Anorexia Nervosa

By Thea B.

The purpose of this paper is to write an overview of the eating disorder Anorexia Nervosa including: the history of Anorexia, some of the notable deaths, the causes, the symptoms, etc. Anorexia Nervosa, more commonly referred to as Anorexia, is an eating disorder (ED) most commonly defined by low weight, food limitation, fear of gaining weight, and a strong want to be thin. People with Anorexia will do many things to become thin and to stay thin. Anorexia is becoming more prevalent in our society today, some reasons for this could be the culture we live in that promotes skinny as beautiful, pro-ana{a people group that encourages and advocates Anorexia} and pro-mia{a people group that encourages and advocates bulimia}sites, as well as psychological, genetic, and environmental factors.

Causes

No single cause has been identified for Anorexia Nervosa, it most likely happens as an effect of biological, environmental, and psychological factors.

Environmental factors may include the hormonal alterations that happen during puberty, plus feelings of anxiousness, stress, and low self-esteem. The fashion industry and media messages proposing that thin is beautiful may also have an impact. Other environmental elements may include physical, sexual, or emotional abuse, family or other relationship difficulties, bullying, a fear of failure and a pressure to succeed or a troubling life circumstance, such as the loss of a loved one or becoming unemployed. According to the U.K.'s counseling directory, people with Anorexia “genuinely need to be in control of their lives; they need to feel special, and they need a sense of mastery.”. Research published in the American Family Physician describes a person with Anorexia as using “calorie intake or excessive exercise to control emotional need or pain.”. When a person feels out of power of one or more aspects of their life, not eating may be one way in which they can at least take control of their body.

Studies in biological and genetic factors have discovered that some people with eating disorders may have an instability in certain brain chemicals that control digestion, appetite, and hunger, but further investigation is required to substantiate this theory.

Genetic factors may affect a person's susceptibility to eating disorders, as they can run in families. Between fifty and eighty percent of the risk for Anorexia is thought to be genetic.

One of the strongest psychological risk factors for an eating disorder is perfectionism, especially a type of perfection called self-orientation perfectionism, which involves setting unrealistically high expectations for yourself.

The physical signs and symptoms of Anorexia Nervosa are affiliated with starvation, but Anorexia also includes emotional and behavioral symptoms involving an unrealistic perception of body weight and an extremely strong fear of gaining additional weight or becoming corpulent. It may be challenging to observe signs and symptoms because what is considered a low body weight is different for each person, and some individuals may not seem exceedingly thin. Also, people with Anorexia often disguise their thinness, eating habits or physical difficulties. Some of the signs and symptoms of Anorexia may be:

Low body mass index (BMI) for one's age and height.

Amenorrhea{An abnormal absence of menstruation}.

Brittle hair.

Yellow and unhealthy skin.

Fear of even the slightest weight gain.

Taking all precautionary measures to avoid weight gain or becoming “corpulent”.

Rapid, continuous weight loss.

Lanugo{Fine, soft hair that usually grows over the body of young babies to keep them warm}

An obsession with counting calories and monitoring fat contents of food.

Preoccupation with food, recipes or cooking.

Food restrictions despite being underweight or at a healthy weight.

Food rituals (cutting food into tiny pieces, refusing to eat in front of other people, hiding or discarding food, etc.).

Purging (may use laxatives, diet pills, ipecac syrup{An emetic and expectorant liquid preparation that is widely used to induce vomiting}, or water pills{Diuretics – Medications designed to increase the amount of water and salt expelled from the body as urine} to flush food out of their system after eating or may engage in self-induced vomiting.).

Excessive exercise including micro-exercising, for example, making small persistent movements of fingers or toes.

Perception of self as corpulent, in contradiction to an underweight reality.

Intolerance to cold and frequent complaints of being cold; body temperature may lower in an effort to conserve energy due to malnutrition.

Hypotension{Abnormally low blood pressure} or orthostatic hypotension{A systolic blood pressure decrease of at least 20 mm Hg or a diastolic blood pressure decrease of at least 10 mm Hg within three minutes of standing}.

Bradycardia{Abnormally slow heart action} or tachycardia{An abnormally rapid heart rate}.

Depression.

Anxiety disorders.

Insomnia.

Solitude; may avoid friends and family and become more reclusive and secretive.

Abdominal distension{A condition where substances, such as air or fluid, accumulate in the abdomen causing its expansion}.

Halitosis{A technical term for bad breath},from vomiting or starvation-induced ketosis{A metabolic state characterized by raised levels of ketone bodies in the body tissues}.

Dry hair and skin, as well as hair thinning.

Chronic fatigue.

Rapid mood swings.

Carotenosis{The technical term for abnormally orange skin}.

Having severe muscle tension, aches and pains.

Evidence/habits of self-harming or self-loathing.

Admiration of thinner people.

Abnormal blood count.

Bluish discoloration of the fingers.

Eroded teeth and calluses on the knuckles from induced vomiting.

Frequent checking in the mirror.

Abdominal cramping.

Gastroparesis{A condition in which your stomach cannot empty itself of food in a normal fashion}.

Telogen effluvium{A scalp disorder characterized by the thinning or shedding of hair}.

If Anorexia is not stopped these symptoms will persist leading to extremely serious consequences and ultimately resulting in death.

Anorexia can have numerous complications. At its most severe, it can be fatal. Death may happen abruptly – even when someone is not severely underweight. This commonly occurs because of heart complications or deficiency of electrolytes. If Anorexia is left untreated it can lead to serious, permanent, sometimes fatal, consequences including:

Osteoporosis{A medical condition in which the bones become brittle and fragile} or Osteopenia{Reduced bone mass of lesser severity than osteoporosis}.

Anemia{A condition characterized by a deficiency of red blood cells or of hemoglobin}.

Infertility{Inability to conceive children}.

Difficulty Conceiving.

Nerve Damage.

Pancytopenia{ A deficiency of all three cellular components of the blood}.

Increased Risk of Cardiac Arrest.

Growth Retardation{The slowing or stopping of growth}.

Hypogonadism{Reduction or absence of hormone secretion or other physiological activity of the gonads (testes or ovaries)}.

Hepatic Steatosis{An accumulation of fat in the liver}.

Wernicke Encephalopathy{ An acute neurological condition characterized by a clinical triad of ophthaloparesis with nystagmus, ataxia, and confusion}.

Delayed Stomach Emptying and Constipation.

Diarrhea.

Acute Pancreatitis{A sudden inflammation of the pancreas}.

Heartburn.

Trouble Swallowing.

Superior Mesenteric Artery Syndrome{ A gastro-vascular disorder in which the third and final portion of the duodenum is compressed between the abdominal aorta and the overlying superior mesenteric artery}.

Arrhythmia{A condition in which the heart beats with an irregular or abnormal rhythm}.

Irregularly Slow Heart Beat.

Low Blood Pressure.

Myocardial Fibrosis{An abnormal thickening of the heart valves}.

Hyperemesis Gravidarum{Persistent severe vomiting leading to weight loss and dehydration, as a condition occurring during pregnancy}.

Sinus Bradycardia{A sinus rhythm with a resting heart rate of 60 beats per minute or less}.

The brain may shrink which results in the lowering of the IQ.

Hypothermia{The condition of having an abnormally low body temperature, typically one that is dangerously low}.

Death.

If Anorexia is left untreated it can lead to one or more of these conditions stated above, which is why it is extremely important to identify Anorexia in the beginning and put an end to it.

An early diagnosis of Anorexia and immediate treatment increases the possibility of a good result. A complete medical history can assist with the identification. A medical practitioner will ask the patient about their weight, and, for females, about menstruation. If the physician suspects that an individual has Anorexia, he or she will typically do various tests and exams to help pinpoint a diagnosis, rule out medical justification for the weight loss, like diabetes, and check for any accompanying complications. These tests and exams generally include:

Physical exam. This may regard measuring of the height and weight; examining of vital signs, such as heart rate, blood pressure and temperature; examining of skin and nails for problems; listening to the heart and lungs; and probing of the abdomen.

Lab tests. These may incorporate a complete blood count (CBC) and more-specialized blood tests to examine electrolytes and protein as well as operations of the liver, kidney, and thyroid. A urinalysis might be done as well.

Psychological evaluation. A medical practitioner or mental well-being professional will most likely inquire about the patients thoughts, feelings, and consumption habits. The patient may also be requested to accomplish psychological self-assessment questionnaires.

Other studies. X-rays may be taken to examine the patients bone density, check for stress fractures or broken bones, or look for pneumonia or heart problems. Electrocardiograms may be done to check for heart irregularities.

According to the American Psychiatric Association's (APA's) Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5), the diagnostic criteria for Anorexia Nervosa is as follows:

Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.

Intense fear of gaining weight or becoming fat, even though underweight.

Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

The National Eating Disorder Association (NEDA) note that even without meeting all these criteria, a person may still have a serious eating disorder.

Though Anorexia was scarce until the second half of the 20th century, it surely subsisted beforehand. The first descriptions of Anorexia in the western world date from the 12th and 13th centuries, Most famously Saint Catherine of Siena, who renounced food as a component of a religious denial of oneself. There are various clinical descriptions of “wasting disease” (the name for Anorexia Nervosa in past centuries) in the 17th – 19th centuries, and in the early 20th century, Anorexia was thought of as an endocrine disorder and treated with pituitary hormones. In Dunglison's dictionary, publicized in 1865, Anorexia is characterized as an “absence of appetite” and specified that this symptom does not necessarily need to be accompanied by any articulated distaste or pronounced loathing” for food. Dunglison said plainly: “Anorexia or want of appetite is symptomatic of most diseases.”. In clinical practice most nineteenth-century physicians respected Anorexia as a plain and unmistakable sign of disease. Medical journals substantiate that medical practitioners saw a deficiency of appetite in numerous contrasting physical statuses like: tuberculosis, or an accompanying pulmonary condition known as phthisis, cancer, stomach diseases, anemias (such as chlorosis), chronic diarrhea, and the nausea of pregnancy. Anorexia was a peculiar symptom of patients troubled from diseases that were noticeable by “wasting”,that is, either short-lived or unrelenting loss of flesh. In abbreviation, Anorexia was an unspecific medical symptom, a mark of disease, but not a disease in its own personal right. In 1973, Hilde Bruch published a book with a quantity of case studies, titled Eating Disorders: Obesity, Anorexia Nervosa, And The Person Within. As the disorder gained public awareness in the 1970s, cases accumulated, spreading beyond the upper class. Because people with Anorexia were heeded as a wonder and a medical perplexity, abstinent girls bestowed entrepreneurial opportunities for sharp promoters. An undisguised case of commercialized intent concerned Josephine Marie Bedard, a poor seventeen year old French-Canadian girl from Lewiston, Maine. Represented as a modern-day Cinderella, Bedard grew up unhappily in the dwelling of her father, a stepmother, and numerous siblings. Evidently, she communicated directly with her departed mother's spirit and systematically sought-after her counsel and advice. According to newspaper reports, the piteous girl had eaten absolutely nothing for a time period of seven years. The newspaper declared that “She had no more desire to eat than other people would have to chew iron.”. Testimonies taken from community supporters affirmed that she ate no solid food but consistently drank tumblers full of water.

Many people have died from Anorexia, some of the most famous deaths from Anorexia would include: Javiera Munoz, who died from Anorexia on January 16, 2018. She was 40 yrs old, she was a Swedish singer best known for her two albums Javiera made in 2001 and True Love made in 2004. She struggled with Anorexia for 10 years. On November 17, 2010, Isabelle Caro passed on, she was a french fashion model, anti-Anorexia activist and actress. She was widely known for her skinniness and she appeared on multiple television shows including CBS's The Insider. She was 28 years old when she passed, she was diagnosed with Anorexia when she was 13. On November 14, 2007, Hila Elmalich passed away, she was an Israeli fashion model. She died when she was 33 years old, she was diagnosed with Anorexia around the time she became a model, so she was about 13 years old. After her death, photographer Adi Barkan had the BMI{The BMI is an index that states the maximum and minimum weight a model can be} (body mass index) edited, which means for example Israeli models who are “5 9” would have to weigh at least 129 lb, so women won't feel so oppressed to lose weight.

It is calculated that eight million Americans have an eating disorder, Seven million women and one million men, and every sixty-two minutes at least one person dies as a direct consequence of an eating disorder. Eating disorders have the highest death rate of any mental illness, one in five anorexic deaths are from suicide. Many people think Anorexia is a singularly female disorder, but it does affect males as well, though it is more rare.

In summary, Anorexia Nervosa is a dangerous illness and, if not treated, can result in extremely serious consequences and ultimately death. Some anorexics do not believe that they are in need of any help, that is why they need to have other people around them to help them. People with Anorexia participate in such unhealthy behavior that is slowly killing them. However, if they get help quickly and early on in their illness they can be saved from the dire consequences.

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