Introduction. What is Anorexia Nervosa?
Anorexia nervosa features critical nutrient restriction causing low body weight. Patients with this disorder fear gaining weight and have a distorted body image. They also cannot comprehend the seriousness of their condition.
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Symptomatic Manifestations and Behaviours
Individuals with anorexia nervosa may exhibit restrictive behaviours, such as portion control and calorie counting, as well as engage in purging procedures, such as the use of diuretics or laxatives or self-induced vomiting. Moreover, extended periods of compulsive physical exercise are common. Patients may experience various symptoms, such as irritability, fatigue, extremity oedema, constipation, cold intolerance and amenorrhea. Anorexia nervosa patients experience numerous complications that result from prolonged starvation and purging behaviours.
Treatment of Anorexia Nervosa
Psychologists, psychotherapists and nutritionists plan their treatment for anorexia nervosa primarily based on psychotherapy and nutritional rehabilitation. Hospitalization might be needed for patients who exhibit severe life-threatening symptoms. Pharmacological therapy is not typically the first-line option for anorexia treatment. However, in cases where patients are acutely affected and not responding to initial treatment, a psychiatrist may prescribe medications, e.g., to stimulate weight gain. Furthermore, for individuals with co-occurring psychiatric conditions, such as anxiety or depression, a psychiatrist or psychotherapist may recommend a combination of pharmacological therapy and psychological therapy (psychotherapy) as the most effective anorexia treatment.
Prevalence
Research demonstrates that anorexia is less common in males than females. Anorexia typically commences in early adulthood or late adolescence. Studies have reported a lifetime prevalence of 0.3% to 1%, independent of race, culture, and ethnicity. European studies revealed that the prevalence is twice higher.
Risk Factors
The common risk factors for anorexia comprise weight-related pressure from peers or family, psychological consequences of sexual abuse, personality attributes such as perfectionism and impulsivity, female gender, anxiety, depression, bipolar disorder and childhood obesity.
Pathophysiology
Several studies indicate that biological factors contribute to the outset of anorexia nervosa, alongside environmental factors.
Individuals with anorexia nervosa have deficiencies in the neurotransmitters such as dopamine, involved in eating behaviour and serotonin, involved in impulse control.
In addition, anorexia nervosa features uneven activation of the corticolimbic brain system related to appetite and fear, and reduced activity in the fronto-striatal brain circuits associated with habitual behaviours.
Moreover, these individuals often exhibit co-occurring psychiatric illnesses such as anxiety disorders and major depressive disorder.
Anorexia. Similarity with other psychiatric disorders
Anorexia and weight loss can result from major depressive disorder, but patients with depression do not obsess with body shape. Conversely, patients with OCD (obsessive-compulsive disorder) may exhibit food rituals, but their weight typically remains within normal limits. Additionally, individuals who abuse drugs such as stimulants, such as cocaine and methamphetamine, experience weight loss due to increased metabolism and a focus on acquiring illicit drugs rather than consuming calories.
Anorexia and similarity with physical illnesses
Weight loss can result from various medical conditions. These can be for example hyperthyroidism, poorly controlled diabetes mellitus, celiac disease or inflammatory bowel disease. Diagnoses of such bodily conditions are based on the patient’s medical history, physical examination and appropriate tests.
Conclusion
Anorexia nervosa is a psychiatric illness in which people critically restrict their food intake. People with anorexia often purge food through the use of laxatives or self-induced vomiting. Despite being noticeably underweight, individuals with this disorder do not recognize their condition due to distorted body image. Prolonged starvation and compensatory purging behaviours can lead to critical complications.
Diagnosis of anorexia typically involves a thorough medical history of a patient, physical examination and laboratory tests to rule out other conditions that may cause weight loss. Anorexia is usually treated by means of psychological therapy or counselling to address body image issues. Anorexia treatment may also include psychiatric pharmacological interventions in case of co-morbid psychiatric disorders such as anxiety or depression. In addition, patients with anorexia may require hospitalization in severe cases e.g., due to complications associated with malnourishment, as a weight gain measure.