Anorexia nervosa

Anorexia nervosa is an eating disorder characterized by voluntary starvation and exercise stress. Anorexia nervosa is a complex disease, involving psychological, sociological and physiological components. A person who is suffering from anorexia is referred to as 'anorexic' or (less commonly) 'anorectic'. "Anorectic" is the noun form, where "anorexic" is the adjectival form. These two are often used incorrectly when applied. The term is frequently but incorrectly shortened to anorexia, which simply refers to the medical symptom of lost appetite.

Characteristics

The causes of anorexia are a matter of debate in medical circles and society in general. General perspectives fit between the poles of it being physiological or psychological (with the potential for sociological and cultural influences being a cause to various degrees) in origin. Many now take the opinion that it is a mix of both, in that it is a psychological condition which is often (though not inherently) borne of certain conducive neurophysiologic conditions.

Related Topics:
Medical - Physiological - Sociological - Cultural

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Physiological

The primary physiological characteristics of anorexia nervosa are voluntary starvation and exercise stress. In addition to intentional starvation, subjects will also take part in a high level of physical activity. Anorexia nervosa also has a negative impact on the immune system and the central nervous system (CNS).

Related Topics:
Immune system - Central nervous system

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It is also thought to be linked to serotonin and dopamine abnormalities.

Related Topics:
Serotonin - Dopamine

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Many individuals who have obsessive-compulsive disorders also have an eating-disordered parent, presumably connected with shared genetic characteristics.

Related Topics:
Obsessive-compulsive - Parent

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Anorexic subjects will often go through a cycle of recovery and relapse.

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Neurochemistry abnormalities

There is increasing speculation that the onset of anorexia has a genetic component, with a certain gene linked to abnormalities with the neurotransmitter chemical serotonin being shown to be more common amongst sufferers than the general population. Such genetic characteristics might potentially equate to an easier path towards overly high serotonin levels, thus instilling heightened levels of anxiety and the like. Biologically, when a person is in a state of starvation, their levels of serotonin decrease, and thence increase again upon the consumption of food because of the tryptophan amino acids contained therein (tryptophan is used by the body to synthesise serotonin). This raises the spectre that the anorexic is conditioned into avoiding food to reduce his or her anxiety, and that there may be yet another layer of complexity with respects to the cause/effect relationship between physiological factors and the mental beliefs of the anorexic.

Related Topics:
Genetic - Neurotransmitter - Chemical - Serotonin - Tryptophan - Amino acid - Conditioned

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Dietary minerals and heavy metals

Victims of mercury, lead, beryllium and arsenic poisoning have been known to develop anorexia as a symptom thereof. Some psychological traits associated with anorexia are consistent with deficiencies in important vitamins and minerals, such as magnesium and the B vitamins. Zinc deficiency is common among anorexics, thereby resulting in heightened levels of copper which is associated with depression and nervousness. That these deficiencies (or untoward exposure to heavy metals) can produce powerful psychological effects, such as depression, anxiety, and loss of appetite, is not widely known. Conversely, overexposure is also harmful.

Related Topics:
Mercury - Lead - Beryllium - Arsenic - Vitamin - Mineral - Magnesium - Zinc - Copper

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Animal model

There exists an animal model of anorexia nervosa that closely mimics the physiological effects of the disease. In the animal model, subjects are intentionally subject to starvation and access to unlimited ability to exercise. Under these conditions, without intervention, subjects will eventually run and starve themselves to death. Compared to cases of food restriction without exercise access, the subject will not starve themselves to death.

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In the animal model of anorexia nervosa, it has been shown that repeated cycling of recover and relapse will lead to physiological adjustments from the subject. Subjects under these conditions will eventually become "resistant" to the animal model, and will not starve themselves to death. Subjects under these conditions show a metabolic adjustment.

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Primary physiological effects

Generally:

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• Voluntary starvation
• Exercise stress
• Obsessive-compulsive behavior

In the animal model:

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• Negative impact on the immune system
• Negative impact on the Central Nervous System
• Serotonin deficiency

Psychological

Anorexia nervosa alters an individual's body image to the point where it is perceived as being fat and bilious irrespective of their actual size. This distorted body image is a source of considerable anxiety, and losing weight is considered to be the solution. However, when a weight-loss goal is attained, the anorexic still feels overweight and in need of further weight loss.

Related Topics:
Body image - Fat - Distorted body image - Anxiety

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The attainment of a lower weight is typically viewed as a victory, and the gaining of weight as a defeat. "Control" is a factor strongly associated with anorexia nervosa, and an anorexic typically feels highly out of control in his or her life. However, the nature of the condition with respect to such psychological factors is highly complicated.

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It is often the case that other psychological difficulties and mental illnesses exist alongside anorexia nervosa in the sufferer. Mild to severe manifestations of depression are common, partly because an inadequate food energy-intake is a well-known trigger for depression in susceptible individuals. Other afflictions may include self-harm and obsessive-compulsive disordered thinking (aside from such disordered thinking connected to their eating disorder). However, not all anorexics have any such problems besides their eating disorder.

Related Topics:
Mental illness - Depression - Food energy - Self-harm - Obsessive-compulsive disorder

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Many anorexics reach a low level of body weight at which hospitalisation and forced-feeding are required on a long-term or recurring basis in an attempt to keep them from literally starving themselves to death. Prolonged starvation will result in death as the body's systems shut down, this in itself being the major danger factor of anorexia aside from intense mental suffering and the risk of suicide.

Related Topics:
Hospital - Forced-feeding - Death - Suicide

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Some anorexics may incorporate bulimic behaviours into their illness: binge-eating and purging themselves of food on a regular or infrequent basis at certain times during the course of their illness. Alternatively, some individuals might switch from having anorexia nervosa to having bulimia. While bulimia poses less of a mortal danger to life and limb, many who have suffered both say that bulimia involves more mental suffering.

Related Topics:
Bulimic - Binge-eating - Purging

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Anorexia alters ones body image so that one does not see the truth about oneself even when one looks in the mirror — to the anorexic mindset, there is no such thing as being too thin. Anorexics acknowledge their condition to different degrees — at one extreme, they do not see their "disease" as dangerous and resent being labelled as psychologically ill; at the other, they understand and accept that they have a problem, yet the anorexia still takes control over their thinking to fluctuating degrees. In ways not too dissimilar from people who have had cult programming or post-traumatic stress disorder, an anorexic may be "triggered" into manic disordered thinking by being exposed to certain words or conditions.

Related Topics:
Mirror - Cult programming - Post-traumatic stress disorder - Manic

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Some people eat unusually small amounts of food for reasons other than their own perceived obesity. Examples include those who fast for religious reasons, execute a hunger strike as a political statement, or are attempting to lengthen their lifespan through caloric restriction. Such individuals are not ordinarily considered anorexic, although some modern critics of religious asceticism have likened habitual fasting to anorexia nervosa.

Related Topics:
Obesity - Fast - Hunger strike - Caloric restriction - Asceticism

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Sociological

The mass media and advertorial marketing, such as beauty advertising, are also frequently viewed as being implicated in triggering eating disorders in teenage girls, although it has recently come to light that there appear to be girls exhibiting anorexic behaviours in remote parts of Africa that have not been exposed to modern forms of advertising. These girls link their self-starvation to religious causes.

Related Topics:
Mass media - Marketing - Beauty advertising - Africa - Advertising - Religious

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Although anorexia is usually associated with western cultures, the exposure to western media has caused the disease to appear in some third-world nations.

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In recent years, the Internet has enabled anorexics and bulimics to contact and communicate with each other outside of a treatment environment, with much lower risks of rejection by mainstream society. If an anorexic is already socially withdrawn, such a network of friends can be very helpful in bringing him or her back. On the other hand, the Internet is also a powerful tool with which people can isolate themselves. A variety of websites exist, some run by sufferers, some former sufferers, and some by professionals; attitudes on these sites range through a no-holds-barred, tough-love "put it in your mouth" approach through simple acceptance and even to promotion of anorexia as an "alternate lifestyle" (see pro-ana).

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Clinical definition

The following is considered the "textbook" definition of anorexia nervosa to assist doctors in making a clinical diagnosis. It is in no way representative of what a sufferer feels or experiences in living with the illness. It is important to note that an individual can still suffer from anorexia even if one of the below signs is not present. In other words, it is dangerous to read the diagnostic criteria and think either oneself or others must not be anorectic because one or more of the symptoms listed are not present.

Related Topics:
Doctors - Clinical diagnosis

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• Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
• Maintaining excessive physical activity.
• Intense fear of gaining weight or becoming fat, even though underweight.
• Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
• In postmenarcheal females (women who have not yet gone through menopause), amenorrhea (the absence of at least three consecutive menstrual cycles).

Restricting Type: during the current episode of anorexia nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)Binge-Eating Type or Purging Type: during the current episode of anorexia nervosa, the person has regularly engaged in binge-eating OR purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).

Related Topics:
Binge-eating - Laxative - Diuretic - Enema

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Dangers

Anorexia has the highest death rate of any psychiatric illness. Starvation can cause major organs to shut down. A heart attack is one of the most common causes of death in those suffering with an eating disorder. People can die from eating disorders at any body weight.

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Osteoporosis is another danger of anorexia. Low calcium intake is only part of the problem. Even in those who take in adequate calcium through food or supplements, amenorrhea prevents the body from absorbing it fully.

Related Topics:
Osteoporosis - Calcium

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