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Encyclopedia > Anorexia nervosa
Anorexia Nervosa
Classification and external resources
An anti-anorexia nervosa billboard featuring recovering anorexic actress Isabelle Caro
ICD-10 F50.0-F50.1
ICD-9 307.1
OMIM 606788
DiseasesDB 749
eMedicine emerg/34  med/144

Anorexia nervosa is a psychiatric diagnosis that describes an eating disorder characterized by low body weight and body image distortion with an obsessive fear of gaining weight. Individuals with anorexia are known to commonly control body weight through the means of voluntary starvation, purging, vomiting, excessive exercise, or other weight control measures, such as diet pills or diuretic drugs. It primarily affects adolescent females, however approximately 10% of people with the diagnosis are male. Anorexia nervosa is a complex condition, involving neurobiological, psychological, and sociological components.[1] Anorexia can refer to: Anorexia nervosa, an eating disorder in which people do not eat correctly due to the obsessive fear of weight gain Anorexia (symptom), the general symptom of decreased appetite Sexual anorexia, a term used to describe a lack of appetite for sex. ... Isabelle Caro, is a French actress, well known for suffering from anorexia. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // F00-F99 - Mental and behavioural disorders (F00-F09) Organic, including symptomatic, mental disorders (F00) Dementia in Alzheimers disease (F01) Vascular dementia (F011) Multi-infarct dementia (F02) Dementia in other diseases classified elsewhere (F020) Dementia in Picks disease (F021) Dementia in Creutzfeldt-Jakob disease (F022) Dementia in Huntingtons... // F00-F99 - Mental and behavioural disorders (F00-F09) Organic, including symptomatic, mental disorders (F00) Dementia in Alzheimers disease (F01) Vascular dementia (F011) Multi-infarct dementia (F02) Dementia in other diseases classified elsewhere (F020) Dementia in Picks disease (F021) Dementia in Creutzfeldt-Jakob disease (F022) Dementia in Huntingtons... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... An MRI scan of a human brain and head. ... In general, diagnosis (plural diagnoses) has two distinct dictionary definitions. ... It has been suggested that this article or section be merged with human weight. ... Body image is a term which may refer to our perceptions of our own physical appearance, or our internal sense of having a body which is constructed by the brain. ... Bulimia nervosa, an eating disorder more commonly known as bulimia, is a psychological condition in which the subject engages in recurrent binge eating followed by intentionally doing one or more of the following in order to compensate for the intake of the food and prevent weight gain: vomiting inappropriate use... Heaving redirects here. ... The term Exercise can refer to: Physical exercise such as running or strength training Exercise (options), the financial term for enacting and terminating a contract Category: ... Anorectics, anorexigenics or appetite suppressants, are substances which reduce the desire to eat (anorectic, from the Greek an- = not and oreg- = extend, reach). Used on a short term basis clinically to treat obesity, some appetite suppressants are also available over the counter. ... This illustration shows where some types of diuretics act, and what they do. ... Neurobiology is the study of cells of the nervous system and the organization of these cells into functional circuits that process information and mediate behavior. ... Psychology (ancient Greek: psyche = soul and logos = word) is the study of mind, thought, and behaviour. ... Sociology is the study of the social lives of humans, groups and societies. ...


The term anorexia is of Greek origin: a (α, prefix of negation), n (ν, link between two vowels) and orexis (ορεξις, appetite) thus meaning a lack of desire to eat.[2] A person who is diagnosed with anorexia nervosa is most commonly referred to with the adjectival form anorexic. The noun form, "anorectic" is generally not used in this context and usually refers to drugs that suppress appetite. Anorectics, anorexigenics or appetite suppressants are drugs that reduce the desire to eat (anorectic, from the Greek an- = not and oreg- = extend, reach). (Anorectic is also a term for an anorexic person, a person suffering from Anorexia nervosa. ... For other uses, see Drug (disambiguation). ...


"Anorexia nervosa" is frequently shortened to "anorexia" in both the popular media and television reports. This is technically incorrect, as the term "anorexia" used separately refers to the medical symptom of reduced appetite (which therefore is distinguishable from anorexia nervosa in being non-psychiatric). This article is about the symptom of decreased appetite. ...

Contents

Diagnosis and clinical features

The most commonly used criteria for diagnosing anorexia are from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD). Due to the epidemic of medical errors, readers are cautioned to be aware that the American Psychiatric Association isnt immune to this. ... The Diagnostic and Statistical Manual published by the American Psychiatric Association The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook for mental health professionals that lists different categories of mental disorder and the criteria for diagnosing them, according to the publishing organization the American Psychiatric Association. ... WHO redirects here. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ...


Although biological tests can aid the diagnosis of anorexia, the diagnosis is based on a combination of behavior, reported beliefs and experiences, and physical characteristics of the patient. Anorexia is typically diagnosed by a clinical psychologist, psychiatrist or other suitably qualified clinician. Notably, diagnostic criteria are intended to assist clinicians, and are not intended to be representative of what an individual sufferer feels or experiences in living with the illness. Clinical psychology is the application of psychology to mental illness or mental health problems. ... For other uses, see Psychiatrist (disambiguation). ...


The full ICD-10 diagnostic criteria for anorexia nervosa can be found here, and the DSM-IV-TR criteria can be found here. The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, is the handbook used most often in diagnosing mental disorders in the United States and other countries. ...


To be diagnosed as having anorexia nervosa, according to the DSM-IV-TR, a person must display:

  1. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
  2. Intense fear of gaining weight or becoming obese.
  3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
  4. The absence of at least three consecutive menstrual cycles (amenorrhea), in women who have had their first menstrual period but have not yet gone through menopause (postmenarcheal, premenopausal females).
  5. Or other eating related disorders.

Furthermore, the DSM-IV-TR specifies two subtypes: Weight, in the context of human body weight measurements in the medical sciences and in sports is a measurement of mass, and is thus expressed in units of mass, such as kilograms (kg), or units of force such as pounds (lb). ... Weight loss, in the context of medicine or health or physical fitness, is a reduction of the total body weight, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue. ... This article is about the medical term. ... Amenorrhoea (BE) or amenorrhea (AmE) is the absence of a menstrual period in a woman of reproductive age. ... The word menopause literally means the permanent physiological, or natural, cessation of menstrual cycles, from the Greek roots meno (month) and pausis (a pause, a cessation). ...

  • Restricting Type: during the current episode of anorexia nervosa, the person has not regularly engaged in binge-eating or purging behavior (that is, self-induced vomiting, over-exercise or the misuse of laxatives, diuretics, or enemas)
  • Binge-Eating Type or Purging Type: during the current episode of anorexia nervosa, the person has regularly engaged in binge-eating OR purging behavior (that is, self-induced vomiting, over-exercise or the misuse of laxatives, diuretics, or enemas).

The ICD-10 criteria are similar, but in addition, specifically mention Binge eating is a pattern of disordered eating which consists of episodes of uncontrollable overeating. ... Laxatives (or purgatives) are foods, compounds, or drugs taken to induce bowel movements or to loosen the stool, most often taken to treat constipation. ... This illustration shows where some types of diuretics act, and what they do. ... This 2qt (about 1. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ...

  1. The ways that individuals might induce weight-loss or maintain low body weight (avoiding fattening foods, self-induced vomiting, self-induced purging, excessive exercise, excessive use of appetite suppressants or diuretics).
  2. Certain physiological features, including "widespread endocrine disorder involving hypothalamic-pituitary-gonadal axis is manifest in women as amenorrhoea and in men as loss of sexual interest and potency. There may also be elevated levels of growth hormones, raised cortisol levels, changes in the peripheral metabolism of thyroid hormone and abnormalities of insulin secretion".
  3. If onset is before puberty, that development is delayed or arrested.

The endocrine system is a control system of ductless endocrine glands that secrete chemical messengers called hormones that circulate within the body via the bloodstream to affect distant organs. ... The hypothalamus links the nervous system to the endocrine system via the pituitary gland (hypophysis). ... Located at the base of the skull, the pituitary gland is protected by a bony structure called the sella turcica. ... The gonad is the organ that makes gametes. ... Amenorrhoea (BE), amenorrhea (AmE), or amenorrhœa, is the absence of a menstrual period in a woman of reproductive age. ... Growth hormone (GH) or somatotropin (STH) is a protein hormone which stimulates growth and cell reproduction in humans and other animals. ... Cortisol is a corticosteroid hormone produced by the Zona fasciculata of the adrenal cortex (in the adrenal gland). ... Structure of the coenzyme adenosine triphosphate, a central intermediate in energy metabolism. ...

Presentation

There are a number of features, that although not necessarily diagnostic of anorexia, have been found to be commonly (but not exclusively) present in those with this eating disorder.[3][1]


==Physical

Anorexia nervosa can put a serious strain on many of the body's organs and physiological resources,[4][5][6] particularly on the structure and function of the heart and cardiovascular system, with slow heart rate (bradycardia) and elongation of the QT interval seen early on. People with anorexia typically have a disturbed electrolyte balance, particularly low levels of phosphate, which has been linked to heart failure, muscle weakness, immune dysfunction, and ultimately death. Those who develop anorexia before adulthood may suffer stunted growth and subsequent low levels of essential hormones (including sex hormones) and chronically increased cortisol levels. Osteoporosis can also develop as a result of anorexia in 38-50% of cases,[7] as poor nutrition leads to the retarded growth of essential bone structure and low bone mineral density. Anorexia does not harm everyone in the same way. For example, evidence suggests that the results of the disease in adolescents may differ from those in adults.[4] Physiology (in Greek physis = nature and logos = word) is the study of the mechanical, physical, and biochemical functions of living organisms. ... The heart and lungs, from an older edition of Grays Anatomy. ... The circulatory system or cardiovascular system is the organ system which circulates blood around the body of most animals. ... Bradycardia, as applied to adult medicine, is defined as a resting heart rate of under 60 beats per minute, though it is seldom symptomatic until the rate drops below 50 beat/min. ... Schematic representation of normal ECG trace (sinus rhythm), with waves, segments, and intervals labeled. ... An electrolyte is any substance containing free ions that behaves as an electrically conductive medium. ... A phosphate, in inorganic chemistry, is a salt of phosphoric acid. ... A scanning electron microscope image of a single neutrophil (yellow), engulfing anthrax bacteria (orange). ... For other uses, see Hormone (disambiguation). ... Cortisol is a corticosteroid hormone produced by the Zona fasciculata of the adrenal cortex (in the adrenal gland). ... Osteoporosis is a disease of bone that leads to an increased risk of fracture. ... A bone mineral density (BMD) test, also called a bone mass measurement, is used to measure bone density and determine fracture risk for osteoporosis. ...


Changes in brain structure and function are early signs of the condition. Enlargement of the ventricles of the brain is thought to be associated with starvation, and is partially reversed when normal weight is regained.[8] Anorexia is also linked to reduced blood flow in the temporal lobes, although since this finding does not correlate with current weight, it is possible that it is a risk trait rather than an effect of starvation.[9] The ventricular system is a set of structures in the brain continuous with the central canal of the spinal cord. ... This article is about extreme malnutrition. ... The temporal lobes are part of the cerebrum. ...


Other effects may include the following:

Look up body mass index in Wiktionary, the free dictionary. ... The endocrine system is a control system of ductless endocrine glands that secrete chemical messengers called hormones that circulate within the body via the bloodstream to affect distant organs. ... Amenorrhoea (BE), amenorrhea (AmE), or amenorrhÅ“a, is the absence of a menstrual period in a woman of reproductive age. ... For other uses, see Libido (disambiguation). ... Impotence or, more clinically, erectile dysfunction is the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. ... Structure of the coenzyme adenosine triphosphate, a central intermediate in energy metabolism. ... Bradycardia, as applied to adult medicine, is defined as a resting heart rate of under 60 beats per minute, though it is seldom symptomatic until the rate drops below 50 beat/min. ... In physiology and medicine, hypotension refers to an abnormally low blood pressure. ... Hypothermia is a condition in which an organisms temperature drops below that Required fOr normal metabolism and Bodily functionS. In warm-blooded animals, core [[body Temperature]] is maintained nEar a constant leVel through biologic [[homEostasis]]. But wheN the body iS exposed to cold Its internal mechanismS may be unable... This article discusses the medical condition. ... An electrolyte is any substance containing free ions that behaves as an electrically conductive medium. ... Lanugo are hairs that grow on the body to attempt to insulate it because of lack of fat. ... General Name, symbol, number zinc, Zn, 30 Chemical series transition metals Group, period, block 12, 4, d Appearance bluish pale gray Standard atomic weight 65. ... White Blood Cells redirects here. ... A scanning electron microscope image of a single neutrophil (yellow), engulfing anthrax bacteria (orange). ... Complexion describes ones physical appearance. ... Types of teeth Molars are used for grinding up foods Carnassials are used for slicing food. ... Constipation, costiveness, or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest. ... Weight loss, in the context of medicine or health or physical fitness, is a reduction of the total body weight, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue. ... A headache is a condition of mild to severe pain in the head; sometimes upper back or neck pain may also be interpreted as a headache. ... A material is brittle if it is subject to fracture when subjected to stress i. ... A bruise or contusion or ecchymoses is a kind of injury, usually caused by blunt impact, in which the capillaries are damaged, allowing blood to seep into the surrounding tissue. ...

Psychological

  • Distorted body image
  • Poor insight
  • Self-evaluation largely, or even exclusively, in terms of their shape and weight
  • Pre-occupation or obsessive thoughts about food and weight
  • Perfectionism
  • Obsessive compulsive disorder (OCD)
  • Belief that control over food/body is synonymous with being in control of one's life
  • Refusal to accept that one's weight is dangerously low even when it could be deadly
  • Refusal to accept that one's weight is normal, or healthy

Body image is a term which may refer to our perceptions of our own physical appearance, or our internal sense of having a body which is constructed by the brain. ... Perfectionism, in psychology, is a belief that perfection should be strived for. ... For other things named OCD, see OCD (disambiguation). ...

Emotional

In psychology, self-esteem or self-worth is a persons self-image at an emotional level; circumventing reason and logic. ... Self efficacy is an individuals estimate or personal judgment of his or her own ability to succeed in reaching a specific goal, e. ... This article is about the medical term. ... On the Threshold of Eternity. ... A mood is a relatively lasting affective state. ... A mood swing is an extreme change in mood. ...

Interpersonal and social

  • Withdrawal from previous friendships and other peer-relationships
  • Deterioration in relationships with the family
  • Denial of basic needs, such as food and sleep

Behavioral

  • Excessive exercise, food restriction
  • Secretive about eating or exercise behavior
  • Fainting
  • Self-harm, substance abuse or suicide attempts
  • Very sensitive to references about body weight
  • Aggressive when forced to eat "forbidden" foods

It has been suggested that Central Ischaemic Response be merged into this article or section. ... Self-harm (SH) is deliberate injury to ones own body. ... Also see Alcoholism and Drug addiction. ... For other uses, see Suicide (disambiguation). ...

Diagnostic issues and controversies

The distinction between the diagnoses of anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified (EDNOS) is often difficult to make in practice and there is considerable overlap between patients diagnosed with these conditions. Furthermore, seemingly minor changes in a patient's overall behavior or attitude (such as reported feeling of 'control' over any bingeing behavior) can change a diagnosis from 'anorexia: binge-eating type' to bulimia nervosa. It is not unusual for a person with an eating disorder to 'move through' various diagnoses as his or her behavior and beliefs change over time.[3] Bulimia nervosa is an eating disorder characterised by recurrent binge eating, followed by compensatory behaviors, referred to as purging.[1] The most common form—practised more than 75% of people with bulimia nervosa—is self-induced vomiting; fasting, the use of laxatives, enemas, diuretics, and overexercising are also common. ... Eating disorder not otherwise specified (EDNOS) is a diagnostic category of sub-clinical mental disorders that involve disordered eating patterns. ...


Additionally, it is important to note that an individual may still suffer from a health- or life-threatening eating disorder (e.g., sub-clinical anorexia nervosa or EDNOS) even if one diagnostic sign or symptom is still present. For example, a substantial number of patients diagnosed with EDNOS meet all criteria for diagnosis of anorexia nervosa, but lack the three consecutive missed menstrual cycles needed for a diagnosis of anorexia.[1] Eating disorder not otherwise specified (EDNOS) is a diagnostic category of sub-clinical mental disorders that involve disordered eating patterns. ...


Feminist writers such as Susie Orbach and Naomi Wolf have criticized the medicalisation of extreme dieting and weight-loss as locating the problem within the affected women, rather than in a society that imposes concepts of unreasonable and unhealthy thinness as a measure of female beauty. Feminism is a social theory and political movement primarily informed and motivated by the experience of women. ... Susie Orbach is a feminist psychologist and writer on womens psychology. ... Image needed Naomi Wolf (born November 12, 1962) is an American author, political consultant, and public intellectual. ... This article or section is in need of attention from an expert on the subject. ...


Causes and contributory factors

It is clear that there is no single cause for anorexia and that it stems from a mixture of biological, social, and psychological factors. Current research is commonly focused on explaining existing factors and uncovering new causes. However, there is considerable debate over how much each of the known causes contributes to the development of anorexia. In particular, the contribution of perceived media pressure on women to be thin has been especially contentious.[10]


Physiological factors

Genetic factors

Family and twin studies have suggested that genetic factors contribute to about 50% of the variance for the development of an eating disorder[11] and that anorexia shares a genetic risk with clinical depression.[12] This evidence suggests that genes influencing both eating regulation, and personality and emotion, may be important contributing factors. In one study, variations in the norepinephrine transporter gene promoter were associated with restrictive anorexia nervosa, but not binge-purge anorexia (though the latter may have been due to small sample size).[13] Twin studies are one of a family of designs in behavior genetics which aid the study of individual differences by highlighting the role of environmental and genetic causes on behavior. ... This article is about mathematics. ... On the Threshold of Eternity. ... The norepinephrine transporter or NET is a monoamine transporter that transports the neurotransmitter norepinephrine from the synapse back to its vesicles for storage until later use. ... A promoter is a regulatory region of DNA located upstream (towards the 5 region) of a gene, providing a control point for regulated gene transcription. ...


Several rodent models of anorexia have been developed which largely involve subjecting the animals to various environmental stressors or using gene knockout mice to test hypotheses about the effects of certain genes.[14] These models have suggested that the hypothalamic-pituitary-adrenal axis may be a contributory factor, although the models have been criticised as food is being limited by the experimenter and not the animal, and these models cannot take into account the complex cultural factors known to affect the development of anorexia nervosa. Suborders Sciuromorpha Castorimorpha Myomorpha Anomaluromorpha Hystricomorpha Rodentia is an order of mammals also known as rodents, characterised by two continuously-growing incisors in the upper and lower jaws which must be kept short by gnawing. ... A gene knockout is a genetically engineered organism that carries one or more genes in its chromosomes that has been made inoperative. ... It has been suggested that HTPA be merged into this article or section. ...


Neurobiological factors

There are strong correlations between the neurotransmitter serotonin and various psychological symptoms such as mood, sleep, emesis (vomiting), sexuality and appetite. A recent review of the scientific literature has suggested that anorexia is linked to a disturbed serotonin system,[15] particularly to high levels at areas in the brain with the 5HT1A receptor - a system particularly linked to anxiety, mood and impulse control. Starvation has been hypothesised to be a response to these effects, as it is known to lower tryptophan and steroid hormone metabolism, which, in turn, might reduce serotonin levels at these critical sites and, hence, ward off anxiety. In contrast, studies of the 5HT2A serotonin receptor (linked to regulation of feeding, mood, and anxiety), suggest that serotonin activity is decreased at these sites. One difficulty with this work, however, is that it is sometimes difficult to separate cause and effect, in that these disturbances to brain neurochemistry may be as much the result of starvation, than continuously existing traits that might predispose someone to develop anorexia. There is evidence, however, that both personality characteristics (such as anxiety and perfectionism) and disturbances to the serotonin system are still apparent after patients have recovered from anorexia,[16] suggesting that these disturbances are likely to be causal risk factors. For the professional wrestling stable, see Ravens Nest#Serotonin. ... In the field of neurochemistry, 5-HT receptors are receptors for the neurotransmitter and peripheral signal mediator serotonin, also known as 5-hydroxytryptamine or 5-HT. 5-HT receptors are located on the cell membrane of nerve cells and other cell types in animals and mediate the effects of serotonin... Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components[1]. These components combine to create the feelings that we typically recognize as anger and known as fear, apprehension, or worry. ... Look up mood in Wiktionary, the free dictionary. ... Deferred gratification is the ability of a person to wait for things they want. ... Tryptophan (abbreviated as Trp or W)[1] is one of the 20 standard amino acids, which are the building blocks of proteins, and an essential amino acid in the human diet. ... Steroid hormones are steroids which act as hormones. ...


Recent studies also suggest anorexia may be linked to an autoimmune response to melanocortin peptides which influence appetite and stress responses.[17] Additional factors appear to be involved in the development of anorexia nervosa in elderly patients.All neurotransmitters associated with appetite decline with age. In addition there is a decline in levels of Substance P and Neuropeptide Y. Substance P is the transmitter that carries complex taste information from the taste-buds to the brain. Neuropeptidee Y regulates carbohydrate cravings.[18] Melanocortins are a group of pituitary peptide hormones that include adrenocorticotropin (ACTH) and the alpha, beta and gamma melanocyte stimulating hormones (MSH). ... Peptides are the family of molecules formed from the linking, in a defined order, of various amino acids. ...


Nutritional factors

Zinc deficiency causes a decrease in appetite that can degenerate in anorexia nervosa (AN), appetite disorders and, notably, inadequate zinc nutriture. The use of zinc in the treatment of anorexia nervosa has been advocated since 1979 by Bakan. At least five trials showed that zinc improved weight gain in anorexia. A 1994 randomized, double-blind, placebo-controlled trial showed that zinc (14 mg per day) doubled the rate of body mass increase in the treatment of AN.[19] Deficiency of other nutrients such as tyrosine and tryptophan (precursors of the monoamine neurotransmitters norepinephrine and serotonin, respectively), as well as vitamin B1 (thiamine) could contribute to this phenomenon of malnutrition-induced malnutrition.[19] General Name, symbol, number zinc, Zn, 30 Chemical series transition metals Group, period, block 12, 4, d Appearance bluish pale gray Standard atomic weight 65. ... The appetite is the desire to eat food, felt as hunger. ... General Name, symbol, number zinc, Zn, 30 Chemical series transition metals Group, period, block 12, 4, d Appearance bluish pale gray Standard atomic weight 65. ... Nutrients and the body A nutrient is any element or compound necessary for or contributing to an organisms metabolism, growth, or other functioning. ... Tyrosine (from the Greek tyros, meaning cheese, as it was first discovered in 1846 by German chemist Justus von Liebig in the protein casein from cheese[1][2]), 4-hydroxyphenylalanine, or 2-amino-3(4-hydroxyphenyl)-propanoic acid, is one of the 20 amino acids that are used by cells... Tryptophan (abbreviated as Trp or W)[1] is one of the 20 standard amino acids, which are the building blocks of proteins, and an essential amino acid in the human diet. ... In biochemistry, monoamines are a group of organic compounds containing only one amino group. ... Chemical structure of D-aspartic acid, a common amino acid neurotransmitter. ... Norepinephrine (INN)(abbr. ... For the professional wrestling stable, see Ravens Nest#Serotonin. ... For the similarly spelled nucleic acid, see Thymine Thiamine or thiamin, also known as vitamin B1, is one of the B vitamins. ...


Psychological factors

There has been a significant amount of work into psychological factors that suggests how biases in thinking and perception help maintain or contribute to the risk of developing anorexia.


Anorexic eating behavior is thought to originate from feelings of fatness and unattractiveness[20] and is maintained by various cognitive biases that alter how the affected individual evaluates and thinks about their body, food and eating. This article or section does not cite its references or sources. ...


One of the most well-known findings is that people with anorexia tend to over-estimate the size or fatness of their own bodies. A recent review of research in this area suggests that this is not a perceptual problem, but one of how the perceptual information is evaluated by the affected person.[21] Recent research suggests people with anorexia nervosa may lack a type of overconfidence bias in which the majority of people feel themselves more attractive than others would rate them. In contrast, people with anorexia nervosa seem to more accurately judge their own attractiveness compared to unaffected people, meaning that they potentially lack this self-esteem boosting bias.[22] In psychology and the cognitive sciences, perception is the process of acquiring, interpreting, selecting, and organizing sensory information. ... The overconfidence effect refers to the human tendency to be more confident in ones behaviours, attributes and physical characteristics than one ought to be. ...


People with anorexia have been found to have certain personality traits that are thought to predispose them to develop eating disorders. High levels of obsession (being subject to intrusive thoughts about food and weight-related issues), restraint (being able to fight temptation), and clinical levels of perfectionism (the pathological pursuit of personal high-standards and the need for control) have been cited as commonly reported factors in research studies.[23] Perfectionism, in psychology, is a belief that perfection should be strived for. ...


It is often the case that other psychological difficulties and mental illnesses exist alongside anorexia nervosa in the sufferer. Clinical depression, obsessive compulsive disorder, substance abuse and one or more personality disorders are the most likely conditions to be comorbid with anorexia, and high-levels of anxiety and depression are likely to be present regardless of whether they fulfill diagnostic criteria for a specific syndrome.[24] A mental illness or mental disorder refers to one of many mental health conditions characterized by distress, impaired cognitive functioning, atypical behavior, emotional dysregulation, and/or maladaptive behavior. ... On the Threshold of Eternity. ... For other things named OCD, see OCD (disambiguation). ... Also see Alcoholism and Drug addiction. ... Personality disorders form a class of mental disorders that are characterized by long-lasting rigid patterns of thought and behaviour. ... In medicine and in psychiatry, comorbidity refers to: The presence of one or more disorders (or diseases) in addition to a primary disease or disorder. ...


Research into the neuropsychology of anorexia has indicated that many of the findings are inconsistent across studies and that it is hard to differentiate the effects of starvation on the brain from any long-standing characteristics. Nevertheless, one reasonably reliable finding is that those with anorexia have poor cognitive flexibility[25] (the ability to change past patterns of thinking, particularly linked to the function of the frontal lobes and executive system). Neuropsychology is a branch of psychology and neurology that aims to understand how the structure and function of the brain relate to specific psychological processes and overt behaviors. ... {{Infobox Brain| Name = Frontal lobe | Latin = lobus frontalis | GraySubject = 189 | GrayPage = 821 | Map = Cerebrum map| MapPos = | MapCaption = Principal fissures and lobes of the cerebrum viewed laterally. ... The executive system is a theorised cognitive system in psychology that controls and manages other cognitive processes. ...


Other studies have suggested that there are some attention and memory biases that may maintain anorexia.[26] Attentional biases seem to focus particularly on body and body-shape related concepts, making them more salient for those affected by the condition, and some limited studies have found that those with anorexia may be more likely to recall related material than unrelated material. This article is about psychological concept of attention. ... For other uses, see Memory (disambiguation). ...

Fairburn and colleagues psychological model of anorexia
Fairburn and colleagues psychological model of anorexia

Although there has been quite a lot of research into psychological factors, there are relatively few hypotheses which attempt to explain the condition as a whole. Image File history File links Download high resolution version (815x399, 63 KB) Summary I created this file myself as an alternative diagram to the one presented in Fairburn CG, Cooper Z, Shafran R. (2003) Cognitive behaviour therapy for eating disorders: a transdiagnostic theory and treatment. ... Image File history File links Download high resolution version (815x399, 63 KB) Summary I created this file myself as an alternative diagram to the one presented in Fairburn CG, Cooper Z, Shafran R. (2003) Cognitive behaviour therapy for eating disorders: a transdiagnostic theory and treatment. ...


Professor Chris Fairburn, of the University of Oxford and his colleagues have created a 'transdiagnostic' model,[27] in which they aim to explain how anorexia, as well as related disorders such as bulimia nervosa and ED-NOS, are maintained. Their model is developed with psychological therapies, particularly cognitive behavioral therapy, in mind, and so suggests areas where clinicians could provide psychological treatment. The University of Oxford (informally Oxford University), located in the city of Oxford, England, is the oldest university in the English-speaking world. ... A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. ...


Their model is based on the idea that all major eating disorders (with the exception of obesity) share some core types of psychopathology which help maintain the eating disorder behavior. This includes clinical perfectionism, chronic low self-esteem, mood intolerance (inability to cope appropriately with certain emotional states) and interpersonal difficulties. Psychopathology is a term which refers to either the study of mental illness or mental distress, or the manifestation of behaviors and experiences which may be indicative of mental illness or psychological impairment. ... Perfectionism, in psychology, is a belief that perfection should be strived for. ... In psychology, self-esteem or self-worth is a persons self-image at an emotional level; circumventing reason and logic. ...


Social and environmental factors

Sociocultural studies have highlighted the role of cultural factors, such as the promotion of thinness as the ideal female form in Western industrialised nations, particularly through the media. A recent epidemiological study of 989,871 Swedish residents indicated that gender, ethnicity and socio-economic status were large influences on the chance of developing anorexia, with those with non-European parents among the least likely to be diagnosed with the condition, and those in wealthy, white families being most at risk.[28] A classic study by Garner and Garfinkel demonstrated that those in professions where there is a particular social pressure to be thin (such as models and dancers) were much more likely to develop anorexia during the course of their career,[29] and further research has suggested that those with anorexia have much higher contact with cultural sources that promote weight-loss.[30] It has been suggested that Big Beautiful Woman be merged into this article or section. ... Gender in common usage refers to the sexual distinction between male and female. ... This article or section should be merged with ethnic group Ethnicity is the cultural characteristics that connect a particular group or groups of people to each other. ... Social status is the standing, the honour or prestige attached to ones position in society. ... A model is a person who poses or displays for purposes of art, fashion, or other products and advertising. ... A contemporary dancer rehearsing in a dance studio Dance generally refers to human movement either used as a form of expression or presented in a social, spiritual or performance setting. ...


Although anorexia nervosa is usually associated with Western cultures, exposure to Western media is thought to have led to an increase in cases in non-Western countries. However, it is notable that other cultures may not display the same 'fat phobic' worries about becoming fat as those with the condition in the West, and instead may present with low appetite with the other common features.[31]


There is a high rate of reported child sexual abuse experiences in clinical groups of who have been diagnosed with anorexia (up to 50% in those admitted to inpatient wards, with a lesser prevalence among people treated in the community). Although prior sexual abuse is not thought to be a specific risk factor for anorexia, those who have experienced such abuse are more likely to have more serious and chronic symptoms.[32]


The Internet has enabled anorexics and bulimics to contact and communicate with each other outside of a treatment environment, with much lower risks of rejection by mainstream society. A variety of websites exist, some run by sufferers, some by former sufferers, and some by professionals. The majority of such sites support a medical view of anorexia as a disorder to be cured, although some people affected by anorexia have formed online pro-ana communities that reject the medical view and argue that anorexia is a 'lifestyle choice', using the internet for mutual support, and to swap weight-loss tips.[33] Such websites were the subject of significant media interest, largely focusing on concerns that these communities could encourage young women to develop or maintain eating disorders, and many were taken offline as a result.[34] It has been suggested that Pro-mia be merged into this article or section. ...


Prognosis

Anorexia is thought to have the highest mortality rate of any psychiatric disorder, with approximately 6% of those who are diagnosed with the disorder eventually dying due to related causes.[35] The suicide rate of people with anorexia is also higher than that of the general population and is thought to be the major cause of death for those with the condition.[36]


Incidence, prevalence and demographics

The majority of research into the incidence and prevalence of anorexia has been done in Western industrialized countries, so results are generally not applicable outside these areas. However, recent reviews[37][38] of studies on the epidemiology of anorexia have suggested an incidence of between 8 and 13 cases per 100,000 persons per year and an average prevalence of 0.3% using strict criteria for diagnosis. These studies also confirm the view that the condition largely affects young adolescent females, with females between 15 and 19 years old making up 40% of all cases. Furthermore, the majority of cases are unlikely to be in contact with mental health services. As a whole, about 10% of people with anorexia are male and about 90% of people with anorexia are female.[1] Anorexia, however, is not exclusively limited to any age or demographic. In March 2008, a British senior university lecturer with PhD in psychology and a professional background in health, Rosemary Pope, died from anorexia.[39] Incidence is a measure of the risk of developing some new condition within a specified period of time. ... In epidemiology, the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. ... Epidemiology is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine. ... PhD usually refers to the academic title Doctor of Philosophy PhD can also refer to the manga Phantasy Degree This is a disambiguation page — a list of pages that otherwise might share the same title. ...


Treatment

The first line treatment for anorexia is usually focused on immediate weight gain, especially with those who have particularly serious conditions that require hospitalization. In particularly serious cases, this may be done as an involuntary hospital treatment under mental health law, where such legislation exists. In the majority of cases, however, people with anorexia are treated as outpatients, with input from physicians, psychiatrists, clinical psychologists and other mental health professionals. A first line treatment or first line therapy is a medical therapy recommended for the initial treatment of a disease, sign or symptom, usually on the basis of empirical evidence for its efficacy. ... A hospital today is an institution for professional health care provided by physicians and nurses. ... For involuntary treatment in non-hospital settings, see involuntary treatment. ... Mental health law is that area of law that deals with mental conditions. ... A hospital today is an institution for professional health care provided in part by physicians and nurses. ... For other uses, see Doctor. ... For other uses, see Psychiatrist (disambiguation). ... Clinical psychology is the application of psychology to mental illness or mental health problems. ...


A recent clinical review has suggested that psychotherapy is an effective form of treatment and can lead to restoration of weight, return of menses among female patients, and improved psychological and social functioning when compared to simple support or education programmes.[40] However, this review also noted that there are only a small number of randomised controlled trials on which to base this recommendation, and no specific type of psychotherapy seems to show any overall advantage when compared to other types. Family therapy has also been found to be an effective treatment for adolescents with anorexia[41] and in particular, a method developed at the Maudsley Hospital is widely used and found to maintain improvement over time.[42] Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living. ... The menstrual cycle is the periodic change in a womans body that occurs every month between puberty and menopause and that relates to reproduction. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicine, used because of its record of reliability. ... Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development. ... The Maudsley Hospital in Denmark Hill, Camberwell, South London is unique as a psychiatric hospital in that it was always intended to be a centre of treatment and research rather than confinement and asylum. Now part of the South London and Maudsley NHS Trust (SLaM) the hospital derives its origins...


Drug treatments, such as SSRI or other antidepressant medication, have not been found to be generally effective for either treating anorexia,[43] or preventing relapse[44] although it has also been noted that there is a lack of adequate research in this area. It is common, however, for antidepressants to be prescribed, often with the intent of trying to treat the associated anxiety and depression. SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Prozac, a selective serotonin reuptake inhibitor (SSRI) Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia (milder depression). ...


Supplementation with 14mg/day of zinc is recommended as routine treatment for anorexia nervosa due to a study showing a doubling of weight regain after treatment with zinc was begun. The mechanism of action is hypothesized to be an increased effectiveness of neurotransmission in various parts of the brain, including the amygdala, after adequate zinc intake begins resulting in increased appetite.[45] This article is about part of the human brain. ...


There are various non-profit and community groups that offer support and advice to people who suffer from anorexia or who care for someone who does.


See also

The history of anorexia nervosa begins with the first recognition and description of anorexia as a disease in the late 19th century. ... Adi Barkan is an Israeli fashion photographer and model agent who has campaigned for legislation banning the use of anorexic models. ... This article is about the symptom of decreased appetite. ... Body dysmorphic disorder (BDD) is a mental disorder in which the affected person is excessively concerned about and preoccupied by an imagined or minor defect in his or her physical features. ... Body image is a term which may refer to our perceptions of our own physical appearance, or our internal sense of having a body which is constructed by the brain. ... Bulimia nervosa is an eating disorder characterised by recurrent binge eating, followed by compensatory behaviors, referred to as purging.[1] The most common form—practised more than 75% of people with bulimia nervosa—is self-induced vomiting; fasting, the use of laxatives, enemas, diuretics, and overexercising are also common. ... // Binge eating disorder (BED), is a psychiatric disorder in which a subject shows the following symptoms: Periodically does not exercise control over consumption of food Eats an unusually large amount of food at one time -- more than a normal person would eat in the same amount of time. ... See also Negative calorie diet, very low calorie diet CRON redirects here. ... Defensive vomiting is a symptom of anorexia nervosa and bulimia nervosa in which a person who has drastically over-eaten (generally in reaction to previous extreme dieting) vomits as a reaction to an excess of food which the body is not prepared to handle. ... Eating disorder not otherwise specified (EDNOS) is a diagnostic category of sub-clinical mental disorders that involve disordered eating patterns. ... Fasting girls were young females, usually preadolescent, who, it was claimed, were capable of surviving over indefinitely long periods of time without consuming any food or other nourishment. ... Human females, as represented in Birth of Venus by William-Adolphe Bouguereau, 1879. ... Percentage of population affected by malnutrition by country, according to United Nations statistics. ... Muscle dysmorphia is a disorder in which an individual becomes obsessed that they are not muscular enough. ... Orthorexia, or orthorexia nervosa is a term coined by Dr. Steven Bratman, a Colorado MD, to denote an eating disorder characterized by a fixation on eating what the sufferer considers to be healthful food, which can ultimately lead to early death. ... It has been suggested that Pro-mia be merged into this article or section. ... Purging disorder is an eating disorder characterized by recurrent purging (self-induced vomiting, misuse of laxatives, diuretics, or enemas) to control weight or shape in the absence of binge eating episodes that occurs in people with normal or near-normal weight. ... Refeeding syndrome is a syndrome consisting of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved or severely malnourished. ... Wannarexia is a label applied to people who claim to have anorexia nervosa, or wish they did,[1] who are also called Wannarexics[2] or anorexic wannabes.[3] The condition is a cultural phenomenon, not a diagnosis. ...

References

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is the 106th day of the year (107th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 112th day of the year (113th in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 113th day of the year (114th in leap years) in the Gregorian calendar. ... General Name, symbol, number zinc, Zn, 30 Chemical series transition metals Group, period, block 12, 4, d Appearance bluish pale gray Standard atomic weight 65. ...

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Postnatal Depression (also called Postpartum Depression and referred throughout this article by the acronym PPD) is a form of clinical depression which can affect women, and less frequently men, after childbirth. ... Wikinews has related news: Dr. Joseph Merlino on sexuality, insanity, Freud, fetishes and apathy Personality disorder, formerly referred to as a Character Disorder is a class of mental disorders characterized by rigid and on-going patterns of thought and action (Cognitive modules). ... Passive-aggressive behavior refers to passive, sometimes obstructionist resistance to following authoritative instructions in interpersonal or occupational situations. ... Kleptomania (Greek: κλέπτειν, kleptein, to steal, μανία, mania) is an inability or great difficulty in resisting impulses of stealing. ... Trichotillomania (TTM), or trich as it is commonly known, is an impulse control disorder characterized by the repeated urge to pull out scalp hair, eyelashes, facial hair, nose hair, pubic hair, eyebrows or other body hair. ... “Voyeur” redirects here. ... A factitious disorder or FD is a mental disorder where the ill individuals symptoms are either self-induced or falsified by the patient. ... This page refers to the self-inflicted factitious disorder. ... Egodystonic sexual orientation is an egodystonic condition. ... Two women in handcuffs and latex miniskirts and tops - Latex and PVC fetishism Wikinews has related news: Dr. Joseph Merlino on sexuality, insanity, Freud, fetishes and apathy Sexual fetishism is the sexual attraction for material and terrestrial objects while in reality the essence of the object is inanimate and sexless. ... Half-wit redirects here. ... 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The diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD), refers to a group of disorders characterized by delays in the development of multiple basic functions including socialization and communication. ... Autism is a brain development disorder characterized by impairments in social interaction and communication, and restricted and repetitive behavior, all exhibited before a child is three years old. ... Rett syndrome/ disorder is a neurodevelopmental disorder that is classified as a pervasive developmental disorder by the DSM-IV. Many[1] argue that this is a misclassification just as it would be to include such disorders as fragile X syndrome, tuberous sclerosis, or Down syndrome where one can see autistic... 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Oppositional defiant disorder is a controversial psychiatric category listed in the Diagnostic and Statistical Manual of Mental Disorders where it is described as an ongoing pattern of disobedient, hostile, and defiant behavior toward authority figures that goes beyond the bounds of normal childhood behavior. ... Separation Anxiety redirects here. ... Selective mutism is a social anxiety disorder in which a person who is normally capable of speech is unable to speak in given situations. ... Reactive attachment disorder (RAD) is the diagnostic term for severe and relatively uncommon disorders of attachment that can affect children. ... A tic is a repeated, impulsive action, almost reflexive in nature, which the actor feels powerless to control or avoid. ... Tourette redirects here. ... Speech disorders or speech impediments, as they are also called, are a type of communication disorders where normal speech is disrupted. ... “Stutter” redirects here. ... 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  Results from FactBites:
 
NAMI | Anorexia Nervosa (1332 words)
Anorexia nervosa is a serious, often chronic, and life-threatening eating disorder defined by a refusal to maintain minimal body weight within 15 percent of an individual's normal weight.
People with anorexia nervosa also tend to have higher than normal levels of cortisol (a brain hormone released in response to stress) and vasopressin (a brain chemical found to be abnormal in patients with obsessive-compulsive disorder).
Anorexia nervosa is among the psychiatric conditions having the highest mortality rates, killing up to six percent of its victims.
Anorexia Nervosa - MSN Encarta (1180 words)
Anorexia Nervosa, mental illness in which a person has an intense fear of gaining weight and a distorted perception of their weight and body shape.
Anorexia nervosa has a wide variety of medical complications that affect every system of the body and can be life threatening.
Undernourishment usually causes females with anorexia nervosa to stop menstruating (see Menstruation)—in fact, this symptom is so typical that it is one of the criteria used to diagnose the disease.
  More results at FactBites »

 
 

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