Anorexia nervosa

Anorexia nervosa

Anorexia nervosa, also known as just anorexia, is an eating disorder. This disorder makes you obsess about your weight and food. If you have this problem, you may have a warped body image. You may see yourself as fat even though you have a very low body weight.

With anorexia, you may use unusual eating habits to cope with stress, anxiety, and low self-esteem. Limiting food may give you a sense of control over your life.

This problem affects more women than men. It often starts during the teenage years. The number of young women between the ages of 15 to 19 who have anorexia nervosa has increased every 10 years since 1930.

Causes

The exact cause of anorexia is not known, but research suggests that a combination of certain personality traits, emotions, and thinking patterns, as well as biological and environmental factors might be responsible.

People with anorexia often use food and eating as a way to gain a sense of control when other areas of their lives are very stressful or when they feel overwhelmed. Feelings of inadequacy, low self-esteem, anxiety, anger, or loneliness also might contribute to the development of the disorder. In addition, people with eating disorders might have troubled relationships, or have a history of being teased about their size or weight. Pressure from peers and a society that equates thinness and physical appearance with beauty also can have an impact on the development of anorexia.

Eating disorders also might have physical causes. Changes in hormones that control how the body and mind maintain mood, appetite, thinking, and memory might foster eating disorders. The fact that anorexia nervosa tends to run in families also suggests that a susceptibility to the disorder might partially be hereditary.

Symptoms

Physical signs and symptoms of anorexia may include:

• Extreme weight loss or not making expected developmental weight gains
• Thin appearance
• Abnormal blood counts
• Fatigue
• Insomnia
• Dizziness or fainting
• Bluish discoloration of the fingers
• Hair that thins, breaks or falls out
• Soft, downy hair covering the body
• Absence of menstruation
• Constipation and abdominal pain
• Dry or yellowish skin
• Intolerance of cold
• Irregular heart rhythms
• Low blood pressure
• Dehydration
• Swelling of arms or legs
• Eroded teeth and calluses on the knuckles from induced vomiting

Some people who have anorexia binge and purge, similar to individuals who have bulimia. But people with anorexia generally struggle with an abnormally low body weight, while individuals with bulimia typically are normal to above normal weight.

Behavioral symptoms of anorexia may include attempts to lose weight by:

• Severely restricting food intake through dieting or fasting
• Exercising excessively
• Binging and self-induced vomiting to get rid of food, which may include the use of laxatives, enemas, diet aids or herbal products

Emotional and behavioral signs and symptoms may include:

• Preoccupation with food, which sometimes includes cooking elaborate meals for others but not eating them
• Frequently skipping meals or refusing to eat
• Denial of hunger or making excuses for not eating
• Eating only a few certain "safe" foods, usually those low in fat and calories
• Adopting rigid meal or eating rituals, such as spitting food out after chewing
• Not wanting to eat in public
• Lying about how much food has been eaten
• Fear of gaining weight that may include repeated weighing or measuring the body
• Frequent checking in the mirror for perceived flaws
• Complaining about being fat or having parts of the body that are fat
• Covering up in layers of clothing
• Flat mood (lack of emotion)
• Social withdrawal
• Irritability
• Insomnia
• Reduced interest in sex

 Diagnosis

Although there are no laboratory tests to specifically diagnose anorexia, a healthcare provider may use various diagnostic tests, such as blood tests, to rule out any medical conditions that could cause weight loss and to evaluate the physical damage weight loss and starvation may have caused.

Tests to rule out weight-loss causing illness or to assess anorexia side effects may include:

• Complete blood count to assess overall health.
• An electrolyte blood panel to check for dehydration and your blood’s acid-base balance.
• Albumin blood test to check for liver health and nutrient deficiency.
• Electrocardiogram (EKG) to check heart health.
• Urinalysis to check for a wide range of conditions.
• Bone density test to check for weak bones (osteoporosis).
• Kidney function tests.
• Liver function tests.
• Thyroid function tests.
• Vitamin D levels.
• A pregnancy test in people assigned female at birth who are of childbearing age. Hormone tests if evidence of menstrual problems in people assigned female at birth (to rule out other causes) and measuring testosterone in people assigned male at birth.