Anorexia Nervosa

Anorexia nervosa is an eating disorder characterized by excessive weight loss, fear of weight gain, and a distorted perception of body weight. It is a serious mental condition in which the person tries to keep body weight as low as possible. The person may try to restrict the diet to lose weight or exercise too much to remain thin. 

Their extreme efforts to have the desired body weight may affect their daily activities. Most people suffering from anorexia have a very low body weight in comparison to their BMI. Anorexia results when somebody tries to equate body weight and self-worth. 

They often lose track of who they actually are. Treatment helps to get back to healthy eating habits and reverse the complications caused by anorexia.

Anorexia nervosa is characterized by behavioral symptoms like: 

• Intense fear of gaining weight
• Distorted body image and prioritizing weight loss
• Severely restricting food 
• Exercising in excess to lose weight
• Self-inducing vomit or over use of laxatives and diet aids
• Denial of hunger and refusing to eat
• Irritability and depressed
• Self-destructive thoughts
• Lying about how much food has been eaten

The physical signs and symptoms of anorexia include: 

• Increased weight loss
• Fatigue
• Insomnia
• Dizziness
• Bluish color in fingers
• Thin and brittle hair
• Lack of menstruation
• Sensitivity to cold
• Dehydration
• Osteoporosis
• Swelling in legs and hands
• Constipation
• Irregular heartbeat

Anorexia nervosa can be caused by a number of factors. A combination of biological, physiological, and environmental factors are implied in this condition. Certain genetic features are considered to increase the risk of anorexia. 

There are some genetic traits which makes a person work towards perfection and sensitivity. These two traits are closely linked to anorexia. Some obsessive-compulsive thoughts about being thin makes a person stick to restricted diet. They often deny being hungry and are obsessed with being thin. Certain cultures in the modern day prefer thin people to normal, healthy individuals. 

Success and self-worth are measured in terms of thinness. Thus young people often develop this habit being thin. 

Factors that increase the risk of anorexia are: 

• Gender – it is more commonly seen among females when compared to men. 
• Age – it prevalent among teenagers, but may develop at any age. 
• Genes – certain genes are found to increase the chance of anorexia 
• Family history – people with a family history of this disease have increased risk of anorexia
• Emotional stress – stress is a major trigger for anorexia

Making diagnosis of Anorexia nervosa is done by several tests.

Tests are recommended to find the underlying cause for weight loss. This will also help to rule out chances of other medical conditions that cause similar symptoms. 

Physical examination include measuring BMI, heartrate, blood pressure, and examining vital organs like heart and lungs.

Lab tests include complete blood count, liver and kidney function tests, measure of electrolytes and proteins, and urinalysis

Psychological tests help to understand eating habits. Self-assessment questionnaires are used to analyze the patient’s thoughts about food and body weight. 

Confirmatory diagnosis is based on The Diagnostic and Statistical Manual of Mental Disorders given by American Psychiatric Association. The main criteria for the diagnosis of anorexia are: 

• Restricted food intake – food intake lesser than what is needed to maintain healthy body weight
• Fear of gaining weight – fear of becoming fat, and behavior tuned to reduce body weight
• Problems with body image – relating body weight to self-worth, and having a distorted image of appearance

A number of treatment methods are used for Anorexia nervosa.

Serious symptoms like distorted heart rhythm, dehydration, and electrolyte imbalance may require hospitalization and medical attention. Vital signs, dehydration, and electrolyte balance are monitored continuously to avoid complications. Severe cases of anorexia may require feeding with the help of nasogastric tube. 

Treatment aims at getting back to normal, healthy body weight. Dietitian provides guidance to regular patterns of eating. They will be able to help out with a diet plan that provides essential nutrients and to maintain normal body weight. 

Individual and family-based therapy also help to treat anorexia. Family-based therapy guides parents to help their child to get back to normal eating habits. Cognitive behavioral therapy aims at normalizing eating behavior in the affected individual. It also helps to change the distorted beliefs about weight. 

Anorexia arises form a combination of biological, psychological, environmental factors and addressing these factors is the only way to prevent this disorder. Reducing risk factors like dissatisfaction about body weight or appearance, and equating self-esteem with thinness helps to prevent anorexia.

Acupuncture, massage, yoga, and meditation are some of the alternative and homeopathic remedies used for anorexia. But none of the alternative medicines are supported by scientific evidence. 

Arsenicum alb, Carcinosin, Hyosyamus, Ignatia, Natrum mur, Phosphoric acid, Platina met., Pulsatilla, Sepia, and Stapysagria are homeopathic medications used in treatment of this eating disorder.

Lifestyle modifications are necessary in order to cope with Anorexia nervosa.

Some self-care steps are equally important as professional steps. Be consistent with the treatment plan and take nutritional supplements, if needed.

Don’t isolate and avoid weighing often.

Take help from family and friends to develop coping strategies.

Anorexia nervosa may cause severe complications, even death. Anemia, heart problems, bone loss, lack of menstruation in women, gastrointestinal problems, electrolyte abnormalities, kidney problems, and suicidal thoughts are some of the complications associated with anorexia.