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Today in Health & Wellness

Anorexia Nervosa

Risk Factors
Commonly Prescribed Drugs
Treatment and Management
Doctors to Consult

Anorexia nervosa or simply anorexia is a chronic eating disorder characterized by an unhealthy fixation on weight control and negative perception of one’s body image. Patients suffering from anorexia become obsessed with weight loss which results in patients being significantly underweight. Anorexia is most common among healthy young women especially in cultures where being thin equates to attractiveness.

The cause of anorexia remains unknown but it is believed to involve psychological, cultural, and biologic risk factors. Anorexia frequently starts with a weight loss diet which becomes stricter due to the fear of regaining the lost weight. Patients view weight loss as an accomplishment and weight gain as a personal failure.

Diagnosis of anorexia is based on the presence of key features which include refusal to maintain a normal body weight for their age and height, intense fear of weight gain, distortion of body image, and lack of menstrual period. Most patients have their weights less than 85% of the normal body weight. Some patients restrict their intake of food and usually do excessive exercise while others eat in excess on a regular basis then self-induce vomiting or abuse laxatives. Laboratory tests and other diagnostic tests can be done to eliminate other conditions that cause weight loss.


Physical symptoms

  • Extreme weight loss
  • Thin appearance due to low body weight
  • Abnormal blood count
  • Fatigue
  • Insomnia
  • Bluish discoloration of fingers
  • Thinning hair that breaks or falls out
  • Lack of menstrual periods
  • Dry or yellowish skin
  • Cold intolerance or increased sensitivity to cold
  • Irregular heart rhythms
  • Osteoporosis
  • Dehydration

Emotional and behavioral symptoms

  • Severe restriction of food intake
  • Excessive exercise
  • Overeating then self-induced vomiting
  • Abuse of laxatives, enemas, diet aids, or herbal products to lose weight
  • Preoccupation with thoughts of food
  • Refusal to eat or starvation
  • Denial of hunger
  • Extreme fear of gaining weight
  • Social withdrawal
  • Irritability
  • Depression
  • Suicidal thoughts
Risk Factors
  • Sex. Females are more prone to anorexia
  • Young age. More common in teenagers
  • Family history. Having an immediate relative who had anorexia
  • Weight changes. Weight changes and comments from others can influence a person’s desire to lose weight
  • Transitions. Changes in the environment or situations like transferring to a new school, home or job, a relationship breakup or death of a loved one
  • Nature of work or sport. Athletes, actors, dancers, and models are at increased risk
  • Genetic component. Some people with genetic tendency towards perfectionism, perseverance, and sensitivity are at increased risk
  • Media and society. Media portray thin models and actors with success and popularity which can promote low body weight
Commonly Prescribed Drugs

Drugs given to anorexic patients are for the treatment of its complications. These drugs do not reduce the desire of the person to lose weight. Some of the prescribed drugs for anorexic patients include:

  • Selective serotonin reuptake inhibitors (SSRIs) are the antidepressant medications given to patients with anorexia and mood disorders such as depression and anxiety. These are usually prescribed to a patient who has already gained enough weight to reduce the severity of side effects. Examples of SSRIs include citalopram, escitalopram, and fluoxetine. Side effects: feeling agitated, dizziness, blurred vision
  • Olanzapine is an antipsychotic medication given to anorexic patients who have not responded to other treatments. It reduces the anxiety felt regarding weight and diet and helps in gaining weight. Side effects: dizziness, bloating, change in vision, stomach acidity
Treatment and Management
  • Treatment approach to anorexia involves different types of treatment such as therapy and nutrition education. The primary goal of treatment is to improve the body weight of the patient. There are no medications approved for treating anorexia specifically. Medications can be prescribed to treat the complications of anorexia.
  • Some patients may require hospitalization. It occurs when medical conditions like heart rhythm disturbances, dehydration, electrolyte imbalance, and psychiatric problems arise on the patient. Anorexic patients with severe malnutrition or continued refusal to eat may also be hospitalized.
  • For teenagers, a family-based therapy is done to involve the parents in the weight restoration of the child.
  • For adults, cognitive behavioral therapies are beneficial. This type of therapy helps normalize eating patterns to support weight gain and maintenance. Negative thoughts regarding weight gain and restrictive eating are targeted.
  • Nutritional counseling is important in restoring normal eating patterns. It provides information on the importance of nutrition and a balanced diet.
  • Continuous treatment even after gaining weight is beneficial. This is especially important during times of high stress or triggering situations to avoid the relapse of the eating disorder.
Home Remedies
Doctors to Consult
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