Anorexia Nervosa

Anorexia nervosa is a serious eating disorder characterised by an extreme food restriction and an irrational fear of gaining weight, as well as a distorted body image. It has the highest mortality rate of any psychiatric illness with 1 in 5 individuals dying either through depression/ suicide (57 times more likely to commit suicide), a depleted immune system, or directly as a result of the medical complications of starvation. It is unusual for anorexics to seek help. This is usually at the insistence of family members or friends. The reason for this is because there is a denial that there is a problem despite physical symptoms, and an immense fear of gaining weight.

General features of Anorexia:

• Young adolescent female usually (90% female)
• Loss of weight (at least 15%below ideal weight, or BMI<17
• Intense fear of being normal body weight.
• Insistence on weight losing
• Loss of menstruation
• Arrested sexual development
• Depression and social avoidance
• Ritual behaviours
• Excessive exercising
• Denial erupting in aggression if challenged
• Evolving illness (may become chronic, but 30% recover).
• 30-50% develop bulimic features.
• 20% early death.
• Family problems; attributed to illness effects.

Reaching an optimal weight may eliminate a lot of the symptoms but given that only one in three fully recover, lengthy psychotherapeutic work is required to prevent relapse or developing Bulimia nervosa.