WHAT IS ANOREXIA?

Anorexia nervosa is a kind of reverse addiction- an addiction to not eating. And like many addicts, anorexics deny having a problem. $hey see themselves as healthy, but others see the terrible damage to body and mind that anorexia causes. .ike addiction, though, anorexia can be confronted and reversed. /ost anorexics, if helped in a timely fashion, overcome their condition and regain their health. Anorexia is a very serious condition where people lose large amounts of weight due to excessive dieting.

Anorexia is generally developed over time as a way of coping with emotional pain, stress, or unhappiness, although the true cause of anorexia is unknown and can involve both genetic and environmental factors. Anorexia is an eating disorder where people starve themselves. Individuals suffering from anorexia have extreme weight loss. Weight loss is usually 15 below the person!s normal body weight. Weight loss is obtained by many ways. "ome of the common techni#ues used are excessive exercise, intake of laxatives and not eating. Anorexics have an intense fear of becoming fat. $heir dieting habits develop from this fear. Anorexia mainly affects adolescent girls. 0eople with anorexia continue to think they are overweight even after they become extremely thin, are very ill or near death. 1ften they will develop strange eating habits such as refusing to eat in front of other people. "ometimes the individuals will prepare big meals for others while refusing to eat any of it. "ufferers of anorexia may insist that they look 2ust right and have an intense fear of becoming fat. $hey also have a fear that they will lose control of their eating behaviour and body si3e once they start eating again. $he American 0sychiatric Association defines anorexia as 4efusal to maintain a body weight normal weight for age and height Intense fear of gaining weight or person is underweight 5enying the seriousness of having distorted image of one%s appearance that is at or above the minimal becoming fat, even though the a low body weight, or having a or shape

$here are two kinds of anorexia. In the restricting type, the person eats very little and loses weight simply by not taking in enough calories, often burning more calories through strenuous exercise. In anorexia that involves purging, people get rid of food they%ve consumed by self& induced vomiting or misuse of laxatives, diuretics, or enemas. Anorexia is commonly seen as a disorder of white, affluent teenaged girls and young women, and in fact up to '( percent of anorexics are female, with the onset of symptoms typically occurring between ages 11 and )(. *ut male anorexics do exist, and anorexia has been diagnosed in children as young as + and in middle&aged and even elderly women. It affects people of all races, ethnic groups, and social classes. $he disorder is thought to be most common among people of higher socioeconomic classes and people involved in activities where thinness is especially looked upon, such as dancing, theater, and distance running. ,,,,.)

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WHAT CAUSES IT?

Anorexia is more than 2ust a problem with food. It!s a way of using food or starving oneself to feel more in control of her life and to ease tension, anger, and anxiety. While there is no single known cause of anorexia, several things may contribute to the development of the disorder *iology 6 "everal biological factors, including genetics and other related hormones, may contribute in the onset the disorder. 9ulture 6 "ome cultures in the :.". have an ideal of extreme thinness. Women may define themselves on how beautiful they are. 0ersonal feelings 6 "omeone with anorexia may feel badly about herself, feel helpless, and hate the way she looks. "he has unrealistic expectations of herself and strives for perfection. "he feels worthless, despite achievements and perceives a social pressure to be thin.

"tressful events or life changes 6 $hings like starting a new school or 2ob or being teased to traumatic events like rape can lead to the onset of anorexia. 7amilies 6 0eople with a mother or sister with anorexia are more likely to develop the disorder. 0arents who think appearance is very important, diet themselves, and critici3e their children!s bodies are more likely to have a child with anorexia.

SIGNS AND SYMPTOMS OF ANORE IA

0eople who have anorexia try to hide their condition, so others may not notice the signs and symptoms of their disorder. "ymptoms in teenagers can be even harder to detect because some warning signs look like normal adolescent development. "ome people with anorexia exhibit many of the following warning signs and symptoms, while others may exhibit only a few.

P"(sic#& signs #n' s()pt%)s

5ramatic recent weight loss unrelated to an illness In women, missing three consecutive menstrual periods ;o energy or complaints about feeling cold all the time 5ry, lifeless hair< brittle nails, poor skin tone

!e"#$i%r#& signs #n' s()pt%)s

"trange eating habits, like restricting certain foods or drastically reducing how much food you eat. =xcessive and>or compulsive exercising 9omplaints about being fat when obviously not 7re#uent weigh&ins and over&attention to tiny fluctuations in weight Always checking in the mirror for body flaws =xcessive trips to the restroom or regular use of laxatives &8&

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S%ci#& signs #n' s()pt%)s

0retending to eat or lying about eating /aking excuses for not eating or for running to the bathroom Wearing baggy clothes to cover up gaunt appearance Apathy, withdrawal from social life or moodiness

EFFECTS OF ANORE IA
Anorexia has dire effects on the body and mind because an anorexic%s body is more or less feeding on itself. When the vital functions of the brain, heart, and lungs don%t get enough nutrients from food consumed, they raid secondary organs, starting with skin, hair, muscles, and bones. In addition, decreasing metabolism slows the heart and lowers the amount of oxygen that gets to the brain, while electrolyte imbalance endangers heart function. $his diagram shows the physical effects of anorexia, as well as some of the emotional effects.

1ther effects of anorexia include tooth decay and gum damage from lack of nutrients and from stomach acid, especially if the person with anorexia vomits fre#uently, and damage to the esophagus and larynx from acid reflux. It isn%t unusual for anorexics to have fre#uent thoughts of suicide. 0eople with anorexia also may be tempted to self&medicate their negative feelings with alcohol or drugs, with more ill effects to their bodies. ,,,,? &?&

Di#gn%sis #n' tre#t)ent %* An%re+i#

A visit to the doctor or clinic is the first step in a process that can lead to recovery from anorexia. Among anorexics that are treated, +5 to @( percent recover completely or make significant progress in regaining full health.

Di#gn%sis
When doctors screen people for anorexia, they first seek to rule out other disorders or diseases that can explain dramatic weight loss and other symptoms of anorexia. "uch screening includes the following a physical exam, including a physical history laboratory tests, such as blood tests and urinalysis other speciali3ed tests, such as an electrocardiogram and an x&ray a psychological evaluation

If the problems a doctor finds aren%t explained any other way and are explained by not eating, the doctor will diagnose anorexia and detail the physical damage already done.

Tre#t)ent G%#&s
$reatment for anorexia happens in many different ways and is individuali3ed according to the patient%s specific needs, but all treatment for anorexia has the same two basic goals- to bring the person with anorexia to a healthy weight and undo whatever physiological damage has already occurred, and to address the underlying psychology of the self&destructive behavior that is anorexia, establishing a healthy mental state in the recovering anorexic. $he earlier the diagnosis is made, the more effective treatment is likely to be. And don%t be discouraged by setbacks- anorexia is noted for its relapse rate, and recovery can be a long, slow process.

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P"(sic#& Tre#t)ent
$he first priority medical personnel have with anorexics is to address their physical condition, stabili3ing them nutritionally. $his isn%t always easy, as many anorexics are in denial about their condition. $hey are often brought in for treatment unwillingly rather than seeking help on their own and see no reason why they should begin eating. Anorexics who have put themselves in danger by not eating A that is, are severely weakened by malnutrition A may need to be hospitali3ed and fed intravenously. 4ecent research suggests that if someone with anorexia is put in the hospital, it should be 2ust long enough to stop the weight loss and treat whatever physical conditions are endangering the patient.

An important part of physical recovery is nutritional counseling, in which a dietitian helps the patient to develop and use plans for food intake that include enough calories to attain a normal weight and get healthy again. 1nce the anorexic%s physiological problems are stabili3ed, he or she can proceed with supportive psychotherapy.

Ps(c"%t"er#p(

$alk therapy that addresses the emotional underpinnings of anorexia has several goals- to identify the feelings, fears, and desires that caused the patient to stop eating< to work through negative attitudes about food and body image and develop new ones< to figure out ways to solve problems and handle negative feelings productively instead of self&destructively. $his, too, isn%t easy- low self&esteem and poor body image can be tough nuts to crack. *ut time and patience often bring success.

While a doctor or psychiatrist may prescribe medication to treat the depression or anxiety that often are intertwined with anorexia or to treat other aspects of the disorder, drugs are not a first line of attack against anorexia, and the psychological components of anorexia can%t be treated by drugs alone. $alk therapy is crucial A again, the sooner the better.

Me'ic#& C%nse,uences %* #n%re+i#?

$here are many medical risks associated with anorexia. $hey include- shrunken bones, mineral loss, low body temperature, irregular heartbeat, permanent failure of normal growth, development of osteoporosis and bulimia nervosa. 9ontinued use of laxatives is harmful to the body. It wears out the bowel muscle and causes it to decrease in function. "ome laxatives contain harsh substances that may be reabsorbed into your system. ,.,,B -.-

G%%' ne/s #0%ut An%re+i#?

Anorexia can be overcome. With proper care, you can overcome your eating disorder and have a healthy child.

An%re+i# St#tistics
1ne percent of teenage girls in the :.". develop anorexia nervosa and up to 1( those may die as a result. of

He&p #n' supp%rt *%r #n%re+i#

Getting He&p #n' Supp%rt
It can be scary and embarrassing to seek treatment for anorexia. *ut if you%re ready to acknowledge that you have a problem with food, it%s important to find people who can help you. Ask your family doctor, school nurse, or campus health center for recommendations.

He&p *%r s%)e%ne e&se

If you%re worried that a friend or family member has anorexia, and you want to encourage him or her to get treatment, you need to tread lightly. *ecause people with anorexia often deny they have a problem, waving around articles about the dire effects of anorexia or declaring CDou%ll die if you don%t eatEF probably won%t work. *ut you can let people you care about know that you%re concerned about their health and that you%re always available to listen. Dou can get advice from a health professional even if your friend won%t, and you can bring others, from peers to parents, into the circle of support. If your friend with anorexia is willing to talk, listen without 2udgment, no matter how cra3y he or she sounds. And dont turn into the food police- someone with anorexia needs support, not an extra mom standing over the table with a calorie counter. Dou can also help by being a good role model. 5on%t make negative comments about your own body or anyone else%s. "how off your own good eating, exercise, and health habits.

Whenever you intervene in someone%s life, that person may not appreciate it, especially at first. *ut if you%re able to persuade someone with anorexia to get help, you may have saved a life. ,,,+ &+&

C#n S%)e%ne Wit" An%re+i# Get !etter?

Des. 0eople with this disorder can get better. $he treatment depends on what the person needs. $he person must get back to a healthy weight. /any times, eating disorders happen with other problems, like depression and anxiety problems. $hese problems are treated along with the anorexia and may involve medicines that help reduce feelings of depression and anxiety. With outpatient care, the patient goes to the hospital during the day for treatment, but lives at home. "ometimes, the patient goes to a hospital and stays there for treatment. 5ifferent types of health care providers, like doctors, nutritionists, and therapists, will help the patient get better. $hese providers will help the patient regain the weight, improve physical health and nutrition, learn healthy eating patterns, and cope with thoughts and feelings related to the disorder. After leaving the hospital, the patient continues to get help from her providers.

Individual counseling can also help someone with anorexia. 9ounseling may involve the whole family too, especially if the patient is young. "upport groups may also be a part of treatment. "upport groups help patients and families talk about their experiences and help each other get better.

W"#t S"%u&' I D% i* I T"in1 S%)e%ne I 2n%/ "#s An%re+i#?

Dou can help. 7ollow these steps from the ;ational =ating 5isorders Association "et a time to talk. "et aside a time to privately talk about your concerns with your friend. *e open and honest. /ake sure you talk in a place away from distractions. $ell your friend about your concerns. $ell your friend about specific times when you were worried about her eating or exercise behaviors. =xplain that you think these things may show a problem that needs professional help. Ask your friend talk about these concerns. "he could talk to a counselor or doctor who knows about eating issues. If you feel comfortable, offer to help your friend make an appointment or go with her to her appointment. Avoid conflicts or a battle of the wills with your friend. If your friend doesn!t admit to a problem, repeat your feelings and the reasons for them. *e a supportive listener. 5on!t place shame, blame, or guilt on your friend. 5o not use accusatory GyouG statements like, GDou 2ust need to eat.G 1r, GDou are acting irresponsibly.G Instead, use GIG statements like, GI!m concerned about you because you refuse to eat breakfast or lunch.G 1r, GIt makes me afraid to hear you vomiting.G Avoid giving simple solutions. 5on!t say, GIf you!d 2ust stop, then everything would be fineEG =xpress your continued support. 4emind your friend that you care and want her to be healthy and happy.

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WHAT IS BULIMIA?
*ulimia Hbuh&.==&me&ahI nervosa is a type of eating disorder. It is often called 2ust bulimia. A person with bulimia eats a lot of food in a short amount of time. $his is called binging. $he person may fear gaining weight after a binge. *inging also can cause feelings of shame and guilt. "o, the person tries to GundoG the binge by getting rid of the food. $his is called purging. 0urging might be done by making yourself throw up taking laxatives H.AJ&uh&tivI A pills or li#uids that speed up the movement of food through your body and lead to a bowel movement exercising a lot eating very little or not at all taking water pills to urinate

0eople with bulimia often feel extremely guilty about their behavior, which is why they may successfully hide the disorder for years, even from their spouses and children. $rips to the bathroom after meals, the sudden disappearance of large #uantities of food, fre#uent dental visits, and mood changes may be hints that something is wrong.

W"% 0ec%)es 0u&i)ic?

/any people think that only young, upper&class, white females get eating disorders. It is true that many more women than men have bulimia. In fact, ' out of 1( people with bulimia are women. *ut bulimia can affect anyone- /en, older women, and women of color can become bulimic. It was once thought that women of color were protected from eating disorders by their cultures. $hese cultures tend to be more accepting of all body si3es. *ut research shows that as women of color are more exposed to images of thin women, they are more likely to get eating disorders. African& American, .atina, Asian>0acific Islander, and American Indian and Alaska ;ative women can become bulimic.

W"#t c#uses 0u&i)i#?

*ulimia is more than 2ust a problem with food. A binge can be set off by dieting or stress. 0ainful emotions, like anger or sadness, also can bring on binging. 0urging is how people with bulimia try to gain control and to ease stress and anxiety. $here is no single known cause of bulimia. *ut these factors might play a role Cu&ture3 Women in the :.". are under constant pressure to be very thin. $his GidealG is not realistic for most women. *ut seeing images of flawless, thin females everywhere can make it hard for women to feel good about their bodies. /ore and more, men are also feeling pressure to have a perfect body.

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F#)i&ies3 It is likely that bulimia runs in families. /any people with bulimia have sisters or mothers with bulimia. 0arents who think looks are important, diet themselves, or 2udge their children!s bodies are more likely to have a child with bulimia. 4i*e c"#nges %r stress*u& e$ents3 $raumatic events like rape can lead to bulimia. "o can stressful events like being teased about body si3e. Ps(c"%&%g(3 Kaving low self&esteem is common in people with bulimia. 0eople with bulimia have higher rates of depression. $hey may have problems expressing anger and feelings. $hey might be moody or feel like they can!t control impulsive behaviors. !i%&%g(3 Lenes, hormones, and chemicals in the brain may be factors in getting bulimia.

What are signs of bulimia?

A person with bulimia may be thin, overweight, or normal weight. $his makes it hard to know if someone has bulimia. *ut there are warning signs to look out for. "omeone with bulimia may do extreme things to lose weight, such as using diet pills, or taking pills to urinate or have a bowel movement going to the bathroom all the time after eating Hto throw upI exercising too much, even when hurt or tired

S%)e%ne /it" 0u&i)i# )#( s"%/ signs %* t"r%/ing up, suc" #s swollen cheeks or 2aw area rough skin on knuckles Hif using fingers to make one throw upI teeth that look clear broken blood vessels in the eyes

"omeone with bulimia often thinks she or he is fat, even if this is not true. $he person might hate his or her body. 1r worry a lot about gaining weight. *ulimia can cause someone to not seem like him or herself. $he person might be moody or sad. "omeone with bulimia might not want to go out with friends. "trict, compulsive, perfectionist family environment. Anorexia nervosa. 5epression. "tress, including lifestyle changes, such as moving or - 10 starting a new school or 2ob. ..10

RIS2 INCREASES WITH

;eurotic preoccupation with being physically attractive.

PRE5ENTI5E MEASURES
4aise children in a wholesome family environment with emphasis on caring and good communication rather than on external appearances. =ncourage rational attitude about weight. Avoid stress.

E PECTED OUTCOME
1utcome is variable< patients can learn to control the behavior with counseling, psychotherapy, biofeedback training and individual or group psychotherapy.

POSSI!4E COMP4ICATIONS
5ental problems including erosion of the enamel of back teeth and cavities. :lcers. Internal bleeding< stomach rupture HrareI. Inflammation of the throat. 5ehydration. 0ancreatitis. Kypoglycemia. ,,,.11 & 11 &

=rratic heartbeat, low pulse rate and low blood pressure. 9essation of menstrual cycles. 7luid and electrolyte imbalance from vomiting. Midney damage. "erious medical problems that without treatment the complications can be fatal. *ulimia is a very serious illness that can lead to anemia, fluid depletion, electrolyte imbalances, infertility, internal bleeding, malnutrition and many other disorders. If not treated, bulimia can lead to various cancers, kidney damage, liver damage and cardiac arrest. 4elapse.

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TREATMENT GENERA4 MEASURES

0sychiatric consultation is fre#uently necessary to overcome bulimia, as the cause is most often psychological. .ong&term treatment may be needed to improve self&esteem. $herapy will consist of assessing nutritional status, establishing target goals, identifying triggers, improving relationships, overall well&being, techni#ues to avoid stress, etc. $reatment in an eating disorder facility may be recommended. Kospitali3ation in severe cases. 0sychotherapy or counseling that may include hypnosis or biofeedback training.

THE POSITI5E OUT4OO2

It is not unusual for a teenager to feel uncomfortable about the way they look or how they feel. It is hard ad2usting to new things at times and you start making decisions that are influenced by others whether it be friends or television. If you do feel that you suffer from this disorder don%t worry you are not alone. $here are many teens that go through the same type of issue. $he main thing you should know is that you should not feel as though you have to look a certain way because that%s how everyone else looks. If you looked like everyone else then you would not be you. 1f course there is nothing wrong with improving the way you look. Nust make sure before you make these improvements that you are doing them for the right reasons.