The Deadliest of all the Psychiatric Disorders Anorexia Nervosa

In the USA alone, 30 million people are suffering from an eating disorder right now. 70 million are suffering worldwide (Farrar, 2014). Eating disorders are becoming an epidemic, especially concerning women. Anorexia nervosa is an eating disorder that involves the relentless pursuit of thinness through starvation (King, 2010, p.455). History of Origin Anorexia first appeared sometime in the 12th and 13th centuries. Saint Catherine of Siena denied herself food as part of a spiritual denial to self. In the 16th century, ascetics (those who denied themselves food for spiritual beliefs) were considered witches and burned at the stake. During the 17th the early 20th century, anorexia was considered an endocrine disorder and treated with pituitary hormones (Deans, 2011). Anorexia nervosa was first given its name in 1868, by William Withey Gull, a British physician at Guy’s Hospital, London. The disease was first documented in 1873, by Charles Lasgue, when he wrote L’anorexie Hysterique. He said that the disorder typically began between the ages of 15 to 20 and had three distinct stages During the Victorian Era, the disorder was thought to be a form of hysteria that affected mainly women of the middle and upper classes. Obesity during this era was thought to be a characteristic of poverty the ideal woman’s body type during the Victorian era was one that was curvy and full- figured. Many women attempted to achieve this body type through the use of corsets. The role of restrictive corsets exemplifies how women began taking extreme measures to achieve the believed ideal body type. Sometime midway in the twentieth century, the mass media became the chief purveyors of the idea that slimness is the ideal image of feminine beauty. This constant emphasis has caused many women to incessantly diet in order to keep up with the demands of modern fashion. In a 1984 survey carried out by Glamor magazine, of thirty-three thousand women between the ages of eighteen and thirty-five, 75 percent believed they were fat, although only 25 percent were actually overweight cultural model became pervasive throughout the media, said New World Encyclopedia contributors (2016). When Hilde Bruch published a book called Eating Disorder: Obesity, Anorexia Nervosa, And the Person Within, public awareness increased along with the number of eating disorder cases in the 1970s (Deans, 2011).

Anorexia nervosa is the deadliest of all the psychiatric disorders. It has a 5-10 percent death rate within 10 years of developing the symptoms, and an 18-20 percent death rate within 20 years of developing the symptoms. Anorexia is already an endemic in the fashion industry, to the point where models are now being airbrushed to add curves (Deans, 2011). Anorexia nervosa has a long history, but what causes anorexia nervosa? Etiology/Causation Anorexia nervosa is a complicated disease. The exact cause is unknown. It is thought that it is like any other disease and is a combination of biological, psychological, and environmental. For the biological standpoint, the genes involved are still unknown, however, there are some genetic changes that certain people at higher risk for developing anorexia. These people are people who have a genetic tendency toward perfectionism, sensitivity, and perseverance, which are all traits associated with anorexia. From the psychological standpoint, some people with anorexia may have obsessive-compulsive personality traits that make it easier to stick to strict diets and forgo food despite being hungry. They may have a drive for perfectionism that makes them think that they are never thin enough. On the environmental standpoint, modern western culture emphasized thinness. People who are thin are successful and worthful. Peer pressure may fuel young girls to be thin (Anorexia nervosa, 2018). There are risk factors that are known for anorexia nervosa. Genetics, dieting and starvation, and transitions are risk factors for anorexia nervosa. People who have a close relative parent, sibling or child who had anorexia have a much higher risk for it. Dieting is a risk factor for developing an eating disorder.

There is strong evidence that many of the symptoms of anorexia are symptoms of starvation. Starvation affects the brain and influences mood changes, rigidity in thinking, anxiety and reduction in appetite. Extreme weight loss may change the way the brain works in vulnerable individuals, which may perpetuate restrictive eating behaviors and make it difficult to return to normal eating habits. When there is a major transition in someone’s life, it is also a risk factor for anorexia nervosa. It can be a new school, home or job, a relationship breakup; or the death or illness of a loved one, change can bring emotional stress and increase the risk of anorexia (Anorexia nervosa, 2018). Onset / Prevalence Eating disorders are becoming more and more common as time progresses. About 1.6 million people have a diagnosed eating disorder. Younger people are most at risk. The average age of onset of anorexia nervosa is 16-17 yet the number of cases of children affected and cases of early onset continues to rise (About Eating Disorders). An estimated 0.5 to 3.7 percent of women suffer from anorexia nervosa at some point in their lifetime. The ratio of girls to boys in children, ages 5-12 years, with anorexia nervosa or bulimia nervosa is 5:1. The ratio in adolescent/adult women to adolescent/adult men is 10:1 (Farrar, 2014). The Department of Health estimates about 4 million people currently struggle with an eating disorder. Anorexia is the leading cause of mental health related deaths. Of those surviving, less than 50% recover, whereas 30% improve and 20% remain chronically ill (About Eating Disorders). There was a sample done to see the time trends in age at onset of anorexia nervosa and bulimia nervosa. They used 1,666 anorexia nervosa subjects and 793 bulimia nervosa subjects between 1985 and 2008. The results were that the age at onset of anorexia nervosa and bulimia nervosa is decreasing in younger generations.

The implications of their findings in terms of long-term outcome remain to be understood (Favaro et al., 2009). Symptoms Anorexia nervosa is not hard to detect in certain people, but others, it can be near impossible. Anorexia has physical, emotional, and behavioral symptoms. The physical signs and symptoms of anorexia may include: extreme weight loss, thin appearance, abnormal blood counts, fatigue, insomnia, dizziness, bluish discoloration of the fingers, hair thins and falls out, absence of menstruation, constipation, abdominal pain, dry or yellowish skin, intolerance of cold, irregular heart rhythms, low blood pressure, dehydration, swelling of arms or legs, eroded teeth, and calluses on the knuckles from induced vomiting (Anorexia nervosa, 2018). Emotional and behavioral signs and symptoms may include: preoccupation with food, frequently skipping meals or refusing to eat, denial of hunger or making excuses for not eating, eating only a few certain safe foods, adopting rigid meal or eating rituals, not wanting to eat in public, lying about how much food has been eaten, fear of gaining weight, frequent checking in the mirror for perceived flaws, complaining about being fat or having parts of the body that are fat, covering up in layers of clothing, flat mood, social withdrawal, irritability, insomnia, and reduced interest in sex (Anorexia nervosa, 2018). Some behavioral symptoms of anorexia may include attempts to lose weight by: severely restricting food intake through dieting and fasting, exercising excessively, and bingeing and self-induced vomiting to get rid of food, which may include the use of laxatives, enemas, diet aids or herbal products (Anorexia nervosa, 2018). Treatment Depending on how old the person with anorexia nervosa is, depends on the treatment. For children, it depends on their age, overall health, medical history, extend of the child’s symptoms, the child’s tolerance for specific medications or therapies, and expectations for the course of the condition (Anorexia Nervosa in Children).

For adolescents, family based treatment is the best evidenced-based approach for anorexia nervosa. This treatment facilitate parental management of the restrictive dieting and over exercise in their child until the child is recovered enough to manage more age appropriate eating. Individual therapy is also an effective treatment appears to take longer for patients to restore weight. Other forms of family therapy also appear to be useful Treatment should always be based on a comprehensive evaluation of the adolescent and family. There are no medications known to be helpful for anorexia nervosa, but medication (usually antidepressants) may be helpful if the adolescent with anorexia is also depressed or anxious. The frequent occurrence of medical complications requires your child’s doctor to be an active member of the management team. Parents play a vital supportive role in any treatment process. Hospitalization may be required for medical complications related to weight loss and malnutrition (Anorexia Nervosa in Children). Conclusion All in all, anorexia nervosa is a mental condition that not many people fully understand. Most people think that it can be turned on and off like a switch. However, they would not think such thoughts if they would educate themselves.

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