Anorexia nervosa is an eating disorder involving food restriction (very small quantiites of food), inappropriate eating habits/rituals, fear of weight gain, a strong desire to be thin, usually resulting in excessive weight loss. Various cognitive biasis present affect how the Pt evaluates/thinks about their:
Body, with an obsession with having a thin figure, and a distorted body self perception (e.g. viewing as overweight/big even when underweight)
Food/eating, with an irrational fear of weight gain
The majority of Pt's nonetheless continue to feel hunger. Anorexia (generally) is the lack/loss of appetite for food
Pathophysiology
Self restriction causes extremely high levels of ghrelin (i.e. hunger hormone signalling need for food) in blood, indicating hunger call is being suppressed/ignored/overridden
Causes
Cause is unknown
Predisposed, by:
Individual
Familial
Cultural, with socities that value thinness having higher rates of disease
Genetic
Precipitated, often by a major life change or stress inducing event, including by:
Developmental
Societal
Social, occurring more commonly in patients involved in activities that value thinness such as high level athletics, modelling, and dancing
Hormonal
Perpetuated, by:
Dietary/malnutrition
Identity
Gain
Sx
Systemic Sx:
Dizziness
Headaches
Drowsiness
Fever
Lack of energy
Counteract these Sx with harmful behaviors, including:
Smoking
Excessive caffeine consumption
Excessive use of diet pills
Increased exercise regime
Overriding hunger feelings with self-harm behaviors
Many patients see themselves as overweight even though they are underweight. When asked, patients usually deny any problems with low weight
They often weigh themselves frequently
Eating only small amounts
Only eating certain foods
Exercise excessively
Forcing themselves to vomit
Use laxatives to produce weight loss
Women will often have amenorrhea (i.e. stop having menstrual periods)
Dx
DSM-5 Dx criteria:
1) Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health
2) Intense fear of gaining weight or becoming fat, even though underweight
3) 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
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