ANOREXIA

 -          Anorexia is an eating disorder where people starve themselves. Anorexia usually begins in young people around the onset of puberty. Individuals suffering from anorexia have extreme weight loss. Weight loss is usually 15% below the person's normal body weight. People suffering from anorexia are very skinny but are convinced that they are overweight. Weight loss is obtained by many ways. Some of the common techniques used are excessive exercise, intake of laxatives and not eating.

-          Anorexics have an intense fear of becoming fat. Their dieting habits develop from this fear. Anorexia mainly affects adolescent girls.

-          People with anorexia continue to think they are overweight even after they become extremely thin, are very ill or near death. Often they will develop strange eating habits such as refusing to eat in front of other people. Sometimes the individuals will prepare big meals for others while refusing to eat any of it.

-          The disorder is thought to be most common among people of higher socioeconomic classes and people involved in activities where thinness is especially looked upon, such as dancing, theatre, and distance running.

SYMPTOMS

There are many symptoms for anorexia, some individuals may not experience all of they symptoms. The symptoms include: Body weight that is inconsistent with age, build and height (usually 15% below normal weight).

Some other symptoms of anorexia are:

• - Loss of at least 3 consecutive menstrual periods (in women).
  
• - Not wanting or refusing to eat in public
  
• - Anxiety
  
• - Weakness
  
• - Brittle skin
  
• - Shortness of breath
  
• - Obsessiveness about calorie intake
  
• - obvious, rapid, dramatic weight loss
  
• - Russell's sign: scarring of the knuckles from placing fingers down the throat to induce vomiting
  
• - lanugo: soft, fine hair grows on face and body 
  
• - obsession with calories and fat content
  
• - preoccupation with food, recipes, or cooking; may cook elaborate dinners for others but not eat themselves
  
• - dieting despite being thin or dangerously underweight
  
• - fear of gaining weight or becoming overweight
  
• - rituals: cuts food into tiny pieces; refuses to eat around others; hides or discards food
  
• - purging: uses laxatives, diet pills, ipecac syrup, or water pills; may engage in self-induced vomiting; may run to the bathroom after eating in order to vomit and quickly get rid of the calories
  
• - may engage in frequent, strenuous exercise 
  
• - perception: perceives self to be overweight despite being told by others they are too thin
  
• - becomes intolerant to cold: frequently complains of being cold due to loss of insulating body fat; body temperature lowers (hypothermia) in effort to conserve calories 
  
• - depression: may frequently be in a sad, lethargic state
  
• - solitude: may avoid friends and family; becomes withdrawn and secretive
  
• - clothing: may wear baggy, loose-fitting clothes to cover weight loss
  
• - cheeks may become swollen due to enlargement of the salivary glands caused by excessive vomiting
  
• - swollen joints
  
• - abdominal distension
  

MEDICAL CONSEQUENCES OF ANOREXIA

There are many medical risks associated with anorexia. They include: shrunken bones, mineral loss, low body temperature, irregular heartbeat, permanent failure of normal growth, development ofosteoporosis and bulimia nervosa.

Continued use of laxatives is harmful to the body. It wears out the bowel muscle and causes it to decrease in function. Some laxatives contain harsh substances that may be reabsorbed into your system.

DIFFERENT BETWEEN ANOREXIA AND BULIMIA

The biggest difference between anorexia and bulimia is that people suffering from bulimia eat large amounts of food and then throw up. This is called binge and purge. Anorexics do not eat large amounts and throw up. Bulimics do.

TREATMENT

1)      Diat and nutrition

-          Zinc supplementation has been shown in various studies to be beneficial in the treatment of AN even in patients not suffering from zinc deficiency, by helping to increase weight gain.

-          Supplement such as vitamin c and essential fatty acids.

-          Nutrition counselling-  referred to as Nutrition Therapy is the development and provision of a nutritional treatment or therapy based on a detailed assessment of a person's medical history, psychosocial history, physical examination, and dietary history.

2)    Medication

-          Olanzapine: has been shown to be effective in treating certain aspects of AN including to help raise the body mass index and reduce obsessionality, including obsessional thoughts about food.

3)     Psychotherapy

-          "The term 'cognitive-behavioral therapy (CBT); is a very general term for a classification of therapies with similarities. There are several approaches to cognitive-behavioral therapy". CBT is an evidence based approach which in studies to date has shown to be useful in adolescents and adults with anorexia nervosa

4)    Family  support

-          To give morale support