Anorexia

What is Anorexia?
Anorexia is an eating disorder in which the individual refuses to eat to maintain a body weight normal for his/her height. It is an emotional illness and usually first strikes females between 12-25 years old. It can affect males as well. If left untreated, it has a mortality rate of 5-18 percent.

What causes Anorexia?
An eating disorder occurs when a person begins to focus obsessively on food and weight. It can develop without intent or awareness, and involves a shift from healthy to unhealthy use of food. Some causes are:

• Biology - Evidence is beginning to show some people genetically may be more prone to developing an eating disorder.
• Family of Origin - How food is used and viewed within a family, i.e. "comfort food."
• Individual - Using food to avoid direct conflict resolution, gain control, suppress emotions, or avoid the responsibilities of adulthood.
• Society's Expectations - Society expects individuals (especially women) to appear thin, beautiful, physically fit, and successful.

Anorexics don't start out trying to starve themselves. They may start dieting after a stressor occurs such as a breaking up of a relationship, parents divorcing, failing grades, or some other loss. By restricting food intake through dieting, they may gain a sense of autonomy and control they don't feel they have in their life.

Signs and Symptoms of Anorexia:

• Constantly thinking about or feeling fat
• Believing weight determines worth
• Feeling guilt or shame after eating
• Changes in eating patterns - eating less
• Problems sleeping or concentrating
• Greater susceptibility to colds/illness
• Thinness - loss of 15% or more of ideal body weight
• Continued dieting when not overweight
• Distorted body image - preoccupation with body size
• Preoccupation with food and calories
• Denial of hunger
• Excessive exercising
• Frequently weighing oneself
• Loss of menstruation (amenorrhea)
• Feeling nauseated or bloated after eating normal amounts of food
• Intense fear of becoming fat

Treatment Options
Any treatment must be tailored to the specific needs of each person, but there are some general principles that apply to treating eating disorders. The first step in treatment is to complete a thorough evaluation of the person, including a medical evaluation by a qualified physician and a psychosocial evaluation by a qualified mental health professional. Keep in mind these professionals should have experience with eating disorders. This information will be used by the mental health professional, the patient, and other members of the treatment team (physician, dietitian/nutritionist, family, etc.) to develop a treatment plan.

Treatment is done primarily in an outpatient setting and usually includes individual therapy, group therapy, and family therapy. Medication may also be necessary and helpful if the patient is experiencing depression or compulsive behavior.

In severe cases where there are significant physical complications (change in vital signs or blood chemistry, severe weight loss, dehydration, abnormal EKG, etc.), co-existing psychiatric disorders, or other unusual circumstances (such as significant resistance to treatment), inpatient hospitalization and treatment may be necessary.