Anorexia nervosa is refusal to maintain body weight at or above a minimally normal weight for age and height Intense fear of gaining weight or becoming fat, even though underweight. 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. This condition is both a physical illness and a psychiatric illness. Anorexia nervosa can be a very severe illness, including a risk of death from starvation. This illness occurs most often in young women.
About 5% to 10% of people with anorexia nervosa are men (Larson). Anorexia nervosa means in Greek and Latin roots lack of appetite of nervous origin. Usually appears in early or middle adolescence. A girl or young woman begins to starve herself and sometimes exercise compulsively as well. Her weight falls and her health deteriorates, but she continues to deny that her behavior is abnormal or dangerous.
She may say she feels or looks fat, although everyone else can see that she is gaunt. To conceal her weight loss from parents and others, she may wear baggy clothes or secretly pocket and discard food instead of eating it. Despite her refusal to eat and despite the misleading term anorexia, her appetite is usually normal, at least at first. Her reasons for rejecting food are a mystery that researchers are still trying to solve (Anorexia). According to the current diagnostic manual of the American Psychiatric Association, a woman is suffering from clinical anorexia, not just dieting or fasting, when her weight has fallen to 15% below the normal range and she has not menstruated for at least three months. Sometimes the diagnosis is made because of drowsiness and lethargy that are affecting her schoolwork.
Other symptoms are dry skin, brittle nails and hair, languor (fine downy hair on the limbs), constipation, anemia, and swollen joints. The level of female hormones in the blood of an anorectic woman falls drastically, and her sexual development may be delayed. Her heart rate and blood pressure can become dangerously low, and loss of potassium in the blood may cause irregular heart rhythms (Bower). Experience has shown that the more distorted an idea the victim has of herself, the more difficult the cure, and the longer the condition goes untreated the more uncertain the outcome. Anorexia nervosa must never be lightly dismissed as a passing phase, which time and maturity will cure.
A person that is anorexic is not nature. Spontaneous cure rarely happen because the victim takes a positive pride in sustaining her hunger. The longer the illness lasts, more weight is lost. This deepens in the anorexic the illusion that being thin is making her significant and outstanding as an individual (Cavendish, 63). Some believe that eating disorders are becoming more common, but the evidence from systematic surveys is inconclusive. What is clear is that fewer cases are going undiagnosed.
One reason is that the average age of puberty in American women has retreated three or four years during this century, probably because of better nutrition and less infectious disease. That means a girl is more likely to develop anorexia while she is still living with her parents, and the disorder is more likely to be noticed and acknowledged as the serious problem it is. As social critics like to point out, drawing a line between eating disorders and the consequences of normal, socially approved dieting is not easy. Many women have symptoms that resemble anorexia in milder forms they may be losing too much weight but still menstruating, or binge eating without vomiting or using laxatives, or bingeing less often than twice a week (Macmillian). According to one estimate, more than two-thirds of college women indulge in an eating binge once a year, 40% at least once a month, and 20% once a week.
As many as 4% of all adults (60% of them women) and 30% of the seriously overweight are thought to be binge eaters. Binge eating without attempts to compensate by vomiting or using laxatives is one of the conditions included in the current APA diagnostic manual under the label eating disorders not otherwise specified. One cause of eating disorders could be abnormalities in the activity of hormones and neurotransmitters that preserve the balance between energy output and food intake. This regulation is a complex process involving several regions of the brain and several body systems. Nerve pathways descending from the hypothalamus, at the base of the brain, control levels of sex hormones, thyroid hormones, and the adrenal hormone cortisol, all of which influence appetite, body weight, mood, and responses to stress. The neurotransmitters serotonin and norepinephrine are found in these hypothalamic pathways. Serotonin activity is low in starving anorectic patients but higher than average when their weight returns to normal.
Another cause for this disease is the social pressure for slenderness. The more likely it seems that a troubled young woman will develop an eating disorder rather than other psychiatric symptoms especially if she believes that control over one’s appetite is the way to win admiration and attain social success. A wish to mold one’s body is also consistent with cultural ideals of achievement and self-sufficiency. Anorexia is especially common among girls committed to the demanding disciplines of ballet, competitive swimming, and gymnastics. According to one survey, 15% of female medical students have had an eating disorder at some time.
But the common belief that high social status raises the risk for eating disorders may no longer be correct, at least for American women. In a 1996 review of 13 surveys, researchers found that eating disorders were equally common among whites and blacks and in all social classes. An unusual, not widely accepted but interesting theory is that in some cases anorexia results from excessive physical activity. Evidence for this theory comes from experiments in which rats are allowed to exercise on a wheel at will but fed only a single daily meal and given only a brief time to eat it. When put on this regime, they start to run more and more and eat less and less. Eventually they may die of starvation.
According to the theory, these conditions are equivalent to self-imposed diet and exercise regimens. Normally people eat more when physical activity rises. But if food intake is restricted at the same time, a self-perpetuating cycle may develop in which restricted food intake heightens the urge to move, and constantly increasing exercise depresses interest in eating (Cavendish). Like most psychiatric disorders, anorexia run in families. The rate of anorexia among mothers and sisters of anorectic women is 2% to 10%.
In one study, researchers found that 20% of anorectic patients but only 6% of people with other psychiatric disorders had a family member with an eating disorder. Several twin studies suggest that this family susceptibility is largely hereditary. In one comparison, anorexia was found in 9 of 16 identical twins of anorectic patients but only 1 of 14 fraternal twins. In another study, researchers found that when one of a pair of identical twins had bulimia, the chance that the other would also have it was 23%, eight times higher than the rate in the general population. For fraternal twins, the rate was 9%, or three times higher than average. The authors calculate a heritability of 55% (“Anorexia”).
In the vast psychological and sociological literature on eating disorders, a wide variety of influences have been suggested, from peer pressure to sexual anxieties. One common theme is starvation as a form of self-punishment with the unacknowledged purpose of pleasing a parent who is seen as needing to impose harsh restrictions. Most anorectic women before, during, and after the illness are serious, well behaved, orderly, perfectionist, hypersensitive to rejection, and inclined to irrational guilt and obsessive worry. Anorexia has been described as one way a girl with this kind of personality may respond to the prospect of adult sexuality and independence. She wants to be strong and successful, but is afraid of asserting herself and separating from her family. Being a good girl and pleasing her parents and teach …