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Thursday, October 3, 2019

Do you know: Over dieting is a nervous disorder

Anorexia nervosa is an eating disorder in which the patient starves himself or herself, by food restriction, reaching a very low body index and not even stopping after reaching critical levels. The patient fears of gaining any weight despite actually being underweight and he/ she has a false perception or belief that her body is fat or overweight. Anorexia nervosa is more common among female population than in males.  It is a seemingly simple disease, however life threatening, that causes many psychological disturbances which may eventually lead to suicide.

Anorexia nervosa can be classified into two categories:

1- Restricting anorexia nervosa, in which the patient starts to lessen the amount of food intake in each meal in order to decrease weight reaching the goal he/ she wants.

2- Binge ( purging ) anorexia nervosa in which the patient eats normally or even eats excessive amounts of food then he/ she starts compensating for this by doing exercises, taking diet pills or inducing vomiting to get rid of the excess amount of food they have just taken.


There are many hypotheses concerning the etiology of anorexia nervosa and factors causing it include biological, psychological, and social factors. Predisposing factors include female sex, adolescence (sexual development and menarche), family history of anorexia nervosa, a low self-esteem, seeking perfection, and genetics predisposes one to anorexia nervosa. Studies show that genetic factors contribute to the disease with a percentage as high as 50-80 %. Furthermore, there is an increased incidence of psychiatric diseases such as anxiety, depression, and obsessive-compulsive disorder mainly due to disturbances in the serotonergic and dopaminergic pathways inside the brain of anorexia nervosa patients.


Symptoms of anorexia patients are diverse, which includes: low body weight due to extreme weight loss, being fatigue most of the day with dizziness spells or fainting, and in night anorexia nervosa, patients usually suffer from insomnia. Most of the time, they are also obsessed with thinking about food, recipes, cooking and restriction of food despite being thin. These patients also have specific food habits and rituals, such as refusing to eat in public, cutting food into very small pieces before eating, or hiding food.

They become isolated and start avoiding friends and family, becoming withdrawn over time. They start getting rid of food (they think of food as excess ingested calories) by self-induced vomiting, purging, using laxatives, and water pills or by doing frequent or compulsive exercise. They usually have swollen cheeks, due to enlarged salivary glands, blue colored fingers and joints, intolerance of cold, xerosis cutis, paronychia, telogen effluvium, constipation, swelling of arms or legs, amenorrhea (cessation of menstruation), dehydration, pellagra, acne vulgaris and osteoporosis. Moreover, they can also have other symptoms such as abdominal distension, lethargy, halitosis, mood swings and orthostatic hypotension.
End stage of Anorexia nervosa is having malnutrition and certain nutrient deficiencies of proteins, vitamins and minerals; subsequently causing multi organ damage and many disturbances in the cardiovascular, neurologic, endocrine, renal, gastrointestinal and reproductive systems.

Cardiac complications may include severe bradycardia, abnormal systolic function and hypotension. Also it can lead to ventricular arrhythmia that may cause the sudden death of the patient. While metabolic complications usually include decreased basal metabolic rate in most of the patients; amenorrhea, decreased fertility, diabetes insipidus due to a decrease in the release of the hormone vasopressin and osteopenia can also occur.

Patients having anorexia nervosa may also complain of constipation and gastric atrophy. They may also have other complications like generalized muscle weakness, cerebral atrophy and many electrolyte imbalances that also have a great significance in the deterioration of the patient’s condition. The general appearance of the patient with anorexia nervosa has a skin observed as scaly and dry with brittle hair and nails.

At the stage of treatment and starting to gain more weight, the anorexic patient with his/ her family require proper education about healthy caloric intake and nutrition. Media has a great role in patient education.

There are many public figures who have suffered from anorexia nervosa such as Victoria Beckham (British singer, formerly of The Spice Girls), Katherine Jenkins (British singer), Justine Bateman (American actress and fashion designer), Isabelle Caro (French model) and Elisa Donovan (American actress). Also some have died suffering from anorexia such as Lena Zavaroni (vocalist), Luisel Ramos (fashion model), Ana Carolina Reston (Brazilian model), Heidi Guenther (American ballerina) and Michael Krasnow.

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