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Anorexia Nervosa PDF Print E-mail
Written by Robert A Wilson   
Friday, 16 February 2007

Anorexia nervosa is an eating disorder characterized by restriction of food intake, binge-eating/purging, or a combination of the two. In the U.S., the incidence is estimated at between 0.5 to 3.7% with an approximate 4:1 female to male ratio. Despite aggressive family and medical intervention, most patients with anorexia nervosa remain in denial and only gradually come to understand and accept the disease process.
In more seriously affected patients, high rates of the following comorbid psychiatric conditions are common.
  • Depression is present in 50-75% of anorexia patients
  • Bipolar disorder is between 4-13%
  • Obsessive-compulsive disorder (OCD) is as high as 25%
  • Anxiety disorders, particularly social phobia, are common
  • Substance abuse has been found in as many as 30-37% of patients with bulimia nervosa and 12-18% with anorexia nervosa
  • Comorbid personality disorders (particularly borderline personality disorder and avoidant personality disorder) estimates range from 42-75%.
  • Sexual abuse has been reported in 20-50%
Men and women who are endurance atheletes and with perfectionist personalities are at higher risk of developing an eating disorder. The onset can be insidious and more apparent to outsiders than family members.

Diagnosis:

Besides the obvious cachectic physical appearance and low BMI, starvation can cause arrythmias, long QT interval, weakness, cold intolerance, ammenorhea, pitting edema, muscle and skeletal pain, abdominal bloating/pain with delayed gastric emptying and fine body hair (lanugo)

Treatment:

Specific treatments include nutritional rehabilitation, psychosocial interventions, and medications (like SSRIs - do not use Wellbutrin); all may be used to correct malnutrition, culturally mediated distortions, and psychological, behavioral, and social deficits. Prognosis is best when detected and treated at a young age. Mortality can be as high as 10%. Despite rigorous treatment, relapse is common and thus, it must be considered a chronic disease. Despite acceptable weight gain and body image, patients with anorexia nervosa will tend to have a lifetime preoccupation with food and low body weight.
Last Updated ( Friday, 08 February 2008 )
 
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