Anorexia Nervosa

Anorexia Nervosa is an eating disorder characterized by an obsessive fear of weight gain, refusal to maintain a healthy body weight, and distorted body image. According to Dr. Thomas Insel, former Director of National Institute of Mental Health, “Research tells us that Anorexia Nervosa is a brain disease with severe metabolic effects on the entire body.” Eating disorders do not discriminate between gender, socioeconomic status, sexual orientation, race, body shape and size, or ethnicity — no one is immune.

Two subtypes of Anorexia Nervosa exist: the restricting subtype and the binge-eating/purging subtype. Individuals with the restricting subtype maintain their low body weight by significantly limiting their food intake. In the binge-eating/purging subtype, individuals restrict their food intake and routinely engage in binge-eating and/or purging behaviors. These behaviors may include self-induced vomiting, compulsive exercise, and abuse of laxatives, diuretics or enemas. Restriction of energy intake relative to an individual’s requirements leads to a significantly low body weight that can cause severe medical complications.

DSM-5 Diagnostic

  1. Restriction of energy intake relative to requirements leading to a significantly low body weight in 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.

Warning Signs

(May Include)

  • Significant weight loss/low body weight
  • Distorted body image
  • Fear of, or behavior interfering with, weight gain
  • Preoccupation with weight, calories, food, etc.
  • Feelings of guilt after eating
  • Denial of severity of low weight
  • High levels of anxiety and/or depression
  • Low self-esteem
  • Self-injury
  • Social isolation
  • Excuses for not eating/denial of hunger
  • Food rituals
  • Intense, dramatic mood swings
  • Pale appearance/yellowish skin-tone
  • Thin, dull, and dry hair, skin, and nails
  • Cold intolerance/hypothermia
  • Fatigue/dizziness/fainting
  • Abuse of laxatives, diet pills, and/or diuretics
  • Excessive and compulsive exercise regimes
  • Control issues
  • Sleep difficulties

Health Complications

(May Include)

  • Low blood pressure
  • Anemia (iron deficiency)
  • Poor circulation in extremities
  • Gastrointestinal problems: constipation and/or bloating
  • Muscle loss and weakness
  • Abnormally slow and/or irregular heartbeat
  • Irregular menstruation or Amenorrhea
  • Heart damage
  • Weak or brittle bones/osteoporosis
  • Dehydration/kidney failure
  • Edema (swelling)
  • Memory loss/disorientation
  • Growth of fine, downy hair (lanugo)
  • Decreased growth hormone which may lead to delayed physical maturation
  • Decreased estrogen/testosterone/thyroid hormone
  • Infertility
  • Electrolyte imbalance that can lead to seizures

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