Anorexia: Symptoms, Causes, Diagnosis and Treatment

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What is anorexia?

Anorexia nervosa (often referred to as anorexia) is one type of eating disorder . More importantly, it is also a psychological disorder. Anorexia is a condition that goes beyond out-of-control dieting. A person with anorexia initially begins dieting to lose weight. Over time, the weight loss becomes a sign of mastery and control. The drive to become thinner is actually secondary to concerns about control and/or fears relating to one's body. The individual continues the endless cycle of restrictive eating often to a point close to starvation in order to feel a sense of control over the body. This cycle becomes an obsession, and is similar to any type of drug or substance addiction. http://www.medicinenet.com/anorexia_nervosa/article.htm

How is anorexia diagnosed?

Anorexia nervosa is a complicated disorder to diagnose. Individuals with anorexia often attempt to hide the disorder. Denial and secrecy frequently accompany other symptoms. It is unusual for an individual with anorexia to seek professional help because the individual typically does not accept that she or he has a problem (denial). The actual diagnosis is not made until there are other medical complications. The individual is often brought to the attention of a professional by family members only after a marked weight loss has occurred. When anorexics finally come to the attention of the health professional, they often lack insight into their problem despite being severely malnourished and may be unreliable in terms of providing accurate information. Therefore, it is often necessary to obtain information from parents or other family members in order to evaluate the degree of weight loss and extent of the disorder.

The actual criteria for anorexia nervosa are found in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).

There are four basic criteria for the diagnosis of anorexia nervosa that are characteristic:

1. The refusal to maintain body weight at or above a minimally normal weight for age and height. Body weight less than 85% of the expected weight is considered minimal.
2. An intense fear of gaining weight or becoming fat, even though the person is underweight.
3. Self-perception that is grossly distorted and weight loss that is not acknowledged.
4. In women who have already begun their menstrual cycle, at least three consecutive periods are missed (amenorrhea), or menstrual periods occur only after a hormone is administered.

The DSM-IV further identifies two subtypes of anorexia nervosa. In the binge eating/purging type, the individual regularly engages in binge eating or purging behavior which involves self-induced vomiting or the misuse of laxatives, diuretics, or enemas during the current episode of anorexia. In the restricting type, the individual severely restricts food intake, but does not engage in the behaviors seen in the binge eating type. For more, please read the Binge Eating Disorders article.

DSM-IV: Anorexia Nervosa (excerpt)

Individuals with this eating disorder keep their body weight below a minimal normal level by exercise, control of food intake, and other means.

Diagnostic criteria for 307.1 Anorexia Nervosa
(cautionary statement)

A. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).

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

C. 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.

D. In postmenarcheal females, amenorrhea, i.e., the absence of at least ...