Anorexia Nervosa Overview
Anorexia nervosa (often called "anorexia") is characterized by extreme weight loss and a preoccupation with body image and dieting. People with anorexia nervosa maintain a body weight that is below normal for their height and age. Even though an anorexic person is underweight and may appear emaciated, they live with an intense fear of being or becoming fat. They are often unaware that they are so thin or think that certain parts of their body (e.g., buttocks, thighs, abdomen) are too fat.
Anorexia nervosa existed in medieval Europe, when extreme fasting was equated with holiness, humility, and purity. Religious women were often afflicted with anorexia mirabilis, or "holy anorexia."
Anorexics spend a great deal of time and mental energy evaluating their weight and body shape by persistently weighing, checking, and measuring their bodies. Their self-esteem is determined by how they perceive their bodies and may congratulate themselves on losing weight, whereas gaining weight is considered a failure and a loss of self-control.
The average age of onset for anorexia nervosa is 17, but the condition can occur at any age. It can be triggered by a major stressful event, such as leaving for college, and progresses differently in different people.
It may have a short course, from which the patient recovers. But anorexia nervosa is usually a chronic illness that comes and goes or worsens over many years. Severe cases require hospitalization and about 10 percent of patients who are hospitalized eventually die from electrolyte imbalance (the loss of salts from bodily fluids and tissues, particularly potassium and sodium, which are essential for proper nerve conduction and muscle function) caused by starvation. Anorexia is most common in adolescent girls and young women, but it can affect boys and men.
Diagnosis of Anorexia
Anorexia nervosa is listed as a mental disorder according to the American Psychiatric Association's DSM-V (Diagnostic and Statistical Manual of Mental Disorders, 5th edition). According to the manual, the following criteria are used to diagnose anorexia nervosa:
- Maintaining a body weight less than 85 percent of normal for a given height and age.
- An intense fear of gaining weight or becoming fat, even though the patient is underweight.
- Denying serious underweight; having an unrealistic perception of body weight and shape; and being overly concerned with weight and shape.