Anorexia nervosa is a psychiatric diagnosis that
describes an eating disorder characterized by low body weight and body image
distortion. Individuals with anorexia often control body weight by voluntary
starvation, purging, vomiting, excessive exercise, or other weight control
measures, such as diet pills or diuretic drugs.
Anorexia nervosa primarily affects young adolescent
girls in the Western world and has one of the highest mortality rates of any
psychiatric condition, with approximately 10% of people diagnosed with the
condition eventually dying due to related factors.
The suicide rate of people with anorexia is also
higher than that of the general population and is thought to be the major cause
of death for those with this condition.
Anorexia nervosa is a complex condition, involving
psychological, neurobiological, physiological and sociological components.
A person who is suffering from anorexia is referred
to as anorexic. Anorexia nervosa is frequently shortened to anorexia in both
the media and scientific literature. This is technically incorrect, as strictly
speaking anorexia refers to the medical symptom of reduced appetite.
It is clear that there is no single cause for
anorexia and that it stems from a mixture of social, psychological and
biological factors. Current research is commonly focused on explaining existing
factors and uncovering new causes. However, there is considerable debate over
how much each of the known causes contributes to the development of anorexia.
In particular, the contribution of perceived media pressure on women to be thin
has been especially contentious.
Anorexia can be difficult to treat. A recent review
suggested that less than one-half recover fully, one-third improve, and 20%
remain chronically ill.
The first line of treatment for anorexia is usually
focused on immediate weight gain, especially with those who have particularly
serious conditions that require hospitalization. In particularly serious cases,
this may be done under as an involuntary hospital treatment under mental health
law, where such legislation exists. In the majority of cases, however, people
with anorexia are treated as outpatients, with input from physicians,
psychiatrists, clinical psychologists and other mental health professionals.
A recent clinical review has suggested that
psychotherapy is an effective form of treatment and can lead to restoration of
weight and improved psychological and social functioning when compared to
simple support or education programs. However, this review also noted that
there are only a small number of randomized controlled trials on which to base
this recommendation. No specific type of psychotherapy seems to show any
overall advantage when compared to other types.
Family therapy has also been found to be an
effective treatment for adolescents with anorexia and in particular, a method
developed at the Maudsley Hospital is widely used and found to maintain
improvement over time.
It is important to note that many recovering
underweight people (who are more or less forced against their will into
recovery by angry parents or other relatives) often harbour a hateful dislike
for those who they feel are robbing them of their treasured emaciation. Often
when well-meaning friends or relatives compliment the recoveree on how much
healthier they look, the recoverees mind replaces healthy with fat.
Drug treatments, such as SSRI or other
antidepressant medication, have not found to be generally effective for either
treating anorexia or preventing relapse although there is a lack of adequate
research in this area. It is common, however, for antidepressants to be
prescribed, often with the intent of trying to treat the associated anxiety and
depression.
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