Anorexia nervosa is a psychological disorder that can be seen especially in young women. This disease usually begins in adolescence and rarely in adulthood. In general, it can be seen that any individual who is passionate about lose weight can occur. This usually begins with the administration of the regimen in a way that is so overweight, that the controllable appetite disappears after a while and the weight loss exceeds normal levels. ‘Anorexia nervosa’, an eating disorder syndrome, is seen not only in young girls but also in men. Life-threatening cases are difficult to treat. Anorexia can also be seen in people with intense psychological problems. Even in people who are not obsessed with dieting or losing weight, eating disorders are in question during a very problematic life. Family, school, work, or emotional issues with people who have a breakdown refuses to eat, if forced to eat. As a result, there will be a lot of weight loss in the short term and all the effects of this disease are experienced. Eating problems disappear with the solution of problems; however, they may experience serious and persistent physiological problems during this stage.The most common symptom is the fear of gaining excess weight.
Symptoms of Anorexia Nervosa
- Fear of obesity as well as deterioration of body image (in this case even the weakest person may find herself very fat in this disease)
- To control weight, food intake is severely restricted and heavy exercises are performed.
- People who have the feeling that they are eating too much food will make themselves vomit by sticking their
- Fingers in their throats. Those who repeat this often have hardening of the back of their hands and caries are caused by stomach acid.
- Eating behaviors of these people and their relationship with food begin to form oddities. They can store food and even hours to cook.
Danger Signs for Anorexia Nervosa
In anorexia nervosa, the body changes caused by the disease are as follows: anemia in patients, deterioration of body water – salt balance, increase in blood cholesterol and urea levels, increase in liver enzymes, decrease in thyroid gland hormones in women, female hormone called estrogen in men. As a result of the decrease in sexual function, decrease in heart beat and irregularities, the increase in the volume of brain cavities compared to brain tissue may occur. Heart attacks and deaths may occur in the future.
Causes of Anorexia
1) Sociocultural Factors
Culturally, obesity is strongly discredited and idealized to be weak. Conflicts between women’s career and traditional roles increase efforts to achieve personal control. Some professions are directly related to physical appearance such as model and ballerina. Women in these occupational groups carry a high risk of eating disorders.
2) Familial Factors
The presence of depressive disorder, alcoholism, obesity or eating disorder in the family history increases the risk of eating disorder. In monozygotic twins, the fear ratio of anorexia nervosa was 50%, whereas in dizygotic twins this rate was 10%. But it is very difficult to distinguish whether it is the result of genetic predisposition or the role of the family in the development of the individual. The attitude of the family about diet behavior, weight and body image is very effective.
3) Individual Factors
Factors such as personal helplessness, fear of losing control, a self-esteem, or “all or nothing,” dependent on others’ thoughts increase the susceptibility to eating disorders. Presence of premorbid obesity increases the risk especially for bulimia nervosa. In women, a history of juvenile diabetes mellitus and childhood sexual abuse increases the risk of eating disorders. Such problems facilitate the development of feelings of helplessness and dissatisfaction with one’s own body. There are some opinions about the association between borderline personality disorder and anorexia nervosa. According to psychoanalytic theories, anorexia nervosa develops as a result of defense or oral regression.
4) Neurohumoral Factors
Neuroendocrine anomalies occur as a result of hunger in patients. Most anomalies do not occur only in fasting. For example, increased cortisol secretion is seen not only in hunger but also in depression.
5) Neurotransmitter Change
Fasting also makes changes in neurotransmitter levels. Neurotransmitter synthesis and matabolism rate decreases with thyroid hormone changes, bradycardia, hypotension and disturbance in temperature regulation. The role of serotonin in bulimia is discussed. Decreased 5-hydroxyindole acetic acid in CSF, increased platelet 5-HT levels and blunted prolactin response to serotonergic changes support this linkage. The feeling of satiety against carbohydrate foods is also controlled by serotonin. 5-HT plays a role in triggering eating crises.
Medical problems may occur in anorexia nervosa due to hunger. Therefore, routine laboratory tests should be performed. These tests; electrolytes, renal function tests, thyroid hormone levels, glucose, amylase, complete blood count, ECG, cholesterol, dexamethasone suppression test. As a result of the tests, normalization of thyroid hormones and decrease in blood glucose level and nonsuppression in cortisol may be detected. Hypotension and bradycardia are the most common cardiovascular complications. Bulimia nervosa does not have as much medical problems as anorexia nervosa. However, the clinician should still have the above-mentioned examinations. While thyroid hormones generally remain normal, non-suppression may be detected in the dexamethasone suppression test. Dehydration and electrolyte imbalances may develop due to laxative use. Especially hypomagnesemia and hyperamylasemia are common.