Anorexia, eating disorders

What is it?

Anorexia nervosa is an eating disorder of the person who has a desperate search for skinniness. It makes the person use strategies to lose weight causing a great thinness. These patients present a great fear of getting fat even being extremely skinny. In most of the cases, 90% are related to female teen-agers and young adult women from 12 to 20 years old. It is a disease which presents clinical risks, and may cause death by malnutrition.

What are the symptoms?

Lost of weight in a short period of time.
Eating worries and obsession with body image and weight.
Even being excessively thin, the person believes she/he is fat.
Stopping of the menstrual cycle (amenorrhea).
Exaggerated interest in food.
Eating in secret and lying about food.
Depression, anxiety and irritation.
Excess of physical exercises.
Progressive isolation from the family members and friends.

Medical complications:

Malnutrition and dehydration.
Hypotension (low blood pressure).
Muscle mass reduction.
Lack of tolerance to the cold.
Decreased gastric motility.
Amenorrhea (stopping of the menstrual cycle).
Osteoporosis(bone rarefying and weakness).
Infertility in chronic cases.

What are the causes?

There is not one unique cause to explain the development of anorexia nervosa. This syndrome is considered multidetermined by various biological, psychological, family and cultural factors. Some researches call our attention to the fact that overvaluing of skinniness and the prejudice against fatness in western societies might be related to the occurrence of such conditions.

How does it develop?

Teen-agers worried about their weight and body image progressively start and a more selective diet, avoiding high calories food at the maximum, together with other strategies to lose weight, such as: excessive physical exercises, vomiting, and absolute fasting.

The person continues to feel fat, even though she/he is extremely thin, becoming a slave of the calories and the rituals in relation to eating. Self-isolation from family members and friends takes place and the person becomes sadder and sadder, irritated and anxious. Very rarely the person admits having problems and does not accept any help at all. The family may take some time to notice that there is something wrong. Therefore, individuals with anorexia nervosa may not receive medical treatment, until they become dangerously thin and undernourished.

How is it treated?

The treatment must be conducted by a multidisciplinary medical team composed of a psychiatrist, psychologist, pediatrician, general clinician and nutritionist, because of the complex interaction of emotional and physiological problems of eating disorders.

When the anorexia nervosa is diagnosed, the physician must evaluate if patient´s is at risk and if so, require him/her to be hospitalized.

The major objective of the treatment is restoring the body weight through an eating habit reeducation with psychological support. In general, it is necessary some kind of psychotherapy to help the patient to cope with the disease and address the emotional issues underlying it.

Individual psychotherapy, family therapy or orientation, cognitive and behavioral therapy (a psychotherapy that teaches the patients how to change their thoughts and abnormal attitudes) are, in general, very productive.

In the case of anorexia nervosa there is no specific medication indicated. The use of antidepressive drugs can be effetive should the symptoms of depression persist after body weight recovering.

The treatment of anorexia nervosa is usually long and difficult. The patient must be monitored after improvement of his/her condition in order to avoid symptoms relapse.

How to prevent it?

A diminishing the cultural and family pressure in relation to the overvaluing of the physical appearance and beauty might reduce an incidence of such cases. It is fundamental to provide information about the risks of strict diets to obtain the "ideal" silhouette, for they have a leading role in the triggering of the eating disorders.