All about anorexia nervosa

GENERAL

Anorexia patients trying to reduce the weight of different ways: exercise, diet, by calling vomiting after meals, washing the stomach and intestine or taking diuretics and laxatives drugs. Patients arises panic fear of weight gain, they are not adequately evaluate their appearance and tend to consider themselves to be complete for no apparent reason. They do not recognize themselves in serious trouble, and until the development of severe complications do not realize that it is anorexia nervosa.

Prolonged fasting causes neuroendocrine disorders and metabolic disorders. In women developing amenorrheaWhile men complain of lack of sexual desire. Anorexia nervosa pathological changes are observed not only by the systems and organs, they affect the tissue and lead to profound disturbances in the whole organism.

Statistical data:

• The danger of this disease is underestimated: about 20% of patients die and half of the deaths occur because of suicides. Total depletion organism provokes the development of heart failure, becoming a major cause of death in anorexia.
• The percentage of cases among more women than men (Ratio of 1.2% to 0.29%). They are particularly vulnerable to the disease, young people involved in ballet, acting and modeling business. Among the girls working at the podium, more than 70% suffer from anorexia.
• The risk group women who are fond of diets and various slimming techniques. In 15% of them develop this obsession.
• Girls aged 12 to 26 years old account for 80% of patients with anorexia nervosaThe remaining 20% ​​are men and women of mature and elderly.

The problem with such emotional disorders associated with the cultivation of social thought that the ideal woman should be thin. Such stereotypes have led to a surge of anorexia and bulimia in European countries, and then approaches to this problem have changed significantly.

CAUSES

The exact causes of anorexia nervosa are unknown. According to many experts, the disease occurs as a result of a combination of traits, characteristics of thinking, physiology and environmental factors.

Predisposing factors:

• Adolescence and early adulthood.
• Genetic predisposition. Some proteins, deterministic genes are responsible for the level of serotonin, which causes a decrease in depression. Improper diet or stress can be a predisposing factor causing anorexia.
• Biological factors: early puberty, increased body mass index (BMI), the dysfunction of neurotransmitters responsible for feeding behavior, zinc deficiency.
  
• Family factors: the presence in the circle of relatives of people suffering from obesity, bulimia or anorexia, and depression and dependence on drugs.
• Personality traits. Anorexia nervosa affects both perfectionists and insecure people with low self-esteem.
• Psychological factors: stress and nervous shock, obsessive-compulsive disorder, phobias, panic disorders.
• Cultural aspects of the place of residence, where an emphasis on thinness as a mandatory feature of beautiful and successful people.

CLASSIFICATION

Types of anorexia depending on the pathogenesis:

• neuropathic - developing influenced experiences due to the excitation of the cortex.
• neurodynamic - by strong physical sensation (pain) is braked centers of the brain responsible for appetite.
• nervous (Kahetsiya) - willful resistance and refusal to eat due to a variety of disorders of the psyche.

Types of anorexia depending on the causative factors:

• primary - arose as a result of illness or injury.
• secondary - eating disorders caused by conscious or refusal to eat a significant limitation of its receipt.

Classification by BMI:

• nervous - BMI below 16.5.
• Ataroksicheskaya anorexia - BMI below 17.5.

The health risk is high in both cases.

SYMPTOMS

Signs of anorexia nervosa is quite polymorphic and varied as the disease affects the state of the whole organism. The symptoms of this disorder vary at each stage of the disease, depending on the degree of exhaustion.

The stages of anorexia:

• 1. The patient is dominated by the idea of ​​totality, he feels inferior, there is anxiety and depressed mood. Man considers himself a long time in the mirror, looking for flaws in the figure and restrict your diet.
• 2. After fasting stable weight is reduced by 30%. This result makes the patient a feeling of euphoria and a desire to lose weight is strengthened even more in his mind. In addition to the diet used exercise. Manifest major symptoms of anorexia nervosa: bradycardia, hypotension, pallor, dry skin, hair loss. Women stop menstruating, men suspended spermatogenesis and libido disappears.
• 3. Kahetsiya characterized by the development of irreversible changes. This stage in the absence of therapy appears after 1.5-2 years of food restriction. The patient loses more than half its weight. There are changes not only by the authorities, but also in the blood. One of the most difficult conditions is a violation of water-salt balance and potassium deficiency. If this process is increased to the critical point, the fatal inevitable.

Characteristic symptoms of anorexia nervosa:

• progressive reduction in body weight;
• failure of the normal power;
• self-confidence in relation to the figures;
• postprandial discomfort;
• weakness, muscle cramps;
• constant feeling of cold;
• defeatist mood.

DIAGNOSTICS

Often, with the establishment of an accurate diagnosis of anorexia nervosa have problems. Due to the nature of the disease, patients with anorexia rarely seek medical help and deny their problems.

Anorexia nerves diagnosed by interviewing the patient and the examination of his health. Psychiatrist sets defining questions, the answers to which help to establish the diagnosis and identify the tendency to starvation. Also, the doctor draws attention to the shortage of body weight and general endocrine disorders.

The aim of the laboratory research is to identify changes in the functioning of the major organs and systems. The state of health and depletion depth indicated by the results of blood analysis, urine samples for kidney function, liver, thyroid, and electrocardiogram.

TREATMENT

For the treatment of anorexia nervosa complex approach is needed. This problem both by specialists of different profiles: a psychiatrist, a psychologist, a therapist and a nutritionist.

The goals of treatment:

• increased activity of the patient in the society;
• reduction of physical activity;
• compliance with supply schedule.

Before the physician and patient should long-term and difficult task to perform which takes years, sometimes decades. Any stress fraught breakdown and renewal of starvation. Of great importance is the support of family and friends.

The positive dynamics is said that when the patient's weight increases by 0.4-1 kg per week. Increasing weight reduces the severity of anorexia symptoms, improve physical and mental condition of the person. Calorie intake is increasing gradually from 1000 to 3500 calories per day. In severe conditions, involving a risk to life, possibly parenteral nutrition or intravenous patient.

Along with a special diet, behavioral and cognitive psychotherapy in the treatment of anorexia nervosa conducted physical therapy prevents the development of complications and recurrences. The patient should undergo treatment on his own, coercive measures do not work. Most often effective therapy requires hospitalization.

COMPLICATIONS

• development of pathologies of the cardiovascular system;
• amenorrhea;
• variations in bowel habits;
• hormonal imbalance;
• hematologic abnormalities;
• polyuria;
• dry skin, nail separation;
• osteoporosis;
• fainting, and as a result - injuries;
• obsessive-compulsive disorder;
• depression;
• suicide.

Early treatment of anorexia nervosa stabilize the patient's condition and prevent the development of irreversible changes. Complications developed due to lack of treatment for the second stage of the disease.

PREVENTION

primary prevention measures:

• Learning healthy eating habits from childhood;
• vaccinating children values ​​that promote the right attitude to your body and balanced perception of their possible shortcomings.

Secondary prevention measures:

• not to focus on food, body shape and weight;
• monitoring of physiological parameters, and body weight when you visit the doctor;
• psychological support within the family.

In many countries around the world in recent years it has been initiated legislation prohibiting involve shooting and replication of media models, anorexic.

FORECAST FOR RECOVERY

Results of treatment of patients with anorexia nervosa are very ambiguous. The recovery period is quite long and is about 4-7 years. Realistic prognosis depends on the start time of treatment and symptoms of anorexia nervosa.

Approximately 50-70% of patients with a similar disorder return to a normal life. A quarter of the total number of patients and can not be restored. The disease becomes chronic in 25% of patients for recurrence of their cases are not uncommon. Among the many conventionally recovered and continue to limit yourself to food and strive for thinness.

A lot of the opposite case, when the background of the treatment of anorexia nervosa develops obesity, and psychological problems these people change the character. Unfortunately, at least 6% of patients with this disease die from starvation or suicide.

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