Anorexia nervosa is a disorder characterized by deliberate weight loss, induced and / or maintained by the patient. The disease occurs most often in adolescent girls and young women, but adolescents and young men may be affected less, and perhaps the children approach puberty and older women with menopause. Anorexia nervosa is an independent team in the sense that:
- The clinical features of the syndrome are easily recognizable, so that the diagnosis is reliable with a high level of agreement between physicians;
- Other research has shown that patients who have not recovered, a considerable number continue to show the same main features of anorexia nervosa, in the chronic form.
Although the causes of eating disorders is still elusive, it is obvious that socio-cultural and biological contribute to its causation, and no less specific psychological mechanism and sensitivity of the personality. This disorder is associated with malnutrition in various degrees, with the result of secondary metabolic and hormonal changes and functional disorders of the body. Still do not know whether endocrine disorders is characteristic in its entirety from malnutrition and the direct effect of different behaviors, which led to the subject (eg, limited food choices, excessive exercise and changes in body composition, vomiting, and purification and, therefore, electrolyte disturbances) or whether uncertain factors are also involved.
Guidelines for The Diagnosis
For diagnosis, all are necessary:
- Body weight is maintained for at least 15% lower than expected (either lost or not achieved) or Quetelet index body mass is 17.5 or less. patients during the growing season may be the lack of expected weight gain during growth.
- Weight loss is self-induced avoidance of "fattening food" and one or more of the following: vomiting, self-induced purging, excessive exercise, use of filters of appetite and / or diuretics.
- There is distortion of body image as a specific psychopathology whereby a dread of the fat is intrusive, overvalued idea and the patient imposes a low weight to another.
- Common endocrine disorder involving the hypothalamic-pituitary-gonadal axis is the apparent lack of menstruation in women than in men as loss of sexual desire and power. (Exception visible vaginal bleeding in women with anorexia Maintain hormone replacement therapy, generally regarded as the birth control pill.) It can also be high levels of growth hormone, high levels of cortisol, the hormone changes in the peripheral metabolism of thyroid and insulin secretion impaired.
- If the start is in the growth period, the sequence of events during puberty is delayed or even arrested (growth ceases; girls breasts are not growing and there is a significant lack of menstruation, genitals boys are minors). With recovery, puberty is often completed correctly, but the menarche is late.
They may be linked to depression or obsessive symptoms, and characteristics of personality disorders that can cause various types of difficulties and / or require the use of more than one diagnostic code. Somatic causes weight loss in young patients, it is necessary to distinguish chronic debilitating diseases, brain tumors, intestinal disorders, such as Crohn's disease or malabsorption.