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The obvious symptom of Anorexia Nervosa (AN) is that the person is starving. Less obvious is that the person has an extremely distorted perception of her own body. It affects mostly women (90%), although a small percentage of those affected are men. Although the diagnosis requires that she be at or below 85% of a normal body weight, she is dreadfully afraid that she is too fat or will become too fat if she doesn't continue to diet and take other measures. She denies the danger associated with her malnutrition; one symptom required for the diagnosis of AN is that she has missed at least three periods (if they had started, know as amenorrea), or that they have failed to start. DSM-IV distinguishes between two types of AN. The first, restricting, type simply does not eat enough. The second type engages in binge eating, followed by purging (most often, vomiting) and is similar in this respect to Bulimia Nervosa. Contrary to the implication of the word "anorexia," people with AN typically have a raging appetite, and about half of them sometimes binge and get rid of the food by vomiting or taking laxatives, or counteract the calories by compulsive exercising. They are preoccupied with food, calories, fat, exercise, and their body image. They are likely to be perfectionists. It is not unusual for people with AN to weigh much less than 85% of a normal weight-- to weigh, for example, 50% to 60% of a desirable weight, and to continue to refuse to eat. The medical results can, understandably, be numerous and extremely serious; 10% of AN patients admitted to university hospitals eventually die. Depression is higher for people with AN than for the general population, and patients may also exhibit symptoms of Social Phobia (fear of eating in public), Obsessive-Compulsive Disorder (obsession with eating and fat), and Body Dysmorphic Disorder (upset about some bodily feature). The incidence of AN is low (probably less than 1% even for adolescent females) but probably increasing. Its course is unpredictable, with all outcomes--single incident only, recurring, chronic--perhaps about equally likely. Hospitalization is necessary in severe cases to prevent death. Near-normal weight can be recovered and maintained in about 2/3 of the cases with careful and persistent treatment. If someone you love shows symptoms of this disorder, you need to consult a mental health professional (clinician, therapist). A mental health professional will conduct a thorough evaluation to first understand what is happening and then will discuss treatment options, including medications if available. There are many ways family members or loved ones can help individuals who are dealing with the disorder. These books may be helpful: Surviving an Eating Disorder : Strategies for Family and Friends by Michelle Siegel, Judith Brisman, Margot Weinshel Anorexia Nervosa : A Guide to Recovery by Lindsey Hall, Monika Ostroff
Last updated 12/19/03 |
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