Anorexia nervosa is an eating disorder characterized by unrealistic fear of weight gain, self-starvation, and conspicuous distortion of body image. The name comes from two Latin words that mean Nervous inability to eat. In females who have begun to menstruate, anorexia nervosa is usually marked by amenorrhea, or skipping at least three menstrual periods in a row. The condition usually occurs in adolescence or young adulthood. It is more common in women, affecting 1-2% of the female population and only 0.1-0.2% of males. Anorexia nervosa is seen mainly in Caucasian women who are high academic achievers and have a goal-oriented family or personality.

Two subtypes are:

Type 1: A restricting type, characterized by strict dieting and exercise without binge eating; and a binge-eating/purging type, marked by episodes of compulsive eating with or without self-induced vomiting and the use of laxatives or enemas. Type 2: It is defined as a binge / as a time-limited (usually under two hours) episode of compulsive eating in which the individual consumes a significantly larger amount of food than most people would eat in similar circumstances.

Anorexia is a disorder that results from the interaction of cultural and interpersonal as well as biological factors. While the precise cause of the disease is not known, it has been linked to the following:

Social influences Occupational goals Genetic and biological influences Psychological factors

Weight Loss of 15% or greater below the expected weight Inappropriate use of laxatives, enemas, or diuretics (water pills) in an effort to lose weight Self-imposed food intake restrictions, often hidden Absence of menstruation Skeletal muscle atrophy Loss of fatty tissue Low Blood pressure Dental cavities may be present with self-induced vomiting Blotchy or yellow Skin Depression may be present in addition to the eating disorder Most individuals with anorexia nervosa refuse to recognize that they have an eating disorder (denial)

Diagnosis of anorexia nervosa is complicated by a number of factors. One is that the disorder varies somewhat in severity from patient to patient. A second factor is denial, which is regarded as an early sign of the disorder. Most anorexics deny that they are ill and are usually brought to treatment by a family member. Most anorexics are diagnosed by paediatricians or family practitioners. Anorexics develop emaciated bodies, dry or yellowish Skin, and abnormally low Blood pressure. There is usually a history of Amenorrhoea (failure to menstruate) in females, and sometimes of abdominal pain, Constipation, or lack of energy. The patient may feel chilly or have developed lanugo, a growth of downy body Hair. If the patient has been vomiting, she may have eroded tooth enamel or Russell's sign (scars on the back of the hand). The second step in diagnosis is measurement of the patient's Weight Loss. The doctor will need to rule out other physical conditions that can cause Weight Loss or vomiting after eating, including metabolic disorders, Brain tumours (especially hypothalamus and Pituitary gland lesions), diseases of the Digestive tract, and a condition called superior mesenteric artery syndrome. Persons with this condition sometimes vomit after meals because the Blood supply to the intestine is blocked. The doctor will usually order Blood tests, an electrocardiogram, urinalysis, and Bone densitometry (Bone density test) in order to exclude other diseases and to assess the patient's nutritional status. The doctor will also need to distinguish between anorexia and other psychiatric disorders, including Depression, Schizophrenia, social phobia, obsessive-compulsive disorder, and body dysmorphic disorder. Two diagnostic tests that are often used are the Eating Attitudes Test (EAT) and the Eating Disorder Inventory (EDI).

The biggest challenge in treating anorexia nervosa is having the person recognize that their eating behaviour is itself a problem, not a solution to other problems. However, most people who suffer from anorexia nervosa deny that they have an eating disorder. Therefore, most individuals enter treatment when their condition is fairly advanced. The purpose of treatment is first to restore normal body weight and eating habits, and then attempt to resolve psychological issues. Hospitalization may be indicated in some cases (usually when body weight falls below 30% of expected weight). Supportive care by health care providers, structured Behavioural Therapy, psychotherapy, and anti-depressant drug therapy are some of the methods that are used for treatment. Severe and life-threatening malnutrition may require intravenous feeding.

In some cases, prevention may not be possible. Encouraging healthy, realistic attitudes toward weight and diet may be helpful. Sometimes, counselling can help.

Anorexia nervosa is a serious and potentially deadly medical condition. By some estimates, it leads to death in 10% of cases. Experienced treatment programs have a two-thirds success rate in restoring normal weight, but relapse is common. Women who develop this eating disorder at an early age have a better chance of complete recovery. Most people with anorexia will continue to prefer a lower body weight and be preoccupied with food and calories to some extent, however. Weight management may be difficult, and long-term treatment may be necessary to help maintain a healthy body weight.

The presence of any of these suggests a severe disease, and hospitalization may be required:

Severe dehydration, possibly leading to cardiovascular Shock Electrolyte imbalance (such as potassium insufficiency) Cardiac arrhythmias related to the loss of cardiac muscle and electrolyte imbalance Severe malnutrition Thyroid gland deficiencies which can lead to Cold intolerance and Constipation Appearance of fine baby-like body Hair (lanugo) Bloating or edema Decrease in white Blood cells which leads to increased susceptibility to infection Osteoporosis Tooth erosion and decay with self-induced vomiting Seizures related to fluid shifts due to excessive Diarrhea or vomiting