Risk factor of anorexia nervosa
Anorexia nervosa - Symptoms and causes
Overview
Anorexia (an-o-REK-see-uh) nervosa — often simply called anorexia — is an eating disorder characterized by an abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight. People with anorexia place a high value on controlling their weight and shape, using extreme efforts that tend to significantly interfere with their lives.
To prevent weight gain or to continue losing weight, people with anorexia usually severely restrict the amount of food they eat. They may control calorie intake by vomiting after eating or by misusing laxatives, diet aids, diuretics or enemas. They may also try to lose weight by exercising excessively. No matter how much weight is lost, the person continues to fear weight gain.
Anorexia isn't really about food. It's an extremely unhealthy and sometimes life-threatening way to try to cope with emotional problems. When you have anorexia, you often equate thinness with self-worth.
Anorexia, like other eating disorders, can take over your life and can be very difficult to overcome. But with treatment, you can gain a better sense of who you are, return to healthier eating habits and reverse some of anorexia's serious complications.
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Symptoms
The physical signs and symptoms of anorexia nervosa are related to starvation. Anorexia also includes emotional and behavioral issues involving an unrealistic perception of body weight and an extremely strong fear of gaining weight or becoming fat.
It may be difficult to notice signs and symptoms because what is considered a low body weight is different for each person, and some individuals may not appear extremely thin. Also, people with anorexia often disguise their thinness, eating habits or physical problems.
Physical symptoms
Physical signs and symptoms of anorexia may include:
- Extreme weight loss or not making expected developmental weight gains
- Thin appearance
- Abnormal blood counts
- Fatigue
- Insomnia
- Dizziness or fainting
- Bluish discoloration of the fingers
- Hair that thins, breaks or falls out
- Soft, downy hair covering the body
- Absence of menstruation
- Constipation and abdominal pain
- Dry or yellowish skin
- Intolerance of cold
- Irregular heart rhythms
- Low blood pressure
- Dehydration
- Swelling of arms or legs
- Eroded teeth and calluses on the knuckles from induced vomiting
Some people who have anorexia binge and purge, similar to individuals who have bulimia.
But people with anorexia generally struggle with an abnormally low body weight, while individuals with bulimia typically are normal to above normal weight.
Emotional and behavioral symptoms
Behavioral symptoms of anorexia may include attempts to lose weight by:
- Severely restricting food intake through dieting or fasting
- Exercising excessively
- Bingeing and self-induced vomiting to get rid of food, which may include the use of laxatives, enemas, diet aids or herbal products
Emotional and behavioral signs and symptoms may include:
- Preoccupation with food, which sometimes includes cooking elaborate meals for others but not eating them
- Frequently skipping meals or refusing to eat
- Denial of hunger or making excuses for not eating
- Eating only a few certain "safe" foods, usually those low in fat and calories
- Adopting rigid meal or eating rituals, such as spitting food out after chewing
- Not wanting to eat in public
- Lying about how much food has been eaten
- Fear of gaining weight that may include repeated weighing or measuring the body
- Frequent checking in the mirror for perceived flaws
- Complaining about being fat or having parts of the body that are fat
- Covering up in layers of clothing
- Flat mood (lack of emotion)
- Social withdrawal
- Irritability
- Insomnia
- Reduced interest in sex
When to see a doctor
Unfortunately, many people with anorexia don't want treatment, at least initially.
Their desire to remain thin overrides concerns about their health. If you have a loved one you're worried about, urge her or him to talk to a doctor.
If you're experiencing any of the problems listed above, or if you think you may have an eating disorder, get help. If you're hiding your anorexia from loved ones, try to find a person you trust to talk to about what's going on.
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Causes
The exact cause of anorexia is unknown. As with many diseases, it's probably a combination of biological, psychological and environmental factors.
- Biological. Although it's not yet clear which genes are involved, there may be genetic changes that make some people at higher risk of developing anorexia. Some people may have a genetic tendency toward perfectionism, sensitivity and perseverance — all traits associated with anorexia.
- Psychological. Some people with anorexia may have obsessive-compulsive personality traits that make it easier to stick to strict diets and forgo food despite being hungry.
They may have an extreme drive for perfectionism, which causes them to think they're never thin enough. And they may have high levels of anxiety and engage in restrictive eating to reduce it. - Environmental. Modern Western culture emphasizes thinness. Success and worth are often equated with being thin. Peer pressure may help fuel the desire to be thin, particularly among young girls.
Risk factors
Anorexia is more common in girls and women. However, boys and men have increasingly developed eating disorders, possibly related to growing social pressures.
Anorexia is also more common among teenagers. Still, people of any age can develop this eating disorder, though it's rare in those over 40. Teens may be more at risk because of all the changes their bodies go through during puberty. They may also face increased peer pressure and be more sensitive to criticism or even casual comments about weight or body shape.
Certain factors increase the risk of anorexia, including:
- Genetics.
Changes in specific genes may put certain people at higher risk of anorexia. Those with a first-degree relative — a parent, sibling or child — who had the disorder have a much higher risk of anorexia. - Dieting and starvation. Dieting is a risk factor for developing an eating disorder. There is strong evidence that many of the symptoms of anorexia are actually symptoms of starvation. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction in appetite. Starvation and weight loss may change the way the brain works in vulnerable individuals, which may perpetuate restrictive eating behaviors and make it difficult to return to normal eating habits.
- Transitions. Whether it's a new school, home or job; a relationship breakup; or the death or illness of a loved one, change can bring emotional stress and increase the risk of anorexia.
Complications
Anorexia can have numerous complications.
At its most severe, it can be fatal. Death may occur suddenly — even when someone is not severely underweight. This may result from abnormal heart rhythms (arrhythmias) or an imbalance of electrolytes — minerals such as sodium, potassium and calcium that maintain the balance of fluids in your body.
Other complications of anorexia include:
- Anemia
- Heart problems, such as mitral valve prolapse, abnormal heart rhythms or heart failure
- Bone loss (osteoporosis), increasing the risk of fractures
- Loss of muscle
- In females, absence of a period
- In males, decreased testosterone
- Gastrointestinal problems, such as constipation, bloating or nausea
- Electrolyte abnormalities, such as low blood potassium, sodium and chloride
- Kidney problems
If a person with anorexia becomes severely malnourished, every organ in the body can be damaged, including the brain, heart and kidneys.
This damage may not be fully reversible, even when the anorexia is under control.
In addition to the host of physical complications, people with anorexia also commonly have other mental health disorders as well. They may include:
- Depression, anxiety and other mood disorders
- Personality disorders
- Obsessive-compulsive disorders
- Alcohol and substance misuse
- Self-injury, suicidal thoughts or suicide attempts
Prevention
There's no guaranteed way to prevent anorexia nervosa. Primary care physicians (pediatricians, family physicians and internists) may be in a good position to identify early indicators of anorexia and prevent the development of full-blown illness. For instance, they can ask questions about eating habits and satisfaction with appearance during routine medical appointments.
If you notice that a family member or friend has low self-esteem, severe dieting habits and dissatisfaction with appearance, consider talking to him or her about these issues.
Although you may not be able to prevent an eating disorder from developing, you can talk about healthier behavior or treatment options.
By Mayo Clinic Staff
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McCallum Place | Eating Disorder Risk Factors
There are still many unanswered questions about eating disorders. Previous studies have shown that there are a number of risk factors that have been linked as possible causes of eating disorders. Eating disorder risk factors are characteristics that are more common in individuals suffering from eating disorders than among the general population. The presence of any of these eating disorder risk factors does not necessarily predict that an individual will develop an eating disorder. However, the more of these eating disorder risk factors that are present, the more likely it is than an individual will develop an eating disorder. If you or a loved one is suffering from an eating disorder, contact McCallum Place to learn about eating disorder treatment programs in St.
Louis and Kansas City.
Gender
While eating disorders can occur in both men and women, females are as much as ten times more likely to develop anorexia or bulimia and 2.5 times more likely to experience binge eating disorder. This means simply that women and girls are at a higher risk for developing an eating disorder.
Age
Eating disorders can occur in individuals of any age from children to older adults. However, studies show a peak in the occurrence of eating disorders during adolescence and early adulthood. Therefore, teenage girls and young women have the highest risk factor for developing eating disorders based on age.
Weight Concerns, Dieting, and Negative Body Image
Individuals who have previously shown weight concerns and a preoccupation with weight, have a history of dieting, and display a negative body image all show risk factors for developing eating disorders.
Psychological and Emotional Disorders
Studies have shown that depression, anxiety, obsessive-compulsive disorder, and low self-esteem are eating disorder risk factors.
Individuals who suffer from these emotional disorders are at risk of developing eating disorder in the future.
History of Sexual Abuse and Other Trauma
A history of sexual abuse is more common in individuals who suffer from eating disorders suggesting that this is an eating disorder risk factor. Additionally, other stressful events and traumas may also be linked to the development of eating disorders.
Childhood Obesity and Eating Problems
There is some evidence to show that adolescents and teens with a history of childhood obesity are at risk for bulimia and binge eating disorder.
Family Factors
Family discord, parental indifference, and overprotective parenting can be eating disorder risk factors. Additionally, the presence of psychological issues and a history of depression in a family can increase an individual’s risk for developing an eating disorder. Finally, families that fail to embrace a positive body image or are overly concerned with physical appearance can also contribute to the development of eating disorders.
Genetics
There is evidence that shows individuals who have a close family member who suffered from an eating disorder or other mental illness are at a higher risk themselves of developing an eating disorder. Therefore, this suggests that there are genetic or biological eating disorder risk factors.
Participation in Specific Activities
Participation in certain sports and activities can be an eating disorder risk factor as these activities encourage athletes to be thin, quick, and extremely fit. These activities include swimming, gymnastics, wrestling, running, and dance.
Personality Traits
Certain personality traits may also contribute to the development of eating disorders. One of these personality traits that is an eating disorder risk factor is a high drive for perfectionism. Individuals who struggle for perfection are at risk for developing anorexia or bulimia.
Risk factors for anorexia
genetic factors.
Linkage analysis of genes in no loci found within the genome for a broad diagnostic category anorexia nervosa, but analysis pedigrees of at least one pair relatives with a restrictive type anorexia nervosa identified clutch with chromosome 1p34. Striving for thinness and obsession are most closely related with anorexia nervosa, causing new genetic loci on chromosomes 1 for the mixed indicator and 13 for striving for thinness. Research on connection studies are focused on study of genes related to specific neurochemical factors eating behavior. One of these candidate is the HTR2A gene for serotonin 5-HT2A receptor. Brain gene neurotrophic factor (BDNF) also involved as a susceptibility gene to anorexia nervosa. This protein is involved in the regulation of eating behavior level of the hypothalamus, including regulation of serotonin levels, the decline of which causes depression. Probably genetic vulnerability lies in the predisposition to a certain type of personality, to a mental disorder (affective disorder or anxiety disorder) or dysfunction of neurotransmitter systems.
Therefore, the genetic predisposition and vulnerability appear in adverse conditions, such as an unhealthy diet or after emotional stress.
Biological factors - overweight and early the onset of the first menstruation. Except Moreover, the cause of the disease may lie in dysfunction regulating food intake behavior of neurotransmitters such as serotonin, dopamine, norepinephrine. Research has clearly demonstrated dysfunction of all three of the above mediators in patients with disorders eating behavior. Nutritional deficiencies Zinc deficiency plays a role in anorexia but is not the cause of the disease. There is evidence that it may be factor that deepens the pathology anorexia. At 1994, randomized placebo study showed that zinc (14 mg per day) doubled the rate weight gain compared to placebo patients.
Family factors are more likely to occur eating disorders in those who has relatives or friends, suffering from anorexia nervosa, nervous bulimia or obesity.
In the presence of family member or relative suffering depression, alcohol abuse or drugs or addiction them, also increases the risk of disorders.
Personal factors - to psychological factors risk include perfectionist-obsessive personality type, especially for restrictive type of anorexia nervosa. Low self-esteem, feeling of inferiority, uncertainties and inconsistencies requirements are risk factors development of anorexia nervosa.
Cultural factors - these include: accommodation in an industrialized country and an emphasis on harmony (thinness) as the main sign of feminine beauty. stressful events such as the death of a loved one relative or friend, sexual or physical abuse can also be risk factors for the development of the disorder eating behavior.
Age factor - from the point of view of psychologists national pathopsychological school age is one of the most important predisposition conditions to anorexia nervosa.
risk group is teenage and youthful age. In recent decades there has been a decline in age disease manifestations.
Anthropological factors - from the point of view of the doctor medical sciences, psychophysiologist Vadim Rotenberg, anorexia nervosa is associated with human search activity.
causes, symptoms and treatment of all types of diseases in Moscow at the FSCC FMBA
Anorexia nervosa: causes, symptoms and treatment of all types of diseases in Moscow at the FSCC FMBA- Main page
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Contents
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Author of the article
Anorexia nervosa is an eating disorder characterized by deliberate loss of body weight caused and maintained by the patient himself, fear of gaining extra pounds, and a distorted perception of his own body. People suffering from anorexia make great efforts to control their weight, which leads to negative health consequences. Anorexia nervosa often leads to death.
Anorexia nervosa is more common in adolescent girls and young women, but in one in 10 cases it can be men.
Causes
The exact cause of anorexia nervosa has not been established. As in the case of other mental illnesses, it can be due to the following:
- Genetic predisposition. There is evidence that demonstrates the dependence of the development of anorexia nervosa on the presence of certain genes. Changes in the biochemical processes that regulate brain function may also play a role in the formation of an eating disorder.
- Psychological or mental disorder.
An unstable psycho-emotional background can contribute to the formation of anorexia nervosa.
Risk factor for anorexia nervosa
Certain factors may increase the risk of developing an eating disorder:
- Family history of anorexia nervosa
- History of mental disorders (anxiety disorder, depression, schizophrenia)
- Diet and fasting as a way of life. There is strong evidence that the symptoms of anorexia nervosa are symptoms of hunger. Hunger and weight loss change brain function, negative eating habits are reinforced, it becomes difficult to return to normal eating behavior
- Stress
Symptoms
- dysmorphophobia (belief in a severe physical defect, excess weight), which is visible to everyone around.
- violation of psychosensory synthesis, in the mirror the patient sees himself as disproportionately fat. In the future, weight correction by any means (refusal of food, exhausting physical training, the use of laxatives and diuretics, inducing vomiting after eating)
- sensitive ideas of attitude ("complex" in relation to one's appearance, belief that others can see the patient's shortcomings)
- perfectionism - very high demands on oneself, constant introspection, a strict assessment of one's actions.
- reduction of criticism to the state of
Consequences of anorexia nervosa:
- subcutaneous fat disappears;
- muscles are thinning
- skin becomes dry, scaly, cyanotic
- posture worsens (patients stoop)
- beriberi occurs
- the menstrual cycle is disturbed up to the complete absence of menstruation
- myocardial dystrophy, decrease in heart rate, decrease in blood pressure
- constipation appears, disruption of the digestive tract
- anemia appears, blood sugar decreases, life-threatening electrolyte disturbances appear.
- weakness, unwillingness to do anything, irritability, decreased activity appear.
Often such patients require hospitalization for health reasons.
Diagnosis
Anorexia nervosa is diagnosed on the basis of an examination by a psychiatrist and laboratory and diagnostic tests.
Methods of treatment at the FSCC FMBA of Russia
The specialists of our Center have developed a step-by-step program of group therapy for anorexia nervosa based on third-wave psychotherapy (the most modern methods of psychotherapy). The group program includes several blocks, during which each participant gradually undergoes a comprehensive psychological recovery.
Treatment of anorexia nervosa is mainly aimed at restoring weight, forming healthy eating habits, and reinforcing positive eating motivation. Particular attention is paid to the elimination of dissatisfaction with the body, the formation of a healthy, adequate attitude towards one's body.
In the case of severe anorexia nervosa, when outpatient treatment is ineffective, hospitalization may be indicated followed by inpatient treatment.
Given the high risk of anorexia nervosa recurrence in the first year after treatment, the doctors of our center focus on algorithms aimed at preventing recurrent episodes of an eating disorder.
