#anorexia - early diagnosis of this scary disease is essential for a successful treatment

Previously, moderate amounts of body fat were sign of good health. Then medicine changed this concept, saying that there is no advantage in accumulating adipose tissue; rather, we should all be thin. Beside this medical recommendation, the social pressure of the standard of beauty that is based on beautiful and absolutely thin top models are bullying the lives of many people. Today, billions of people struggle against overweight, reducing the ingestion of food and taking many sorts of medicatiosn. This can cause an exaggerated concern leading to a severe psychiatric disorder that is the distortion of self-image. The person looks in the mirror and sees a figure that does not reflect reality (false image): she/he can't note the intense weight loss and the prominent bones. 

Anorexia is an eating / psychiatric disorder result of an excessive concern with body weight. The person looks in the mirror and, although extremely thin, a fat image is seen. Such distortion makes the person to stop eating, exaggerate on physical activity and take laxatives and diuretics. The association of this disease with depression, panic disorder, obsessive-compulsive behaviors, kleptomania, self-mutilation, sexual promiscuity, alcoholism and drug abuse is common. 

Anorexia manifests mainly in young women, although its incidence is also increasing in men. Sometimes those affected by the disorder quickly come to cachexia, an extreme degree of malnutrition. When the anorexic person eats, it is basically water and coffee without sugar. They eat an average of 200 calories per day which represents a slice of orange, one cream-cracker cookie, a slice of ricotta and liters of laxative tea. 

The mortality rate for anorexia is between 15% and 20%. People die due to clinical complications or suicides because depression is a serious disorder that may manifest itself in the course of the disease. 

Symptoms 

* Exaggerated and rapid weight loss with no justification (in the most severe cases, the body mass index can be lower than 17); 

* Refusal to participate on family meals (anorexics claim that have eaten and are not hungry anymore); 

* Exaggerated concerns with calories intaken (patients eat only 200 kcal per day); 

* Disruption of the menstrual cycle (amenorrhea) and regression of female characteristics;

* Exaggerated and intense physical activity; 

* Depression, panic disorder, obsessive-compulsive behaviors; 

* Distorted view of the body (although extremely thin, these people think they are fat or obese); 

* Very dry skin very covered with lanugo; 

* Osteoporosis can be regarded as the most serious manifestation of the disease. Fractures can occur spontaneously. 

* Intestinal and cardiac abnormalities are common, because anorexics do not eat properly and start using laxatives and diuretics. Diuretics cause reduction of potassium blood levels, which are essential for the proper functioning of the heart. Such drastic reduction can cause death by arrythmia or cardiac arrest. Associated with laxatives, diuretics increase the water loss, which can cause dehydration and renal failure. 

Causes 

Several factors predispose to this disease: 1) genetic predisposition, 2) current fashion concept which determines the absolute thinness as the standard of beauty and elegance, 3) pressure of the family and social groups and 5) brain neurochemical changes, especially in the concentration of serotonin and noradrenaline. 

Risk groups 

Some professions are considered at risk for anorexia. Dancers, jockeys, olympic athletes may suffer pressure to reduce body weight in order to achieve better performance in competitions and shows. 

Another risk group consists of teenagers. In fact, age is dropping in cases of anorexia. The family needs to focus especially on the girls who disguise weight loss, wear baggy clothes and always find an excuse not to attend meals at home. 

Treatment

Treating anorexia is very difficult and the relapse rate is high. Once anorexia is diagnosed, the reintroduction of foods should be gradual in order to avoid further cardiac overload. Hospitalization is essential in some cases for the gradual supply of calories, controlled by doctors and nutritionists. 

There is no specific medication for anorexia nervosa. Antidepressant medications may help on relieving depressive, compulsive and anxiety symptoms. In general, the treatment of these patients requires the work of a multidisciplinary team.