A Family Doctor's Tale - ANOREXIA NERVOSA

DOC I HAVE ANOREXIA NERVOSA

Anorexia nervosa is defined as the persistent refusal to eat resulting in marked loss of weight.

It is a psychological problem with patient becoming obsessed with his or her so called obesity with
intent to lose weight as a result.

There is 3 components to this eating problem:

1.fear of weight gain

2.distorted image of  thin body as the perfect body

3.refusal to eat to gain a healthy body weight


This condition is more prevalent in women than in men.

Onset usually occur in puberty.

The most common causes are:

1.obstensible fear of obesity resulting in excessive dieting.

2. distorted image of the body size related to psychosexual conflicts in the brain.

3.fear of eating resulting in low weight and thin body size

Risk factors in anorexia:

1.familial - can occur in families and more common in females

2.Dissatisfaction about body size

3.Low self esteem about his or her appearance

4.perfectionism in every thing he or she does


5.family problems

6.Dieting history in family

7.Difficulty in communication

8.history of physical or emotional abuse


Symptoms:
1.progressive and excessive weight loss


2.obsessed about being thin -

a.reduce food,

b.eating low calorie foods

3.preoccupied about food and meal times -

a.avoiding certain food,lying about food eaten,

b.throwing away or hiding food,

c.complains of stomach pain during meal time


4.secret meal time rituals

a.refuse to eat with the rest of family

b.chewing food and then spitting it out

5.taking laxatives, diuretics and diet pills to lose weight

6.excessive physical exercise to burn off fats

7.Fixation on a thin image

a.checking on body in the mirror

b.constant monitoring and measurement  of weight

Complications of anorexia nervosa are:


1.Associated induced endocrine changes (amenorrhea, hirsutism)


2.Loss of energy and weakness


3.vitamin deficiency and anemia


4. depression and mood changes

5.bloating of abdomen and constipation

6.gingivitis (gum infection) and tooth decay

7.brittle finger nails

8.dry skin

9.giddiness and headaches

10.poor memory and concentration


Anorexia nervosa may be associated with bulinia and induced vomiting

Treatment of anorexia nervosa:

Psychotherapy:

1.The patient must acknowledge  that she or he has a eating problems which need to be treated

2.counseling by psychologist or psychiatrist can help by:

a.remove negative thoughts about body size

b.provide positive thoughts about a healthy body and mind

c.help to deal with stress, family relationships, emotional upsets

d.stay away from friends who advocate bad eating habits


Medical treatment:
1.Hospitalization and forced feeding in severe cases


2.Correction of nutrition and metabolic deficiency

-a nutritionist will help teach healthy food habits and a proper meal plan to achieve a healthy weight


3.Use of antidepressant and serotonin blockers may reduce low self esteem and depression


Prognosis
Good in mild cases.


Poor in severe cases,may be fatal as in the case of Mary Carpenter.

Prevention:

1.Nutritional education regarding the needs of the body for nutrients which will help the mind, endocrine system, physical appearance


2.Psychotherapy to emphasize the importance  and positive effects of nutrients on the person to develop  a healthy mind and  body