CauseS

The cause of anorexia nervosa is unknown, but it is thought to be a complex of psychological, social, and biological factors. There are numerous theories, such as that the victim is attempting to control some aspects of life in an environment where it is difficult to exert control; that it is an attempt to manipulate others and gain attention; and social pressures, conflicting roles, and family disorders that serve as stimuli. Other theorists hypothesize that the disorder is a defense against sexual maturation, related to a fear of sexual intimacy. Society's obsession with physical appearance is also thought by some to play a role. Researchers are studying whether there could be a genetic component, as well as whether malfunction of the hypothalamus might play a role.

Symptoms. 

 Criteria for diagnosis of anorexia nervosa identified by the American Psychiatric Association are as follows: 

(1) intense fear of becoming obese that does not diminish as weight loss progresses;

(2) disturbance of body image, such as claiming to feel fat even when emaciated; 

(3) refusal to maintain body weight over a minimal normal weight for age and height; 

(4) no known physical illness that would account for the weight loss; and 

(5) amenorrhea in postmenarchal females. 

 

It is often accompanied by self-induced vomiting or use of laxatives and/or diuretics and extensive exercise. Accompanying physical signs in addition to profound weight loss include hypotension, bradycardia, edema, lanugo, metabolic changes, and endocrine disturbances.

 

Treatment. 

The treatment of anorexia nervosa is difficult and lengthy. The primary goals are restitution of normal nutrition and resolution of underlying psychological problems. Modes of therapy that can be used include behavior therapy, behavioral contracts, psychoanalysis, group therapy, insight-oriented therapy, and family therapy.

Nutritional counseling, social services and support, health education, and health care are all components in the physical and psychological recovery from an eating disorder. The physical sequelae, as well as the social and cultural aspects, require a multidisciplinary approach individualized to the unique needs of the victim and family. Inpatient treatment, either partial or complete, is required when the individual's problems warrant intensive services or if outpatient treatment is not successful. Some hospitals have special units for patients with eating disorders, providing an environment for treatment that emphasizes the simultaneous treatment of physiologic and psychological problems by professionals trained in the management of these patients. The American Psychological Association has identified numerous areas for research related to eating disorders.

Information and support for professionals as well as persons affected by the disorder can be obtained from the National Association of Anorexia Nervosa and Associated Disorders by writing to them at P.O. Box 7, Highland Park IL 60035 or calling their hotline at 1-847-831-3438.