Anorexia Nervosa
Anorexia nervosa, often called
"anorexia," is among the most disabling psychiatric disorders. It is characterized
by:
-
refusal to keep one's body weight
at or above a minimally normal weight for one's age and height;
-
an intense, irrational fear of
weight gain or of becoming fat; and
-
a misperception of the weight
or shape of one's body, an excessive influence of body weight or shape
on self-evaluation, or refusal to acknowledge the seriousness of one's
subnormal weight status.
According to the NIMH, the incidence
of anorexia among adolescent girls is 1 percent. Ninety percent of anorectics
are female, and most female anorectics are 12 to 21 years old. The physical
symptoms of anorexia nervosa include bradycardia, low blood pressure, missing
menstrual periods, brittleness of the hair and nails, and dryness and yellowing
of the skin. Its symptoms may also include edema, mild anemia, muscle wasting,
and subnormal body temperature.
Long-term semi-starvation
can result in severe metabolic disturbances, heart dysfunction, and damage
to the brain and other vital organs. Anorexia seriously increases the risk
of developing osteoporosis. According to the NIMH, in 10 percent of anorexia
cases the disorder leads to death from starvation, cardiac arrest, other
medical complications, or suicide.
Treatment objectives
for anorexia nervosa include weight normalization; correction of the irrational,
consuming fear of weight gain; and relapse prevention. Treatment usually
involves participating in an inpatient or daytime program that features
psychological counseling and supervised eating and exercising. Many anorectics
who undergo treatment in an eating-disorder unit attain a normal body weight,
but the long-term correction of psychological aspects of anorexia is demanding,
and relapse is common in over half the cases.
Bulimia Nervosa
Bulimia is that eating disorder
characterized by:
-
recurrent binge eating
-
recurrent willful vomiting
-
and/or recurrent inappropriate
compensatory measures to prevent weight gain (e.g., laxative abuse, diuretic
abuse, or overexercising)
-
and an excessive influence of
body weight or shape on self-evaluation; self esteem.
According to the NIMH, about
3 percent of adolescents and young adults develop bulimia. Bulimia is not
as dangerous as anorexia, but it can have many unpleasant physical effects,
including fatigue, constipation, fluid retention, hand scarring (from repeated
digital induction of vomiting), dental-enamel erosion, swelling of the
salivary glands, and throat soreness from repeated vomiting. Binge eating
can cause stomach rupture and frequent vomiting can cause potassium losses
leading to heart failure.
There are two approaches to
treating bulimia:
(1) psychological counseling,
and
(2) the administration of
antidepressants that can contribute to moderating the frequency of bingeing.
Although the treatment of
bulimia is successful more often than is the treatment of anorexia, it
fails in 33 to 50 percent of patients.
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