*traduci*  *traduci* da suite101

Signs, Symptoms and Consequences of Anorexia Nervosa
Author: Mark Stuart Ellison
Published on: June 29, 1999

Editor's Note: The material below is intended as an informational tool for education and research. It should not be used for diagnostic purposes. Having one or more of the symptoms or characteristics described here does not necessarily indicate anorexia nervosa. However, if you suspect yourself or a loved one of having anorexia, promptly consult a physician or other qualified health care professional.

According to the American Anorexia Bulimia Association (AABA), one percent of all teenage American girls develop anorexia nervosa and up to 10% of those who develop it die from it. The National Eating Disorders Organization (NEDO) observes that 90-95% of all victims are female. Because untreated anorexia nervosa is a proven woman-killer, knowing the warning signs is essential to successful recovery.

In the 1870s, Sir William gull coined the name "anorexia nervosa," which means "nervous loss of appetite." The phrasing was unfortunate because, as the National Association of Anorexia Nervosa and Associated Disorders (ANAD) points out, anorexics are perpetually hungry, but deny their impulse to eat because they are terrified of gaining weight. Only in the most advanced stages of the condition do anorexics lose their desire for food.

There are two types of anorexia nervosa: restrictive and binge/purging. According to the Academy for Eating Disorders, restrictors maintain a low body weight through self-starvation and excessive exercise. In addition to calorie cutting, binge/purgers stuff themselves, then induce vomiting or misuse laxatives, diuretics, or enemas. Because of its resemblance to bulimia nervosa, a diagnosis for the latter group can be problematical. If a patient meets criteria for both anorexia and bulimia, she is diagnosed as an anorexic, binge/purging type. According to NEDO, one-third of anorexics develop bulimia.

The Academy for Eating Disorders notes that most clinicians will suspect anorexia in a patient who is 85% or less of normal body weight. But what is "normal"? Norms vary with individual body type and chemistry. For this reason, Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED) advises against relying on charts, tables or complex formulas. Instead, ANRED recommends a combination of subjective and objective factors. How do you feel? If the answer is "strong, energetic, and healthy," you're probably on the right track. Are your blood pressure, cholesterol and sugar levels good? Are you free of the back or joint pain associated with bone loss due to malnutrition? If so, these are signs that you have achieved a healthy weight.

By contrast, warning signs of anorexia nervosa, according to NEDO, include:

• Significant to extreme weight loss with no known medical illness
• Ritualistic eating habits
• Denial
• Criticism and Intolerance of others
• Excessive Exercise
• Eating low- to no-fat, and low-calorie foods
• Sufferer says she is fat, even when this is obviously untrue

AABA adds these:

• hair loss
• cold hands and feet
• fainting
• exhaustion
• shortness of breath
• dry, brittle skin

Finally, a few from ANRED:

• depression
• withdrawal
• tooth and gum decay
• dressing in baggy clothes
• hyper-competitiveness

  Let's examine some of these in more detail.

  Ritualistic habits. According to ANRED, the anorexic skips meals, refuses to eat with others, and concocts strange dishes. She will grocery shop and cook tasty recipes for the entire family, but refuse to ingest her culinary creations. There is always an excuse not to eat. In a subconscious cry for help, a binge/purger-type anorexic will often leave clues: empty food packages; foul-smelling bathrooms; running water (to cover sounds of vomiting); and overuse of breath fresheners.

  Intolerance of others, excessive exercise, and hyper-competitiveness. These, according to ANRED, are related to a desire for perfection. The anorexic wants to be the best in everything.

  Denial. The sufferer believes that the thinner she becomes, the closer she gets to perfection - even if she resembles a concentration camp inmate. Thus, from her point of view, there is no problem.

  Depression and withdrawal. The Academy for Eating Disorders observes that adolescence is a time when self-esteem is vulnerable. Since onset of anorexia primarily occurs during the teen years, it is not surprising that sufferers have low self-esteem. ANRED says that they detest certain body parts, especially those naturally rich in fat: breasts, belly, thighs, and buttocks. The anorexic cannot feel good about herself because she's never thin enough to satisfy her standard of perfection.

  Baggy clothes. These are used to hide wasting, and to keep warm.

  Tooth and gum decay. According to ANRED, anorexics lack buffers in their saliva that protect teeth from acid produced by mouth bacteria. Some sufferers grind their teeth in their sleep. My mother, who lost her battle with restricting-type anorexia, had her dentist make her a special plate to prevent this behavior. Still, she had lost half her teeth by the time she died at age 49. You can read more about her in "Growing Up With An Anorexic Mother" Parts I and II.

  Over time, these symptoms lead to real damage. In order to protect itself, the body begins to shut down. The following medical consequences of advanced anorexia are from NEDO:

  • heart muscle damage resulting in death (This is what happened to Karen Carpenter). According to ANAD, the most common cause of death in late-stage anorexics is low potassium, which can cause an irregular heartbeat.
  • cessation of menstruation
  • kidney failure
  • lanugo, a fine body hair, on arms and face
  • muscle atrophy
  • osteoporosis

  The National Eating Disorders Screening Program conducts evaluations to identify sufferers of anorexia. For more information, and to see an excerpt from a sample test, click here.

scusate se non solo in italiano, tradurrò quando avrò tempo per farlo

corpo    mente   relazioni   morte