Anorexia is a disease characterized by disordered eating behavior. A person suffering from anorexia purposefully refuses to eat, which results in an increase in metabolism. Therefore, doctors of many specialties classify the disease as a group of mental disorders.
Anorexia, translated from ancient Greek, means – lack of urge to eat. Most often, the disease occurs in women of reproductive age, so the incidence of anorexia in women aged 15 to 45 years is up to 4.3%. A large number of cases of the disease, about 40%, are registered in girls aged 18 to 25 years.
Causes of Anorexia
The disease is still being studied, but it is safe to say that there are predisposing factors. To prescribe the right course of treatment, the doctor must figure out where the trigger points are.
Neurohumoral factor
Sometimes endocrine disorders occur in the body, which are characterized by increased production of the hormone leptin. Fat cells, adipocytes, are responsible for the secretion of this hormone. As a result of a large amount of leptin in the blood, which acts on the hypothalamus, the latter reduces the production of neuropeptide. The hypothalamic neuropeptide is responsible for the formation of the feeling of hunger.
Genetic factor
Currently, this reason is at the stage of study, but today it is already known about the presence of such genes as НТR2A and BDNF. They block the production of neurotransmitters that are responsible for the formation of the feeling of hunger. Scientists around the world do not stop there and are constantly trying to change the presence of pathological genes through genetic engineering.
Stress factor
Diseases in which the secret of the causes of occurrence is hidden, this factor plays a key role. In fact, this is not accidental. Stressful situations that can form anorexia include: the death of a loved one, the inability to achieve a goal, uncertainty about the future and much more.
Cultural and personal factor
The desire to be beautiful and attractive is promoted in many countries. Women are ready to exhaust themselves with long periods of fasting to be in trend. But, unfortunately, they themselves do not notice how their body is exhausted. The feeling of hunger disappears, and metabolic processes increase.
Social factor
The environment around us plays a significant role in the formation of our health. After all, if you recall the definition of health according to WHO – it is a state of spiritual, physical and social well-being. Our condition is influenced to a greater extent by microsocial factors than macrosocial factors. A family in which an anorexic patient lived or currently lives can adhere to certain rules – neglect food, refuse food.
Other factors
These include somatic causes, in which refusal to eat is associated with the presence of a chronic disease, most often a malignant neoplasm. Drug-induced anorexia occurs as a result of taking medications .
Pathogenesis or mechanism of disease development
The process of disease formation consists of several stages. First of all, dissatisfaction with oneself arises. This term refers not only to appearance, but also to the inability to achieve certain goals. Self-esteem is violated, which leads to disturbances in the patient’s mental health like headache ,irriation ,isolation and apathy . This state is characterized by refusal to eat & activation of metabolism, namely the catabolic phase. This stage is called initial (beginning, pre-norexic).
Adipose tissue consists of cells called adipocytes. In the catabolic stage, fat cells die and the hormone leptin is released into the blood. As a result, the latter affects the hypothalamus in the brain, which reduces the formation of neuropeptide. Neuropeptide is responsible for the formation of the feeling of hunger in the human body. The stage is directly anorexic.
If a person’s weight decreases by more than 50% of the initial value, the cachectic phase of the disease begins. This stage is characterized by dystrophy of internal organs and the formation of depressive symptoms. The osmotic pressure of the blood decreases due to the low protein level, which leads to the formation of edema. This period is the most dangerous, difficult to treat and often leads to death.
Types of anorexia
There are several classifications of the disease that a doctor needs to clarify the diagnosis and draw up a treatment plan.
Depending on the causes of occurrence
- Primary
- Medicinal
- Somatic
- Mental anorexia
- Anorexia nervosa
Depending on the degree of exhaustion
- Mild malnutrition (BMI 16-16.99 kg/m2)
- Moderate degree of exhaustion (BMI 15-15.99 kg/m2)
- Severe malnutrition (BMI < 15 kg/m2)
Stages of anorexia
- Initial or first stage of anorexia
- Anorexic stage
- Cachectic stage is the last stage of anorexia
Symptoms of Anorexia
The clinical picture of anorexia is characterized by the presence of several symptoms. The manifestation of these symptoms depends on the stage of the disease. For convenience, psychiatrists combine the clinical manifestations of anorexia into four groups.
Changes in eating behavior
Patients refuse to eat any food under any pretext. They try to carefully study the caloric content of food. They are constantly haunted by the obsessive idea of getting rid of supposedly excess weight. They categorically refuse to participate in table gatherings, and induce vomiting on their own.
Destructive behavior
Increased physical activity and constant weight control. Changes in thinking, tendency to solitude. Prefer oversized clothing. When friends, acquaintances or close people make comments about changes in eating behavior, they consider the criticism to be unfounded.
Physiological changes in the body
The signs of anemic syndrome appear and these include feeling faint when standing, pale skin, growing drowsiness, fatigue and less performance. The appearance of protein edema on the lower extremities. Menstrual cycle disorders, which are manifested by a complete absence of menstruation, decreased sexual desire.
Disturbances in mental behavior
Sleep is disturbed, apathy and complete dissatisfaction with not only external forms, but life in general appear. Depression manifests itself in frequent aggressive outbursts on loved ones.
Complications of anorexia
If untimely and inadequate treatment is provided, anorexia can lead to death. But these are exceptional cases, since both medications and non-drug methods of treatment have already been developed and are widely used. However, patients who suffer from anorexia may develop complications of the disease.
From the endocrine organs
Pathogenetic mechanisms of the disease are directly related to the effect of the hormone leptin on the hypothalamus. As a result, the work of the main structure of the brain is disrupted – the hypothalamic-pituitary system, which is responsible for almost all metabolic processes in the human body. Suppression of the function of this structure leads to a decrease in the production of sex hormones, which leads to infertility or menstrual irregularities. The lack of production of thyroid hormones leads to the development of secondary hypothyroidism, the clinical manifestations of which are a decrease in mental activity and disruption of the heart.
From the cardiovascular system
The cause of rhythm and conduction disorders is a malfunction of the thyroid gland. Dystrophic changes in the myocardium are formed due to a lack of microelements: sodium, potassium, calcium. They are necessary for muscle contraction. Due to the fact that the amount of protein in the peripheral blood of patients with anorexia decreases, the level of osmotic pressure decreases. Ultimately, this leads to the formation of protein edema. Low blood pressure adversely affects the functioning of the heart and central nervous system.
From the digestive system
Due to the lack of regular food intake, the epithelium of the mucous membrane of the digestive tract undergoes a number of changes. The cells waste , the duodenal wall becomes thinner. Patients suffer from dyspeptic manifestations of the disease: constipation or diarrhea, bloating, painful sensations. All this can lead to cancerous degeneration.
From the musculoskeletal system
The body’s compensatory capabilities try to compensate for the lack of calcium by washing it out of bone tissue.
From the urinary system
A decrease in blood pressure leads to a decrease in the filtration capacity of the kidneys and to the loss of microelements (sodium and calcium). As a result of such morphological changes, signs of chronic renal failure arise.
From the nervous system
Here more needs to be said about mental health. Patients do not see, or perhaps do not want to see, the results of treatment, attempts by relatives to change the situation. This condition leads to the emergence of suicidal thoughts.
From the circulatory system
A decrease in the amount of hemoglobin in the peripheral blood is caused by low levels of iron, folic acid and vitamin B12. Various forms of anemic syndrome occur, which manifests itself in brittle hair and nails, pale skin, decreased performance and apathy, decreased attention and memory.
Diagnosis of anorexia
To make a diagnosis, a consultation with a psychiatrist alone will not be enough. This is a whole complex of diagnostic manipulations, in which therapists, neurologists, cardiologists, gynecologists and andrologists take part. This approach to early detection of the disease consists of differentiation and exclusion of other chronic diseases – secondary anorexia. To make a diagnosis, five signs of the disease must be present:
- Decrease in body mass index – to understand the picture, we offer you a formula for calculating your index – weight / height 2. Normally, this indicator is from 17.5 to 25, anything below is considered a body mass deficit.
- Hormonal disorders – early diagnostics of menstrual cycle disorders in women, which manifests itself in the absence of menstruation. In men, sexual desire decreases.
- Study of eating behavior – spontaneous refusal to eat. This sign can be detected during a personal conversation with the patient or when questioning close relatives, friends.
- Identifying the presence of an obsession – the presence of thoughts about a beautiful appearance and a constant desire for perfectionism leads a person to exhausting, prolonged starvation.
- Delayed sexual development is characterized by underdevelopment of the genitals. In girls, this is manifested by a decrease in the growth of the mammary glands, in men by underdevelopment of secondary sexual characteristics.
Treatment of anorexia
Only through a comprehensive approach to treatment can the desired result be achieved. Therapy directly depends on the stage of anorexia. But in any case, it is based on the use of three directions: diet therapy, psychotherapy and drug treatment.
Use of special diets
The nutritionist selects diet therapy taking into account the patient’s taste needs. Using persuasion, he proves the need to eat properly and regularly. If the desired effect cannot be achieved, specialists use parenteral administration of drugs.
Psychotherapeutic influence
At this stage, the psychiatrist tries to find the true cause of the disease. After which he begins the cognitive-behavioral psychotherapy method. The essence of the method is that at the initial stage, conversations are held, then they try to reduce anxiety and destroy the internal conflict.
Medicines
To replenish lost microelements, blood components are prescribed to maintain the proper hemoglobin level. Protein parenteral nourishment is proposed to reinstate osmotic stress. Hormone spare treatment comprises the usage of gender hormones and thyroid hormones.
Group or domestic treatment sittings
Comprehensive treatment of anorexia includes not only individual sessions with a psychotherapist. Family therapy sessions, where the cause of the disease is most likely located, play an important role. Psychologists try, and believe me, in most cases productively eradicate the problem. Group therapy involves communication with people who also suffer from anorexia. Psychologists help solve the problem together.
Treatment of anorexia usually does not require hospitalization. However, in severe cases of the disease, patients are sometimes admitted to the intensive care unit.
But the problem with treatment is that most patients do not want and do not wish to admit the problem. They seek medical help already at the anorexic or cachectic stage, but not at the initial stage of the disease.
Prognosis for anorexia
The outcome of the disease depends on the following reasons: early diagnosis of anorexia and adequate treatment. The previous vagaries in the patient’s body are noticed, the more actual the behavior will be. It is worth remembering that the cachectic stage of anorexia can lead to death.
Prevention of anorexia
Remember that anorexia is not a disease of one patient. This disease is associated with the environment in which this patient is, his microsociety – family and macrosociety – society. Therefore, treatment should always be comprehensive and not only consist of visits to a psychiatric clinic. Change the attitude in the family and the negative influence of others and everything will change for the better.
Answers to questions
How to bring yourself to anorexia?
Of course, it is better not to bring yourself to it. In fact, this happens because a person with psychological problems also develops problems with eating behavior.
Does anorexia occur in men?
Yes, the disease also occurs in men, but statistically less often than in women.
What are the consequences of anorexia?
Unfortunately, the disease has an indelible impact on the entire body. Everything depends on the stage of the disease, when the patient consulted the doctor, how carefully she followed his recommendations and a number of other factors.
What is the food for anorexia?
The nutritionist plans a diet therapy that meets the preferences of the patient. He uses hypnosis to convince the viewer to eat right and at the right times. If the desired effect cannot be achieved, specialists use parenteral administration of drugs.
Can you die from anorexia?
Death from anorexia is possible, unfortunately, in advanced cases, in the absence of timely treatment this can happen.
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