=adtarget=HARVARD"body">A person with this disorder fears being fat, and may be completely convinced that she is overweight despite what the scale shows or what other people say. To achieve or maintain leanness, she may exercise obsessively or use laxatives. Since a super-restrictive diet requires exquisite control, she may become quite careful, inhibited and controlled in other areas of life. For example, she may retreat from social contacts or may perform ritual behaviors.

The term anorexia nervosa literally translates to "no appetite, caused by nervousness." However, the disorder is defined not by whether a person feels hunger but by how much weight he or she has lost.

Most people with this disorder do feel hunger, but they disregard it, and diet to the point of starvation. Anorexia nervosa is most often diagnosed in industrialized societies, where thinness is equated with attractiveness. The problem usually begins in adolescence. In girls, the beginning of menstruation may be delayed or it may stop once it has started if dieting progresses far enough. It affects about three-quarters of a percent of all females in the United States.

The cause of anorexia nervosa is not clear. It is likely a combination of genetic (inherited) and environmental factors. Some of the proposed causes include:

• A variant of depression or anxiety — Anorexia, depression, anxiety and obsessive-compulsive disorder tend to run in families, and many people with anorexia nervosa have symptoms of depression or obsessive-compulsive disorder.
• A consequence of fears about becoming an adult — One such fear may be fear of the sexual experimenting that begins in adolescence.
• Environmental pressures — Images from TV and film and pressure from peers leave the impression that thin is best.
• Difficult family relationships — Although these difficulties have been suggested as a cause of the illness, they may actually develop once the disease has started, because a person with anorexia nervosa may test the patience of those she lives with. People with the disorder describe a feeling of power and control over others through their dieting.

In advanced stages of the illness, the dieting is hard to reverse. At that point, hunger may disappear completely and the pursuit of thinness becomes a way of life. Starvation causes medical complications of its own, such as thyroid problems, anemia and joint pains. Death can occur in the most severe cases, most commonly because of an irregular heartbeat caused by an imbalance of the salts in the bloodstream.

There are two subtypes of anorexia nervosa, a restricting type and a binging/purging type. A person with the restricting type of anorexia diets, fasts and exercises. The binging/purging type involves eating large quantities of food, then vomiting. Many people go back and forth between these two patterns.