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Anorexia Nervosa

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What's the big deal?  Its just a diet...right?

Anorexia is not just a diet.  That statement couldn't be more wrong.  The tricky thing about anorexia is that it often starts out as "just a diet" and then escalates into a full blown disorder.  It sneaks up on you so that by the time you're in the disease you don't even know it.  This is one of the most dangerous things.  People with anorexia don't realize that their diet has gone too far because they have what is referred to as a distorted body image.  A person with anorexia can not realize that they have lost weight because they still see themselves as needing to lost weight, when in fact it can be just the opposite.  Check out some more signs, symptoms and affects of this dangerous disorder.

Signs and Symptoms

  • Dramatic weight loss in a relatively short period of time
  • Wearing big or baggy clothes or dressing in layers to hide body shape and or weight loss
  • Obsession with weight and complaining of weight problems (even if "average" weight or thin)
  • Obsession with calories and fat content of foods
  • Obsession with continuous exercise
  • Determines self worth in terms of their ability and performance
  • Often misses out on other activities such as school, work and relationships in order to exercise
  • Is hardly ever or never satisfied with athletic abilities and accomplishments
  • Continues exercising despite injury or medical warnings
  • May cease menstruation
  • Visible food restriction and self-starvation
  • Visible binging and/or purging
  • Frequent trips to the bathroom immediately following meals (sometimes accompanied with water running in the bathroom for a long period of time to hide the sound of vomiting)
  • Use or hiding use of diet pills, laxatives ipecac syrup (can cause immediate death!) or enemas
  • Isolation and/or fear or eating around and with others
  • Unusual food rituals such as shifting the food around on the plate to look eaten, cutting food into tiny pieces, chewing food and spitting it out into a napkin
  • Hiding food in strange place to avoid eating
  • Flushing uneaten food down the toilet (this can cause sewage problems)
  • Vague or secretive eating patterns
  • Pre-occupied thoughts of food, weight and cooking
  • Self-defeating statements after food consumption
  • Hair loss
  • Pale or "grey" appearance to the skin
  • Dizziness and headaches
  • Frequent soar throats and/or swollen glands
  • Low self-esteem and feelings of worthlessness.  Need for acceptance and approval from others
  • Complaints of often feeling cold
  • Low blood pressure
  • Loss of menstrual cycle
  • Constipation or incontinence
  • Bruised or callused knuckles; bloodshot or bleeding in the eyes; light bruising under the eyes and on the cheeks
  • Perfectionistic personality
  • Mood swings.  Depression.  Fatigue.
  • Insomia.  Poor sleeping habits.
  • Gums become infected and teeth wear down
  • Swelling of glands that make saliva
  • Swelling of ankles and feet

Affects of Anorexia

  • Damage to the brain.  In severe cases the brain may even shrink, resulting in a personality change.  Fortunately if proper health and weight is achieved and maintained within a certain period of time the brain can change back to its original size
  • Damage to the heart.  The anorexic may develop an irregular heartbeat and may experience heart failure. 
  • Breathing rate, pulse rate and blood pressure drop.
  • The thyroid gland slows.
  • Menstraul periods stop. 
  • Thirst, urination and constipation increase.
  • Nails and hair lose nutrients and become very brittle.  Hair may begin to fall out.
  • In severe cases, bones become very brittle and break easily.
  • Skin may become dry and yellow. 
  • The body temperature drops and the body can't handle the cold.  In severs cases a soft hair, called lanugo, grows on the skin to keep the body warm.  (This is similar to the fuzz often felt on newborn babies.)
  • Joints often swell
  • Muscle mass drops significantly
  • Lightheadness is often experienced
  • Out of ten anorexics that are admitted to the hospital, one will die.

Diagnosis

In order to be "diagnosed" with anorexia nervosa, the following must be present:
  1. The individual must be at least 15% below normal for age, height and body type.
  2. An intense fear or gaining weight, or becoming fat must be present.  This fear often becomes more intense as more weight is lost.
  3. The individual must have a distorted body image. This can either mean that the individual feels fat all over, or it may be focused on specific body parts.  Their body size and shape is a major factor in determining their self worth, but they deny that it is any cause for serious concern.
  4. Women must have missed at least three consecutive menstraul cycles, or if she only gets her period while on a hormone pill.
This is according to the Diagnostic and Statistical Manual, fourth edition 1994.
 
The DSM-IV also recognizes two types of anorexia nervosa:
 
"Restricting type" -people who generally lose weight by restricting caloric intake and compulsive over-exercise.
 
"Binge-Eating/Purging Type" -people who regularly binge and purge through induced vomiting, abuse of laxatives, diuretics, enemas, excessive exercise or fasting.

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