Anorexia Nervosa

What is anorexia nervosa?

Anorexia nervosa is an eating problem that occurs when you are extremely afraid of becoming overweight and therefore eat as little as possible. If you have this disorder, you see yourself as being overweight when you are not.

This condition is both a physical illness and a mental illness. Hormone changes result from the low weight and low levels of body fat. In young women menstruation stops.

This illness occurs most often in young women. However, about 5% to 10% of people with anorexia nervosa are men. The illness can occur in athletes, dancers, and actors who want to maintain low weight for better performance.

Anorexia nervosa can be a very severe illness. Death may occur from starvation or suicide.

How does it occur?

The cause of anorexia nervosa isn't clear. Part of the cause in many cultures is the emphasis on equating female beauty with thinness.

You may be at risk of developing anorexia nervosa if you:

• have a family history of anorexia nervosa or other eating disorders
• have a family or personal history of mood disorders, such as major depression and bipolar disorder (manic depression), anxiety disorders, or obsessive-compulsive personality disorder.

What are the symptoms?

Symptoms may include:

• weight loss from strict dieting, usually severe
• binge eating (eating large amounts of food in a short period of time) and/or purging (using laxatives or making yourself throw up)
• weakness and feeling dizzy
• brittle nails and hair
• feeling cold all the time
• feeling depressed or anxious
• insomnia
• if you are a woman, not having monthly periods when your weight drops below a certain level
• fasting or eating very little
• seeing yourself as being overweight when you are not
• too much exercise
• fearing weight gain even when you are underweight
• thinking about food all the time.

How is it diagnosed?

Your health care provider will do a physical exam and medical history. He or she will ask about your eating and other behavior patterns, such as:

• extreme selectiveness in choosing food that is low in calories
• binge eating
• purging, taking laxatives
• ritualistic eating
• over exercising
• denying hunger or denying you have any problem at all.

How is it treated?

This can be a very difficult condition to treat. Anorexia nervosa does not go away or get better alone. Your health care provider or dietitian will help you to start eating normally again. Also, you will probably need individual psychotherapy and family therapy. Your health care provider may prescribe medicine (especially medicine used for mood disorders) to:

• help reduce your fear of becoming fat
• help reduce depression and anxiety
• help you gain weight.

You may need to be hospitalized if your condition is severe and life threatening.

How long will the problem last?

If you have anorexia, you may have symptoms for many years and will probably need ongoing treatment. Any stressful situation can cause a relapse. After you have reached a normal weight, you may need to continue having psychotherapy or taking medicine for months or years. In addition, you may be weighed regularly to make sure you continue eating properly.

How can I take care of myself?

In addition to following your provider's treatment plan and developing a support network, you can:

• Eat a nutritious, well-balanced diet.
• Limit your exercise program as advised by your treatment team.
• Get plenty of rest and sleep.
• Maintain a realistic weight for your height and body frame.
• Take mineral and vitamin supplements, if recommended by your health care provider.
• See your health care provider regularly to have your weight, blood pressure, heart rate, and temperature checked.
• Keep an optimistic outlook.
• With your therapist, work out areas of conflict in your life. Learn healthy coping strategies.
• Balance your work with recreation and social activities.
• Learn to communicate your feelings.

What can be done to help prevent anorexia nervosa and maintain good physical health?

Accepting yourself and your body can help prevent this problem. In addition you can:

• Keep appointments with your health care provider or therapist.
• Avoid skipping meals.
• Avoid using laxatives.
• Avoid excessive exercise.
• Avoid drinking alcohol.
• Avoid smoking cigarettes.

You may want to contact:

The National Mental Health Association (NMHA). NMHA's toll-free number is 1-800-969-NMHA. The Web site is http://www.NMHA.org.

Eating Disorders Awareness and Prevention, Inc. (EDAP). There toll-free number is: 1800-931-2237. The Web site is http://www.nationaleatingdisorders.org.