Desmond Kaplan MD FAPA

Child, Adolescent & Adult Psychiatry

1777 Reisterstown Road, Suite 50
 Baltimore, MD 21208

Anorexia Nervosa

Anorexia nervosa is a serious emotional eating disorder that involves an obsession with food, weight and body image. Anorexics go to extreme measures to starve themselves or exercise excessively in order to prevent weight gain. Often, anorexia nervosa is not really about food, but a psychological condition that manifests in an unhealthy and dangerous way to cope with emotional problems and issues of control and perfectionism. Females suffer from anorexia nervosa more often than males.

Symptoms of Anorexia Nervosa

People with anorexia have a skewed vision of their own body and often think they are fat when they may in fact be extremely thin. They may have a strong fear of gaining weight and go to extreme measures to remain thin. Many anorexics control calorie intake by causing themselves to vomit after eating. Additional symptoms of anorexia may include:

  • Extreme weight loss
  • Refusal to eat
  • Denial of hunger
  • Eating very small amounts of only certain foods
  • Fatigue
  • Dizziness
  • Thinning or breaking hair
  • Development of more body hair
  • Absence of menstrual cycle
  • Preoccupation with food
  • Excessive exercise
  • Dry skin
  • Dehydration
  • Social withdrawal

People with anorexia may also have other psychiatric conditions including depression, anxiety or obsessive behavior. Anorexics may also have substance abuse problems, especially the use of stimulants, laxatives or diet aids.

Causes of Anorexia Nervosa

The cause of anorexia is not known, but it is likely a combination of biological, psychological, environmental and cultural factors. Media and peer pressure can often influence an extreme desire to be thin, especially in young girls. Life changes or stressful events may lead to the onset of anorexia and mental conditions such as depression or anxiety may also be a factor in developing the condition.

Diagnosis of Anorexia Nervosa

If anorexia nervosa is suspected, the doctor will perform a full physical examination as well as additional diagnostic tests to rule out any other underlying conditions. Tests may be performed to check electrolyte and protein levels as well as liver and kidney function, and may include:

  • Urinalysis
  • Blood tests
  • X-rays

In addition, a full psychological evaluation will be conducted and the patient will be asked about thoughts, feelings and eating habits.

Treatment of Anorexia Nervosa

The goal of anorexia treatment is to get the patient back to a healthy weight. If the patient's life is in danger, they may be admitted to a hospital. In severe cases, people with anorexia may initially require a feeding tube to deliver nutrients to their body. Treatment for anorexia nervosa often involves a team of health professionals including doctors, nutritionists, psychiatrists and therapists. Medical treatment may be administered if the body has become damaged by the condition. Nutritional counseling can help the patient to develop healthy eating patterns and psychological counseling can help to address mental health issues. Anorexia often requires long-term treatment to prevent relapses, and may be a life-long process.

It is critical for patients with anorexia nervosa to seek medical treatment before the condition worsens. Untreated anorexia can lead to complications such as anemia, bone loss, heart, kidney and lung problems, and death.

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