Overview : Anorexia Nervosa
MENTAL DISORDERS :
- Mental disorder is a group of emotional , cognitive and behavioral symptoms that causes distress or disability .
EATING DISORDERS :
- Eating disorders are characterized by a severe disturbance in eating behavior .
- Eating disorders make you obsessed with food and distort your perception about ideal body size .
TYPES OF EATING DISORDERS :
Within the DSM there are two types of adult eating disorders :
- Anorexia Nervosa
- Bulimia Nervosa
- The term ' Anorexia Nervosa ' literally means " lack of appetite induced by nervousness " . But the real problem is not the lack of appetite . At the heart of anorexia nervosa is an intense fear of gaining weight or becoming fat , combined with a refusal to maintain even a minimally low body weight .
- Descriptions of extreme fasting or ascetic food refusal that were probably signs of anorexia nervosa can be found in the early religious literature .
- The first known medical account of anorexia nervosa was published in 1689 by Richard Morton . Morton described two patients , an 18 year old girl and a 16 year old boy , who suffered from a " Nervosa consumption " that caused wasting body tissue . The female patient eventually died because she refused treatment . The disorder did not receive its current name until 1873 , when Charles Lasegue in Paris and Sir William Gull in London independently described the clinical syndrome . In his last publication on the condition , gull described a 14 year old girl who began " without apparent cause , to evince a repugnance to food ; and soon afterwards declined to take any whatever , except half a cup of tea or coffee " after being prescribed to eat light food every few hours , the patient made a good recovery .
DSM - IV - TR :
- Refusal to maintain a body weight that is normal for the persons age and height .
- Intense fear of gaining weight or becoming fat , even though underweight .
- Distorted perception of body shape and size .
- Absence of at least three consecutive menstrual periods .
Although the DSM criteria for anorexia nervosa require that post - menarcheal females stop menstruating in order to be diagnosed with the disorder , some have questioned the value of this diagnostic criteria . Studies have suggested that women who continue to menstruate but meet all the other diagnostic criteria for anorexia nervosa are just as ill as those who have amenorrhea . For men the equivalent of the menstruation criteria is diminished sexual appetite and lowered testosterone levels .
GENERAL CHARACTERISTICS :
- Patients suffering from anorexia nervosa deny having any problem .
- Patients may be quite proud of their weight loss .
- Patients conceal their thinness by wearing baggy clothes or sometimes carry hidden bulky objects to make themselves look heavier than they are .
- If they are being weighted , patients with anorexia nervosa may drink large amount of water to increase their body weight temporarily .
DIFFERENCE ( Between Binge - Eating / Purging Type Of Anorexia Nervosa And Bulimia Nervosa ) :
- The clinical picture of the binge - eating / purging type of anorexia has much in common with bulimia nervosa . Indeed some researchers have argued that the bulimic type of anorexia nervosa should really be considered other form of bulimia .
- The difference between a person with bulimia nervosa and a person with the binge - eating / purging type of anorexia nervosa is weight . By definition , the person with anorexia nervosa is severely underweight . This is not true of the person with bulimia nervosa . Consequently , if a person who binges or purges also meets for anorexia nervosa , the diagnosis is anorexia nervosa and not bulimia nervosa .
- It is important to understand that people with anorexia nevosa and bulimia nervosa share a common and overwhelming fear of becoming fat . However , unlike patients with anorexia nervosa , bulimic patients are typically of normal weight . Sometimes they may even be sightly overweight . The fear of becoming fat helps explain the development of bulimia nervosa .
TYPES OF ANOREXIA NERVOSA :
There are two types of anorexia nervosa :
- The Restricting Type
- The Binge - Eating / Purging Type
THE RESTRICTING TYPE :
- In the restricting type , every effort is made to limit how much food is taken , and caloric intake is tightly controlled . Patients avoid eating in presence of other people . When they are at the table , they may eat excessively slowly , cut their food into very small pieces , and dispose of food secretly .
THE BINGE - EATING / PURGING TYPE :
- Patients with binge - eating / purging type of anorexia nervosa differ from patients with restricting type of anorexia nervosa because they either binge , purge , or binge and purge .
- A binge involves the out - of - control eating of amount of food that are far greater than what most people would eat in the same amount of time and under the same circumstances .
- Binge can be followed by the efforts to purge , or remove the eaten food from their bodies . Methods of purging can be self induced vomiting , use of laxatives etc . Purging strategies do not prevent the absorption of all calories from food .
CASE STUDY :
- John , a 10 year old boy , is referred by a pediatrician who asked far an emergency evaluation because of a serious weight loss during the past year for which the pediatrician could find no medical cause . John is extremely concerned about his weight and weighs himself daily . He complains that he is too fat , and if he does not lose weight , he cuts back on food . He has lost 12 kg in the past year and still feels that he is too fat , though it is clear that he is underweight . In desperation , his parents have removed the scales from the house , as the result , john is keeping a record of the calories that he eats daily . He spends a lot of time on this , checking and rechecking that he has done it just right .