Eating Disorders in Teens Health Channel

Definition

Anorexia nervosa is an eating disorder in which a person refuses to stay at even the minimum body weight considered normal for their age and height. Persons with this disorder may have an intense fear of weight gain and a distorted body image. Inadequate eating or excessive exercising results in severe weight loss.

See also:

• Bulimia
• Intentional weight loss

Alternative Names

Eating disorder - anorexia

Causes, incidence, and risk factors

The exact causes of anorexia nervosa are unknown. Genetic and environmental factors may play a role. Risk factors include:

• Being female
• Eating and gastrointestinal problems during early childhood
• Childhood anxiety
• Increased concern or attention to weight and shape
• Negative self-image
• Accepting societal attitudes towards thinness
• Perfectionism and other personality traits

Anorexia nervosa usually occurs in adolescence or young adulthood. It is more common in females. The eating disorder is seen mainly in Caucasian women who are high academic achievers and have a goal-oriented family or personality.

Symptoms

Most individuals with anorexia nervosa refuse to recognize (deny) that they have an eating disorder.

Symptoms may include:

• 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
• No menstruation
• Skeletal muscle atrophy
• Loss of fatty tissue
• Low blood pressure
• Dental cavities due to self-induced vomiting
• Blotchy or yellow skin
• Depression

Signs and tests

A diagnosis of anorexia nervosa is not made until other causes of weight loss are ruled out. The health care provider will determine if endocrine, metabolic, digestive, and central nervous system abnormalities can explain the weight loss. (For example, extreme weight loss could be due to celiac disease, inflammatory bowel disease, Addison's disease, and many other possible conditions.)

Tests will be done to help determine the cause of weight loss or to determine what damage the weight loss has caused cause. They may include:

• CHEM-20
• Urinalysis
• Thyroid function tests
• ECG
• LH response to GnRH

Treatment

The biggest challenge in treating anorexia nervosa is having the person recognize that their eating behavior is itself a problem, not a solution to other problems. However, most persons with anorexia nervosa deny that they have an eating disorder.