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Anorexia nervosa 

Anorexia nervosa (anorexia nervosa, AN) is a syndrome of abnormal mental attitudes, expressed with reduction of the amount of food intake, with somatic, metabolic and endocrine changes. The disease is often considered to be a syndrome of modern times, but the author of the first medical description of a patient with anorexia nervosa was the English physician W. Morton early as in the 1694 year, and the term "anorexia nervosa" was first used in the late nineteenth century by W.W. Gulla. 

The term anorexia (anorexia) comes from the Greek words: an - lack and orexis - appetite. Anorexia is more frequent in cases of women (approximately 10 times more) than for men, although in recent years the incidence of this condition in men increases. 

Nervosa

Diagnostics

Modern diagnostic criteria for anorexia nervosa according to DSM-IV are:

  • Weight loss or lack of weight gain in children, leading to weight loss of at least 15% below normal or expected, according to age and height, in the case of older girls BMI <17.5 kg / m2.
  • Constant fear of weight gains or obesity, even if the patient is underweight.
  • Disturbances in self-assessment regarding weight and appearance. Patient considers normal weight to be excessive. 
  • No psychoses and organic causes of emaciation.

There are two types of anorexia nervosa: 

1) The restrictive - with a large weight loss as a result of restrictions on the consumption of foods and / or intense exercise.

2) Binge-Eating - with episodes of binge eating and the use of methods of purification (self-induced vomiting, use of laxatives, diuretics, vigorous exercise).

This type is often confused with a diagnosis of bulimia nervosa, whose characteristic features episodes of gluttony followed by compensatory behaviors. The weight in bulimia, however, remains normal or may be decreased, but its decrease is lower than 15% normal or expected weight.

The unusual form of AN include:

  • The occurrence of the disease at the age of > 25 years of age,
  • Married woman,
  • Males,
  • Women (professional) athletes (anorexia "Athletica") and dancers.

It usually touches young girls during puberty or young women, usually between 14 and 18 years of age, on average, in 15 years of age, with the present trend of lowering the age at onset of life. This disorder involves making a number of deliberate actions leading to weight loss and / or maintaining a low body weight of the patient, the body weight is at least 15% below the expected norm for age and height, or body mass index (body mass index - BMI), ie. Quelet index (weight in kilograms divided by height in meters squared) is equal to or falls below 17.5. 

The patient's suffering from anorexia goal is excessive weight loss, and subsequently maintaining achieved too low body weight. Therefore:

  • the patient constantly limits the amount and frequency of food intake, restricts diet, avoid the so-called "fattening foods" with high caloric index;
  • additionally, performs at least one of the following:  exhaustive exercise, adopt measures reducing appetite, leads to vomiting, using laxatives or diuretics;

the above-mentioned actions are accompanied by distorted body image, the patient sees them as "still too fat", accompanied by the fear of gaining weight;

Patients have hormonal imbalance which may be accompanied by many other somatic disorders and abnormalities, fluid or electrolyte and metabolic imbalance, including symptoms of cachexia, muscle atrophy, edema, pallor, dry and scaly skin, low body temperature, hair loss, lanugo, low blood pressure, decreased heart rate, arrhythmia, fainting, headache, dizziness, constipation, flatulence, inflammation of the mucous membrane of the stomach, anemia, and (as a result of severe vomiting ) - swelling of the salivary glands, and tooth decay. Anorexia should be differentiated as some somatic diseases, especially gastrointestinal disorders and neurohormonal.

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