Everything you need to know about anorexia. Anorexia (anorexia nervosa) Anorexia as a disease

Before we move on to consider the features of anorexia, let’s dwell on what the specified condition is to which it can lead, that is, protein-energy malnutrition (abbr. PEM).

PEM is defined as a nutritional state caused by energy imbalance, as well as imbalance of proteins and other types of nutrients, which in turn produces undesirable effects affecting function and tissue, as well as similar clinical outcomes. In the case of anorexia, PEM occurs against the background of inadequate food intake (although along with it, conditions of the body such as fever, drug treatment, dysphagia, diarrhea, chemotherapy, heart failure, radiation therapy and other effects on it that lead to PEM can be identified) .

Symptoms of protein-energy malnutrition occur in a number of ways. Meanwhile, it is against this background that weight loss occurs in adults (not too noticeable in case of obesity or general swelling), while in children there are no changes in terms of weight gain and height.

Let us dwell on a generalized consideration of the symptoms of the disease that initially interests us. Actually, with anorexia (i.e., lack of appetite), patients lose weight, and this disease itself can be a companion to another type of disease (oncological, somatic, mental, neurotic diseases). Lack of appetite is persistent, accompanied by nausea, and in some cases vomiting occurs as a result of attempts to eat. In addition, there is increased satiety, in which there is a feeling of fullness in the stomach even with a small amount of food eaten.

The listed symptoms can act as the only manifestations of anorexia, or be either the leading manifestations of the patient’s general condition, or be accompanied by many other complaints. Diagnosis in this case directly depends on what symptoms of anorexia accompany it.

Anorexia can occur in a number of conditions, let's highlight some of them:

• neoplasms of a malignant type, having a different nature of manifestation and their own different localization features;
• diseases of the endocrine system (hypopituitarism, thyrotoxicosis, diabetes mellitus, Addison's disease, etc.);
• alcoholism, drug addiction;
• helminthiasis;
• depression;
• intoxication.

What is noteworthy is that the very definition of “anorexia” is used not only in the designation of the symptom that it represents (decreased appetite), but also in the definition of the disease, which in particular is “anorexia nervosa”.

Anorexia determines a fairly high mortality rate for patients. In particular, based on some data, it is possible to determine its rate at 20% for all patients with anorexia. What is noteworthy is that in approximately half of the indicated percentage of cases, mortality is determined by the suicide of patients. If we consider natural mortality against the background of this disease, then it occurs due to heart failure, which, in turn, develops due to the general exhaustion achieved by the body of the sick person.

In approximately 15% of cases, women, carried away by weight loss and diets, reach a state in which they develop an obsessive state in combination with anorexia. In most cases, anorexia is diagnosed in adolescents and young girls. Similar to victims of drug addiction and alcoholism, anorexics do not recognize the fact that they have any kind of disorder, nor do they perceive the severity of the disease itself.

Anorexia can manifest itself in the following varieties:

• Primary anorexia . In this case, we consider states of lack of appetite in children due to one reason or another, as well as loss of hunger due to hormonal dysfunction, malignant tumor or neurological pathology.
• Anorexia mental (or cachexia nervosa, anorexia nervosa). In this case, mental anorexia is considered as a condition with refusal to eat or loss of the feeling of hunger due to suppression of appetite against the background of psychiatric diseases (catatonic and depressive states, the presence of delusional ideas regarding possible poisoning, etc.).
• Anorexia mental painful . In this case, patients with anorexia have a painful feeling of weakening and loss of ability in the waking state to be aware of the sensation of hunger. The peculiarity of this type of condition lies in the fact that in some cases they are faced with almost “wolfish” hunger in their sleep.
• Drug-induced anorexia . This case considers conditions in which patients lose the feeling of hunger, provoking this loss either unconsciously (in the treatment of a particular type of disease) or intentionally. In the latter case, efforts are aimed at achieving the goal of weight loss through the use of appropriate medications, which causes a loss of hunger. In addition, in this case, anorexia acts as a side effect when using certain stimulants and antidepressants.
• Anorexia nervosa . In this case, it means a weakening of the feeling of hunger or its complete loss, which arose as a result of a persistent desire to lose weight (often such a desire does not find an appropriate psychological justification) with patients excessively limiting themselves in relation to food intake. This type of anorexia can provoke a number of serious consequences, including metabolic disorders, cachexia, etc. It is noteworthy that the period of cachexia is characterized by patients excluding their own frightening and repulsive appearance from the attention of patients; in other cases, the achieved results give them a feeling of satisfaction .

We have considered the conditions of mental anorexia and painful mental anorexia sufficiently for a general description of these conditions (in particular, this concerns its painful form; mental anorexia is characterized by a complex clinical picture, determined on the basis of a concomitant psychiatric disease). Therefore, below we will consider the remaining forms of the disease (respectively, with the exception of the forms indicated).

Primary anorexia: symptoms in children, treatment

This type of anorexia is actually a serious problem that exists within modern pediatrics, and this problem is determined by the fact that it occurs quite often and is not so easy to treat. A child has poor appetite - such a complaint often accompanies a visit to the attending physician, and, you see, it does not lose its relevance. Signs (symptoms) of anorexia in a child can manifest themselves in different ways: some children start crying when they need to sit down at the table, thereby refusing this need, others begin a real hysteria, spitting out food. In other cases, children may eat only one of the dishes every day, or even eating at all is accompanied by severe nausea and vomiting.

It should be noted that anorexia in children can be not only primary, but also secondary; in the latter case, it is caused by concomitant diseases of the gastrointestinal tract and other systems and organs that are relevant for the small patient. Secondary childhood anorexia in its own symptoms is considered strictly individually, depending on the disease that accompanies it, but we will focus specifically on primary anorexia, which occurs against the background of eating disorders in healthy children.

The main factors whose influence leads to the development of the form of anorexia we are considering are the following:

• Eating disorders. As our readers probably know, the development of the feeding reflex, as well as its consolidation, is ensured precisely by the regime, in which, accordingly, certain feeding hours are observed.
• Allowing the child to consume easily digestible carbohydrates during the periods between main feedings. These carbohydrates include candy, sweet soda, chocolate, sweet tea, etc. Because of this, in turn, there is a decrease in excitability from the food center.
• Food, monotonous in its composition, the same type of feeding menu. For example, feeding exclusively dairy products or fatty foods, or carbohydrates, etc.
• The child has suffered from a disease of one or another etiology.
• Large portions when feeding.
• Overfeeding a child.
• Sudden change in climate zone.

Anorexia nervosa in children, as one of the forms of primary anorexia, occupies a special place; it is caused by force feeding. For example, in many families, a child’s refusal to eat is almost equated with drama, which is why parents and family members go to all sorts of tricks in order to feed him. Various methods are used, ranging from distracting the child (which implies, for example, distraction with music, fairy tales, toys, etc.), and ending with harsh measures, which, again, are designed to ensure the peace of parents due to the fact that when they are implemented, the child will - I finally ate “as I should.”

Any of the listed methods (naturally, these are only two directly opposite options; different actions can be used that lead to the same result in question) lead to a sharp decrease in the excitability of the food center, and also ensure the development of a negative form of reflex in the child. This reflex manifests itself not only in the form of a negative reaction to the need to feed with the accompanying pushing away of the spoon and the occurrence of vomiting, but also in the form of a specific reaction, which, again, consists in the appearance of vomiting, but which occurs even with just the sight of food.

In removing a child from a state of anorexia, it is necessary to focus on the following step-by-step actions (before this, it is important to determine what the mistake was that led to this state):

• Providing feeding in accordance with age, but with portions reduced by three times. In addition, foods that stimulate appetite are additionally introduced (this measure is permissible if anorexia in children over 1 year of age is eliminated): garlic, lightly salted vegetables, etc. Carbohydrates and fats (sweets, candies, etc.) should be excluded from the child’s diet.
• With the return of appetite, the volume of portions can be gradually increased, leaving proteins at normal levels and excluding half of the fats from the norm established in accordance with age.
• Next, a return to the original diet is ensured; fats in it should also be limited.

To the general recommendations regarding primary anorexia in children, we add the following. So, by the first half of the day it is necessary to give children protein foods and fatty foods, including carbohydrate foods, including dairy products, in the diet in the second half of the day. Gradually it will be possible to make the transition to a standard diet.

In case of physical or emotional fatigue, it is important to reschedule meals until after the child has rested. No less important is the moment of concentrating on the meal, without any distractions. The introduction of new dishes into the standard diet is carried out in small portions, in particular you should pay attention to the design and presentation.

Beautiful dishes are important; in comparison with the serving size, the dishes should look larger - this will allow the child to be “deceived” by the fact that there is not much food. If the child refuses food, you should not force him, wait until the next feeding period. Do not force a child with anorexia to completely eat food; in this case, hungry pauses have their own benefits. In a situation where the child has vomited, do not scold him under any circumstances; on the contrary, try to distract him while waiting for the next feeding. In it, if possible, try to offer the child several options of dishes to choose from, but the “golden mean” is no less important - there is no need to reduce meals to a restaurant meal either.

To top it off, we note that parents mistakenly treat hyperactive games with their interruption for meals. This kind of entertainment for the child should be planned for the period following the main meals.

Anorexia nervosa: symptoms

Anorexia nervosa is primarily common in adolescents (girls), who lose about 15-40% of their normal body weight, and, unfortunately, cases of anorexia nervosa in this category of patients are only becoming more frequent. The basis of the condition under consideration is that the child experiences dissatisfaction with his own appearance, which is complemented by an active, but, as a rule, hidden desire to lose weight. To get rid of what they consider to be excess weight, teenagers sharply limit themselves in nutrition, provoke vomiting, use laxatives, and engage in intense physical exercise.

Hence the desire to take a standing position rather than a sitting one, which, in their opinion, ensures greater energy consumption. The perception of one’s own body is distorted, real horror appears associated with the possibility of obesity; patients with anorexia see only low weight as an acceptable result for themselves.

As a result, children lose weight, and in many cases reaching critical levels, many develop a negative food reflex. Moreover, for many, this reflex reaches such a form that even after the teenager’s own conviction of the need to take food, attempts to do this lead to vomiting. All this causes exhaustion, as well as poor tolerance of high/low temperatures, chilliness, and decreased blood pressure. Changes occur in the menstrual cycle (menstruation disappears), body growth stops. Patients become aggressive and find it difficult to freely orient themselves in the surrounding space.

Anorexia nervosa develops in several stages.

• Initial (or primary) stage

Its duration is about 2-4 years. A characteristic syndrome for this period is dysmorphomania syndrome. In general terms, this syndrome implies that a person has a painful belief, which is delusional or overvalued, regarding the presence of one or another imaginary (exaggerated or overestimated) defect. In the case of anorexia we are considering, such a defect is excess weight, which, as is clear from the definition of the syndrome, may not be such at all. Such a belief in one’s own excess weight is in some cases combined with a pathological idea regarding the presence of another type of defect in appearance (the shape of the ears, cheeks, lips, nose, etc.).

The determining factor in the formation of the syndrome in question is that the sick person does not correspond to the “ideal” chosen for himself, which can be anyone, from a literary hero or actress to a person from his immediate environment. The patient strives for this ideal with all his nature, accordingly, imitating it in everything, and, above all, in external features. In this case, the importance of the opinions of others regarding the results achieved by the patient is lost, however, it is precisely the critical remarks perceived by him from the environment (relatives, friends, teachers, etc.) that can only “encourage” him to achieve the goal due to increased vulnerability and sensitivity.

• Anorectic stage

The beginning of this stage is accompanied by an active desire aimed at correcting appearance; conventionally, the effectiveness of weight loss is reduced to the loss of 20-50% of the initial mass. Secondary somatoendocrine changes are also noted here, changes occur in the menstrual cycle (oligomenorrhea or amenorrhea, i.e. a decrease in menstruation in girls or its complete cessation).

The methods by which results in weight loss are achieved can be very different; patients, as a rule, hide them at first. Here, as already noted, many actions are performed while standing; in addition, patients can tighten their waist using cords or belts (“to slow down the absorption of food”). Due to excessive effort in performing certain exercises (for example, “bending-extension”), in combination with increasing weight loss, the skin is often injured (the area of ​​the shoulder blades, the sacrum, the area where the waist is tightened, the area along the spine).

During the first days of food restrictions, patients may not have hunger, but often, on the contrary, it is extremely pronounced in the initial stages, which makes it difficult to refuse food and they have to look for other ways to achieve the goal (losing weight itself). Such methods often include the use of laxatives (much less often - the use of enemas). This, in turn, causes sphincter weakness, and the possibility of rectal prolapse (sometimes quite significant) cannot be ruled out.

An equally common companion to anorexia nervosa in the pursuit of weight loss is artificially induced vomiting. Mostly this method is used consciously, although accidental arrival at such a decision is not excluded. So, in the latter case, the picture may look like this: the patient, unable to restrain himself, eats too much food at once, as a result, due to the overcrowding of the stomach, retaining food in it becomes impossible. It is because of the vomiting that occurs that patients begin to think about the optimality of this method of releasing food before it is absorbed.

During the earlier stages of the disease, vomiting with its characteristic vegetative manifestations causes a number of unpleasant sensations in patients, but later, due to the frequent induction of vomiting, the procedure is greatly simplified. So, patients can simply perform an expectoration movement for this (you can simply tilt the torso for this), pressing on the epigastric region. As a result, everything that was eaten is thrown away, and there are no vegetative manifestations.

Initially, they carefully compare what is eaten with the amount of vomit, then perform gastric lavage. Artificially induced vomiting is inextricably linked with bulimia. Bulimia implies an irresistible feeling of hunger, in which there is practically no satiety. In this case, patients can absorb a huge amount of food, and often it can be inedible. When eating a huge amount of food, patients experience euphoria and autonomic reactions appear.

Next, they provoke vomiting, after which the stomach is washed out, then “bliss” sets in, a feeling of indescribable lightness in the body. To top it off, patients feel confident that their body is completely freed from what they have eaten, as evidenced by the rinsing waters being light in color and without the characteristic aftertaste of gastric juice.

And although significant weight loss is achieved, patients experience virtually no physical weakness; moreover, they are very active and mobile, and their performance remains normal. The clinical manifestations of anorexia during this stage often boil down to the following disorders: palpitations (tachycardia), attacks of suffocation, excessive sweating, dizziness. The listed symptoms occur after eating (a few hours later).

• Cachectic stage

In this period of the disease, somatoendocrine disorders become predominant. Following the onset of amenorrhea (a condition, as we indicated, in which there is no menstruation), patients lose weight even more rapidly. During this stage, subcutaneous fatty tissue is completely absent; dystrophic changes affecting the skin and muscles increase, against which myocardial dystrophy also develops. Conditions of hypotension, bradycardia, some loss of skin elasticity, a decrease in temperature and blood sugar levels cannot be excluded, in addition, signs of anemia are noted. Nails become brittle, teeth are damaged, and hair falls out.

Due to prolonged malnutrition and eating behavior, a number of patients are faced with an aggravation of the clinical picture of gastritis and enterocolitis. Physical activity maintained during the initial stages is subject to reduction. Instead, the predominant conditions are asthenic syndrome, and with it adynamia (muscle weakness and a sharp loss of strength) and increased exhaustion.

Due to the complete loss of critical condition, patients still continue to refuse food. Even with an exceptional degree of exhaustion, they often continue to claim that they are overweight, and sometimes, on the contrary, they are satisfied with the results they have achieved. That is, in any case, a delusional attitude towards one’s own appearance prevails, and the basis for this, apparently, is an actual violation of perception regarding one’s body.

With a gradual increase in cachexia, patients often lie in bed and become inactive. Blood pressure is extremely low and constipation occurs. Against the background of water and electrolyte disturbances, painful muscle cramps may occur, in some cases it can lead to polyneuritis (multiple nerve damage). Lack of medical care at this stage can be fatal. Often, hospitalization required in severe cases of this condition occurs in a forced manner, because patients do not realize how serious their condition has become.

• Reduction stage

As part of the stage of elimination from the previous condition, cachexia, the leading positions in the clinical condition of patients are occupied by asthenic symptoms, fixation on emerging gastrointestinal pathologies, and fear of getting better. A slight increase in weight is accompanied by the actualization of dysmorphomania, an increase in the depressive state, and the desire for a repeated scheme of “correction” of one’s own appearance.

Improvement in the somatic condition leads to the rapid disappearance of weakness with the appearance of extreme mobility, within which there is a desire to perform complex physical exercises. Here, patients can begin taking laxatives in large doses, and after attempts to feed them, they attempt artificial vomiting. Accordingly, for the above reasons, they need careful supervision in a hospital setting.

So, let’s summarize what symptoms of anorexia occur in patients, dividing them into certain groups:

• Eating behavior
  • obsessive desire to get rid of excess weight, regardless of the real state of affairs (even with existing underweight);
  • the appearance of obsessions directly related to food (counting calories consumed, focusing on everything related to the possibility of losing weight, narrowing the range of interests);
  • obsessive fear of excess weight, obesity;
  • systematic refusal of food under any pretext;
  • equating a meal to a ritual, with the accompanying thorough chewing of food; dishes consist of small pieces and are served in small portions;
  • the presence of psychological discomfort associated with finishing a meal; avoiding any events in which there is a possibility of feasting.
• Other types of behavioral reactions:
  • adherence to increased physical activity, the appearance of irritation as a result of the inability to achieve certain results during overload;
  • tendency to solitude, exclusion of communication;
  • fanatical and tough type of thinking without the possibility of compromise, aggressiveness in proving one’s own rightness;
  • choosing clothes in favor of baggy outfits, which can be used to hide “excess weight.”
• Physiological manifestations of anorexia:
  • frequent dizziness, weakness, tendency to faint;
  • significant lack of weight in comparison with age norms (from 30% or more);
  • the appearance of vellus soft hair on the body;
  • problems with blood circulation, which causes constant hunger;
  • decreased sexual activity, women experience menstrual disorders, reaching amenorrhea and anovulation.
• Mental state with anorexia:
  • apathy, depression, decreased ability to concentrate, decreased performance, self-absorption, dissatisfaction with oneself in all areas (weight, appearance, weight loss results, etc.);
  • a feeling of the impossibility of controlling one’s own life, the futility of any efforts, the impossibility of being active;
  • sleep disturbances, psychological instability;
  • rejection of the existing problem of anorexia and, as a consequence, the need for treatment.

Drug-induced anorexia: symptoms

As we noted in the general description of the disease, drug-induced anorexia occurs either on an unconscious level, which occurs when treating a particular disease when taking certain drugs, or intentionally, when such drugs are used for a specific purpose aimed at losing excess weight. Anorexia can also occur as a side effect, which occurs when taking stimulants and antidepressants.

At the moment, doctors take the problem of side effects when taking medications with specific effects quite seriously. Long-term therapy using such drugs determines the possibility of recovery from quite serious, and in some cases, fatal diseases while simultaneously returning to an active lifestyle. At the same time, the harm caused to the immune system due to this becomes the cause of the development of another type of disease, the result of which can be no less terrible. This, in particular, includes one of the results of taking drugs in significant quantities, drug-induced anorexia, which interests us.

In light of this effect achieved by using drugs, a definition for it called “drug disease” was introduced in domestic medical practice. It should be noted that this definition implies not only drug-induced anorexia, but also other diseases that arise against the background of corresponding exposure, and these are endocrine diseases, allergies, Addison's disease, asthenia, drug addiction, etc. Almost any drug can lead to a drug-induced disease, Accordingly, this does not exclude the possibility of developing drug-induced anorexia against this background.

Symptoms of drug-induced anorexia, in general, fall under the general picture of this disease. So, this includes nausea and lack of appetite, the presence of painful sensations in the epigastric region, and general exhaustion of the body. There is also a frequent urge to vomit, rapid satiety occurs when eating, and this is accompanied by a feeling of fullness in the stomach. Patients with anorexia in this form in every possible way deny the existing problem, continuing to use drugs that cause weight loss. In the latter case, the signs of drug-induced anorexia become decisive for this disease, therefore it is important to pay attention to them in time, thereby preventing progression.

Anorexia in men: symptoms

Anorexia, although considered to a greater extent as a female disease due to the desire of the fair sex to achieve “ideal” parameters, is not an exclusively female disease. Anorexia in men is a common and growing phenomenon; moreover, male bulimia is also associated with this condition, and men experience bulimia three times more often than women.

Male anorexia, the symptoms of which we will consider, is also based on the desire to achieve ideals in terms of one’s own complexion. Obsessing over it, men exercise vigorously, deliberately refusing food and tracking calories. What is noteworthy is that the age of males introduces this disease to a younger group. Thus, the first symptoms of anorexia, manifested in a decrease in muscle mass, are increasingly found among schoolchildren.

Similar to the female self-perception, male anorexia in combination with bulimia comes down to weight control and breakdowns due to fullness in the stomach with the intention of getting rid of what has been eaten by artificially inducing vomiting. After this, a feeling of guilt appears, against the background of which, in turn, psychosomatic disorders develop.

The difference between male anorexia and female anorexia is that it generally develops at a later age (despite the initially indicated tendency to increase the incidence of this disease in schoolchildren). Moreover, anorexia, the symptoms of which are diagnosed in men, in many cases is inherently associated with the relevance of schizophrenic processes for them.

There are certain risk factors for the occurrence of this disease in men, we will highlight them:

• the presence of a problem of excess weight in childhood;
• engaging in exhausting sports (in this case, runners have a higher risk of developing anorexia compared to, for example, weightlifters and football players);
• the presence of a hereditary predisposition to mental illness;
• cultural features (when fixing the environment on external physical appearance, diets, etc.);
• a type of activity in which it is important to be “in shape” (artists, male models, etc.).

Before the onset of the disease, patients, as a rule, have problems in the form of short stature, underdevelopment of the vascular and muscular systems, problems associated with the gastrointestinal tract, appetite disturbances, and intolerance to certain types of food.

There is a certain picture that future anorexics fall into, in addition to the problems mentioned above. Thus, they are brought up mainly in “greenhouse” conditions, their parents protect them as much as possible from certain difficulties. Due to such dependence on parents, there is a constant shifting of one’s own problems onto the shoulders of the environment. As they grow older, such men become more unsociable, withdrawn, and emotionally cold (which determines the presence of schizoid traits). It is also possible to evaluate themselves as incompetent, helpless and unbearable individuals (which, in turn, determines the presence of asthenic personality traits). Symptoms of anorexia in women in terms of personal manifestations determine the predominance of hysterical traits in them.

What is noteworthy is that some men with anorexia are initially convinced of their own excess weight, but in this case such a belief is delusional, that is, we are talking about false judgments that cannot be corrected. Accordingly, such beliefs are appropriate for them even if there is already a problem of underweight. When fixated on fictitious fatness, anorexic men stop reacting to really existing, and often ugly, defects in their appearance.

As already indicated, weight loss is achieved through the same measures as in women, that is, by refusing to eat, inducing vomiting and excessive physical exertion, due to which the result is determined in the form of severe exhaustion. It should be noted that artificially induced vomiting does not cause severity similar to female vomiting. As for refusing food, it is either motivated in a formal way, or in a completely absurd way (cleansing the soul and body; food is a hindrance in activity and in life in general, etc.).

The development of anorexia in men determines for them the subsequent addition of another type of signs of schizophrenia. Signs of schizophrenia in this case are manifested in impaired thinking, self-absorption, and a narrowing of the usual range of interests.

In addition, of course, anorexia in men can also manifest itself as an independent disease, which determines the generally recognized symptoms of this condition.

Anorexia during pregnancy

For women who have previously experienced anorexia, including bulimia, as a form of eating disorder, trying to get pregnant is comparable to serious difficulties. The basis for this statement is the fact that these patients are twice as likely to resort to artificial insemination, which, accordingly, indicates the negative impact of eating disorders in the future on reproductive function.

Based on the results of one study, it is known that out of 11,000 cases with a history of eating disorders, 39.5% of women require about 6 months to conceive successfully, while a similar problem occurs in only a quarter of women without eating disorders . 6.2% of those with a history of eating disorder problems are patients of in vitro fertilization clinics, while 2.7% of the total number in this case did not have problems in the form of anorexia and bulimia in the past. What is noteworthy is that most often pregnancy with anorexia is unplanned; therefore, not in all cases this disease is comparable to infertility.

If there is a malnutrition during pregnancy, a miscarriage may occur, and the possibility of developing gestational diabetes is not excluded - a disease that goes away after childbirth, unlike other types of diabetes, which are chronic, characterized by an increased level of glucose in the blood.

During pregnancy, women gain about 10-13 kg, which is necessary to ensure the normal development of the child. In most cases, pregnant women consume about 2000 kcal per day, and by the last trimester - about 2200 kcal. If you have anorexia, it is quite difficult to come to terms with such facts.

If your body mass index (BMI) is abnormal during pregnancy, there is a risk of having a low birth weight baby, which is especially likely with concomitant smoking. Also against this background there is a risk of premature birth.

Diagnosis

In general, the diagnosis of anorexia is based on a comparison of general symptoms within the framework of the following criteria:

• changes accompanying the condition that occurred before the age of 25 (derogations are possible, including based on gender);
• weight loss of 25% or more of the indicator serving as the starting point for diagnosis;
• the absence of any organic disease acting as the main cause of weight loss;
• a perverted approach to eating and one’s own weight;
• absence/presence of mental illness concomitant with the condition;
• the presence of at least two manifestations from the following list:
  • lanugo (appearance of very fine body hair);
  • amenorrhea;
  • episodes of bulimia;
  • bradycardia (a condition in which the heart rate at rest is 60 beats per minute or less);
  • vomiting (possibly intentionally induced).

Treatment

Treatment of anorexia in some cases is possible without reaching the stage of development of severe forms of complications, which only accompanies a rapid recovery, often at a spontaneous level. Meanwhile, in most cases, patients do not recognize the disease, and accordingly, they do not seek help. Severe forms imply the need for complex therapy, this includes inpatient treatment, drug therapy, and psychotherapy (including for members of the patient’s family). In addition, a normal diet is subject to restoration, in which an increase in the calorie content of the food consumed by the patient is gradually achieved.

As part of the first stage of treatment, the somatic condition is subject to improvement, in which the process of weight loss is suspended and the threat to life is eliminated, and the patient is brought out of cachexia. As part of the next, second stage, they focus on treatment using medications in combination with psychotherapy methods while simultaneously distracting the patient from the existing fixation on appearance and weight, in particular, on the development of self-confidence, acceptance of the surrounding reality and oneself. Anorexia, a video and photo of which is available in our article, also determines the possibility of achieving some effect in “reaching out” to the patient, in particular, to his perception of the situation and possible results with further progression of the disease.

Relapse of anorexia is a frequent stage in this disease, due to which several courses of treatment are often required. It is extremely rare that excess weight or obesity becomes a side effect of therapy.

Anorexia requires an integrated approach to diagnosis and treatment, which is why consultation with a number of specialists may be required at the same time: psychologist (psychotherapist), neurologist, endocrinologist, oncologist and gastroenterologist.

Anorexia. Today a lot is written about this disease in the media and spoken on television. The sight of the emaciated bodies of the sick frightens ordinary people no less than the photographs of prisoners of Buchenwald and Auschwitz. Experts call scary figures: the proportion of deaths from anorexia in the world reaches 10-20%. Moreover, about 20% of patients have suicidal tendencies and attempt suicide. Anorexia chooses young people: the age limit of those affected is 12-25 years, 90% of them are girls. And another statistical paradox: the higher the standard of living in a country, the more people are susceptible to the disease.

What kind of disease is this that forces physically healthy people to extinguish their natural feeling of hunger and bring the body to complete exhaustion? Why does the desire to eat food disappear when there is a need for it? Is it possible to somehow resist this pathological process? Let's talk about everything in order.

The concept of "anorexia"

Note: The term “anorexia” is used in the wider literature and means both a symptom of decreased appetite and a separate disease – anorexia nervosa.

The name itself comes from Greek (ἀν- - “not-”, as well as ὄρεξις - “appetite, urge to eat”).

This syndrome accompanies a large number of other diseases and is a component of them.

Anorexia nervosa is a mental illness that manifests itself in the form of an eating disorder that is caused and maintained by the patient himself. At the same time, he has a pathological craving for weight loss, a strong fear of obesity and a distorted perception of his own physical form.

Considering anorexia as only a problem of excessive desire for thinness and slimness, which is fashionable today, is fundamentally wrong. Attempts to present everything in the light of excessive enthusiasm for diets only aggravate the situation with the prevalence of the disease. This is a pathology with a complex etiology, the development of which involves many causes, both internal and external, related to the body of a particular person.

In addition, social and cultural factors, as well as subtle connections between a person and society, also play a very serious role. That is why anorexia is considered a disease and medical measures are necessary to properly combat its development. After all, help not provided on time poses a serious threat to health and, unfortunately, often to human life.

A popular documentary film is devoted to the problems of the social background of anorexia. The authors try to answer the question about the global causes of the spread of such a disease as anorexia:

For quite a long time, it was believed that anorexia is a disease that affects exclusively representatives of the fair half of humanity, and many still adhere to such views. However, this is not entirely true.

There is some data regarding the prevalence of anorexia:

• On average, in women, anorexia occurs in 1.3-3% of cases among all diseases.
• The incidence rate among men is 0.2%.
• There are known cases of anorexia in childhood and adolescence
• If untreated, the mortality rate is 20%.
• Adequate therapy is prescribed only in 5-10% of cases.
• Among psychiatric diseases, anorexia is in the top three in terms of the frequency of deaths.

Anorexia, like any disease, has certain risk factors that increase the incidence of the disease.

Proven ones are:

Warning signs of anorexia

To make a clinical diagnosis of anorexia, certain reliable signs are necessary, but there is a group of symptoms, the appearance and combination of which should alert the relatives of the patient, or the patient himself, about the possibility of the onset of the disease process.

These include:

• a person’s feeling of his own completeness;
• expressed fear of weight gain;
• changing the way you eat;
• sleep disorders;
• constant low mood;
• unmotivated mood swings;
• tendency to solitude;
• passion for cooking with preparing luxurious meals without participating in meals;
• close attention to diets and methods of losing weight;
• a person’s obvious denial of the existing problem.

If these symptoms are present, especially when several signs are combined with each other, or when some are added to existing ones, a mandatory consultation with a specialist is necessary!

Note:A specially designed eating attitude test is used as an assessment of the risk of developing anorexia.

Important!When seeking medical help, the ultimate goal is to visit a psychiatrist. No nutritionists, endocrinologists, nutritionists, therapists or doctors of other specialties can provide truly adequate care for patients with anorexia, although during the process of examination and treatment you will have to consult with many specialists.

Currently, reliable signs of anorexia in a patient are a combination of ALL of the following symptoms:

Important! All these symptoms of anorexia are diagnosed in seemingly healthy adolescents, whose thinness can easily be confused at first glance with the constitutional characteristics of the body itself.

The verification of the diagnosis of anorexia does not consist of an examination by a psychiatrist alone. To confirm the diagnosis and exclude other causes that may also occur, consultation with other specialists is necessary.

Stages of anorexia

Anorexia is a progressive disease and in its course goes through a number of specific stages that are connected with each other. Each of the subsequent ones is not only more severe in terms of clinical symptoms, but also reflects the evolution of the disease, its aggravation and the formation of increasingly destructive consequences for the body.

The main stages of anorexia nervosa include:

• dysmorphomania;
• anorexia;
• cachexia

Symptoms of the dysmorphomania stage

It is mainly characterized by the dominance of mental and psychological symptoms. The patient is dissatisfied with his own weight, considering it excessive, and the assessment is subjective. Very often such patients are depressed or anxious. Gradually their style of behavior begins to change. Their activity is quite intense in terms of searching for ideal diets and the most effective ways to lose weight.

It is believed that the full completion of this stage is noted with the beginning of the first attempts to change one’s own eating behavior (fasting, vomiting, exhausting training against the background of insufficient food intake).

Symptoms of the anorexia stage

It is considered the peak of the clinical picture and is observed against the background of persistent starvation. Each record of weight loss is considered an achievement and at the same time is a stimulant for even more tightening of the diet or the use of several methods of changing eating behavior.

Patients with anorexia, due to reduced food intake, can deliberately induce vomiting by taking pharmacological laxatives and intense physical activity. At this stage of anorexia nervosa, any praise for their thinness is perceived as a compliment and at the same time as “hidden mockery.”

Critical remarks can cause significant affective reactions with auto-aggression, or a maximum, unreasonable, repeated tightening of the “achieving ideal weight” regime. All the results achieved are never sufficient due to a persistent change in the perception of one’s own body. It is at this stage of anorexia nervosa that symptoms of changes in the functioning of all organs and systems begin to be observed.

Cachexia stage

In essence, it is the final stage. There is exhaustion of the body with irreversible changes in all organs and tissues. At this stage, treatment is ineffective due to multiple irreversible multisystem damage to the entire body. The average time for the onset of this stage is 1-2 years.

Important!With anorexia, absolutely all organs of the human body suffer, and damage to particularly important systems leads to an increase in the rate of progression of the disease and an early onset of death..

Treatment of anorexia

Curing anorexia is possible, but it is a rather complex, multicomponent and lengthy process that has many points of application.

The following are used in the treatment of anorexia nervosa:

• psychotherapeutic techniques;
• nutrition correction;
• emotional support;
• medicinal methods

Psychotherapeutic methods for treating anorexia

Various types of psychotherapy aim to normalize the patient’s mental background. Many experts consider them as a basis for recovery.

When implementing various mental correction programs, correction of previously distorted ideas about one’s own inferiority and excess weight is achieved.

Psychological methods for treating anorexia help normalize the perception of one’s own body. A separate area is the normalization of relationships in the family and immediate environment of an anorexic patient.

Creating a background of emotional support and assistance for anorexia.

In fact, this is one of the types of psychological help in the treatment of anorexia. Only it comes not from the doctor, but from the closest people, thanks to whom a positive emotional background is created, allowing patients to receive a positive response in response to difficult or unusual decisions for them. This helps resolve crises and relieve constant stress.

Nutritional therapy for anorexia

An extremely important point in the treatment of anorexia is the normalization of body weight, which requires a gradual increase in food intake. For this purpose, appropriate programs have been developed that allow you to restore weight without negative effects for the “practically atrophied” digestive system.

Pharmacotherapy in this situation is an additional factor and consists of correcting mental disorders with appropriate medications. Taking medications to increase appetite is also indicated. Some regimens also include medications to reduce the likelihood of possible relapses.

Disease prognosis

Anorexia is characterized by the following development options:

• Full recovery.
• Recovery from existing organic consequences of organs and systems.
• Recurrent course with varying frequency and duration of exacerbations.
• Death for various reasons - ranging from suicide to cachexia.
• In rare cases, the disease transforms into bulimia - uncontrolled overeating.

Remember! Therapy for cachexia is a long process and largely depends on its correctness and the time of initiation of adequate treatment for anorexia. Ignoring the problem, as well as self-medication, is detrimental not only to health, but often to the life of patients.

General practitioner, Sovinskaya Elena Nikolaevna

Over the past 5 years, the number of patients diagnosed with anorexia has increased almost 10 times! 40% of them are teenagers aged 11 to 16 years, another 35% are models, actresses and other public people. In connection with such a catastrophic situation, numerous studies began to be conducted in the United States and Western European countries on this disease, which annually leads to nervous and physical exhaustion, and also claims the lives of thousands of people around the world.

It's time to find out what kind of deviation this is, what are its causes and mechanisms of development, and most importantly, whether it can be treated and how effective modern therapeutic methods are.

What it is?

Anorexia is not just a disease. In all reference books it is listed as a syndrome. The difference is that the mechanisms of development of the latter have not yet been studied well enough and are the subject of close study by scientists around the world. In this regard, the effectiveness of treatment methods for such pathologies is questioned and is not guaranteed. Indeed, psychotherapy, which is today the main tool in the fight against this disease, does not produce positive results in all cases.

The essence of anorexia is a lack of appetite, despite the body's need for nutrients. Most often, a person consciously refuses food due to a mental disorder against the background of internal complexes about his own figure and excess weight. By accustoming themselves not to eat, constantly exhausting the body with diets, patients bring the body and psyche to complete exhaustion. Much less often, this happens unconsciously and is dictated by the presence of other, no less serious diseases (for example, schizophrenia, intoxications of various kinds, cancer, etc.).

Difference from bulimia

Along with, anorexia is considered an eating disorder. According to many models, they suffered from both at the same time, although the manifestations of these diseases are completely different.

Bulimia is characterized by uncontrollable hunger pangs. After long and grueling diets, patients break down and eat huge amounts of food at once. And after they realize what happened, they become ashamed of such behavior. This leads to artificial induction of vomiting, abuse of laxatives and enemas, just to get rid of consumed food. Then the everyday life of grueling diets begins again until a new breakdown.

Anorexia is not characterized by such attacks of hunger; with this diagnosis, appetite is almost completely absent. And if with bulimia the body occasionally, but still receives and even manages to absorb at least some nutrients during such breakdowns, then here exhaustion is diagnosed much earlier, and more deaths are noted.

Interesting fact. In the course of research, scientists have established a connection between the type of eating disorder and the character of the person who suffers from it. People who are emotionally unstable and impatient and find it difficult to control themselves are prone to bulimia. Among anorexics, on the contrary, there are many closed and stubborn people who find it difficult to prove something. This explains the difficulty of treating the latter.

Causes

The reasons are so varied that in some cases it can be extremely difficult to identify them. Most often, depression is the main provoking factor, but this formulation is not enough for successful treatment. Psychotherapy digs much deeper and seeks to identify more root problems.

Mental

Age factor: adolescents and young adults are at risk, and the lower bar has been falling lower and lower in recent years. Excess weight in childhood, leading to problems with the environment (pressure from parents, calling names by classmates).

The presence of a negative example in the family: relatives with anorexia, bulimia, or obesity, as well as those suffering from depression, alcoholism, drug addiction. Tensed relationships in the family, too strict parents, because of which the child strives to meet high standards and becomes depressed if he does not live up to them. Lack of parental attention.

Wrong eating habits: eating unhealthy foods in large quantities, not following a diet.

Low self-esteem, self-doubt, internal complexes, feelings of inferiority. Perfectionist-obsessive personality type. Mental illnesses, neurological pathologies. Parents' divorce. The formation of personality when a teenager tries to prove to himself and others that he has willpower and can consciously refuse food in order to meet the expectations of society.

Hobbies, interests, profession requirements: actors, models, musicians, singers and other public people.

Physical

These include:

• alcoholism, drug addiction;
• aneurysm;
• anemia;
• Addison's disease;
• gastritis, pancreatitis;
• helminths;
• hemochromatosis;
• hepatitis, liver cirrhosis;
• hypopituitarism;
• hormonal dysfunction;
• zinc deficiency;
• dysfunction of neurotransmitters responsible for eating behavior (dopamine, serotonin, norepinephrine);
• prolonged coma;
• malignant tumors;
• leukemia;
• lymphoma;
• excess weight;
• neurosurgical operation;
• digestive problems, gastrointestinal diseases;
• early onset of menstruation in girls;
• sarcoidosis;
• diabetes mellitus type I;
• Kanner, Sheehan, Simmonds syndromes;
• thyrotoxicosis;
• brain injuries;
• schizophrenia;
• eclampsia.

Genetic

Not so long ago, genetics was practically not considered as one of the possible causes of anorexia, considering the latter a purely mental and social syndrome. However, not so long ago (in 2010) large-scale studies were conducted in the United States, which involved not only patients with this diagnosis, but also their closest relatives of at least 2 people. The DNA responsible for feeding behavior was studied. The results surprised many: obsessions with losing weight and refusing to eat were often determined at the chromosomal level. They found a gene for brain-derived neurotrophic factor, which differed from the others in its sensitivity to this disorder.

It is involved in stimulating appetite and satisfying hunger in the hypothalamus, and also controls the level of serotonin in the body. Researchers have concluded that people may be genetically predisposed to anorexia. This consists in the inheritance of dysfunctions of neurotransmitter systems, a certain personality type and a number of mental disorders. Moreover, in most cases, such heredity may not manifest itself throughout life. But as soon as it receives an impetus from the outside (illness, depression, taking powerful medications, long-term diet) it manifests itself in all its “glory.”

And others

Uncontrolled use of anorexigenic drugs for the purpose of losing weight. A side effect of using certain medications - hormones, psychostimulants, glucocorticosteroids.

Single stressful events that occurred 4-6 months before the onset of the eating disorder: this could be the death of a loved one or physical (sexual) abuse.

Dream of becoming a model. An obsession with thinness, which is perceived as the ideal of modern beauty. Persistent promotion of certain beauty standards in the media, passion for social networks.

Facts, facts... Sad statistics blame the family for everything, claiming that anorexia is rooted in childhood. As practice shows, teenagers suffering from this disorder have seen enough of their mother (aunt, sister) losing weight and have not been taught to eat properly.

Classification

There are different types of anorexia. Due to the fact that the mechanisms of its development have not yet been fully studied, medical circles adhere to several classifications of this syndrome. They are based on the factors that provoked its appearance.

Classification No. 1

• Somatogenic (primary) - develops against the background of other physical pathologies and diseases.
• Functional-psychogenic (secondary) - caused by stress and mental disorders.

Classification No. 2

• Neurotic - strong negative emotions lead to powerful stimulation of the cerebral cortex.
• Neurodynamic - inhibition of the appetite center in the hypothalamus due to strong stimuli of a non-emotional nature (most often pain).
• Neuropsychiatric (or cachexia) is a persistent, conscious refusal of food, a sharp limitation in the amount of food consumed, caused by a mental disorder.

Classification No. 3

• Medicinal - develops against the background of taking anorexigenic drugs for the purpose of losing weight; it can be a side effect of other medications (most often antidepressants, psychostimulants, hormones).
• Mental - a mental disorder accompanied by loss of appetite: develops against the background of schizophrenia, paranoia, and advanced stages of depression.
• Symptomatic - a sign of a serious somatic disease: lungs, gastrointestinal tract, hormonal system, in the field of gynecology;
• Nervous (psychological) - conscious restriction of oneself in food, fear of weight gain, distorted perception of one’s own body.

There are different codes for different types of anorexia in the ICD. Correct and accurate diagnosis allows you to choose the most effective treatment methods in each individual case.

Clinical picture

At first, people with anorexia do not seem like that, because today most women diet and care about their own weight. Is it possible to suspect a model who strives to achieve ideal body parameters using all kinds of methods of an eating and mental disorder? After all, this is her profession, and she must look good and take care of her own body. But over time, when a person can no longer stop and continues to lose weight, it is impossible not to notice.

The very first signs of anorexia:

• BMI falls below the normal value of 18.5;
• refusal to eat;
• weight and figure become an obsession (in the nervous form of the disease).

It is impossible to say exactly at what weight anorexia begins, because this is too individual a parameter, which also depends on height. For example, 44 kg for a height of 154 cm is still the norm, but the same body weight for a height of 180 cm is already a pathology. Therefore, first of all, BMI is calculated and compared with normal values. If he has dropped below the bottom bar, it’s time to sound the alarm.

Determination of body mass index:
I (BMI designation) = m (body weight in kg) / h 2 (height in meters).

Common symptoms for all forms:

• discomfort after eating;
• muscle weakness and cramps;
• low body weight, which only decreases over time;
• limiting food intake under any pretext;
• refusal to get better;
• constant feeling of cold and chills due to poor circulation;
• fear of food;
• depressed, depressed state;
• phobia of excess weight.

This is just the beginning. Over time, the patient’s condition worsens more and more, and this is noticeable in his appearance, health and broken psyche.

Mental condition

These symptoms are characteristic primarily of anorexia nervosa:

• apathy;
• insomnia at night and drowsiness during the day;
• fast fatiguability;
• depression;
• looking at your naked (or in underwear) body in the mirror for a long time;
• daily weigh-ins;
• unhealthy fascination with topics related to weight;
• incorrect goal setting: “I want to lose weight from 45 kg to 30 kg” (and this is with a height of 180 cm);
• mood instability;
• refusal to share meals (for example, teenagers do not go to the school canteen and, under any pretext, do not attend family meals);
• lack of appetite;
• complete eating disorder: they eat either only standing, or only crushed, pureed foods, or only cold, or only raw, and other oddities;
• irritability, aggressiveness, constant feeling of resentment towards others;
• decreased libido;
• social isolation, cessation of communication.

Appearance

• Alopecia;
• pale or yellowish skin;
• bleeding gums, caries, tooth loss and decay;
• weight loss, muscle dystrophy, unhealthy thinness;
• splitting and brittleness of nails.

Health

• Algodismenorrhea;
• anemia;
• gastritis;
• dizziness;
• delayed physical development in adolescence and childhood: growth stops, girls’ breasts do not enlarge and menstruation does not occur, boys’ genitals do not develop;
• leukopenia, leukocytosis;
• hormonal imbalance;
• fainting;
• cessation of menstruation in women;
• gallbladder problems;
• indigestion;
• spontaneous gag reflex after eating;
• failure of the liver and kidneys;
• cardiac arrhythmia;
• thrombocytosis;
• endocrine disorders: amenorrhea in women, impotence in men, increased cortisol levels, insufficient production of thyroid hormone, problems with insulin secretion;
• enterocolitis.

Unlike other diseases, anorexia is insidious in that the patient himself, for mental reasons, is not aware of the disease and does not see even its most striking symptoms. His consciousness is so permeated with obsessive ideas that even among the bones covered with skin (this picture is observed in the last stages), he manages to see folds of fat.

through the pages of history. In Soviet psychiatry, anorexia, in its clinical manifestations and treatment methods, was practically equated with another mental illness - schizophrenia. Nowadays medicine has moved away from such an understanding of the syndrome, but they have not stopped comparing these two conditions. Recently, cases of schizophrenia developing against the background of anorexia have become more frequent (a person is delusional with obsessive ideas about his body and the excess weight from which he allegedly suffers).

stages

Doctors call three stages of development of anorexia with their corresponding symptoms.

1. Dysmorphomanic (initial) stage

• Looking at your body in the mirror for a long time, often with the doors locked.
• Obsessive thoughts about one's own inferiority.
• Food restrictions, searches and compliance with the most.
• Depressed state, anxiety.
• Constant conversations about food, diets, models.
• Weight loss is not yet critical, but already noticeable.

2. Anorectic

• The fasting continues and does not end: the patient does not agree to all the persuasion of loved ones to improve nutrition, believing that he is leading a normal lifestyle.
• Inadequate assessment of the degree of one’s weight loss (considers one’s weight to be normal).
• Refusal of sexual activity.
• Noticeable weight loss of 20%.
• Complete loss of appetite: the patient may not remember to eat all day.
• The first signs of concomitant diseases appear: hypotension, bradycardia, alopecia, adrenal insufficiency.
• With nervous forms of anorexia, excessive physical activity is also added to the diet.
• Reducing the volume of the stomach.

3. Cachectic

• Deficiency of vitamins and microelements.
• Dystrophy of the body and internal organs.
• Violation of water and electrolyte balance.
• Unhealthy thinness, weight loss by 50% of the original value.
• Dehydration.
• Swelling of the whole body.
• Inhibition of the functions of almost all body systems.

As a rule, the first stage proceeds almost unnoticed and, with timely support from loved ones, may not develop further into a pathological condition. But the latter often ends in death (sometimes due to suicide) and is very difficult to treat. Even if a person manages to get out, the consequences will haunt him throughout his life.

Diagnostics

The main diagnostic tool for detecting the disease is the anorexia test, whose name is “Attitude to Eating”. The first part consists of 26 general and easy questions. The second is only 5, but they involve monitoring your own eating behavior over the past 6 months. This method has several significant disadvantages, due to which it is not always possible to rely on it for an accurate diagnosis.

Firstly, in most cases the patient cannot objectively assess his own eating behavior. Accordingly, he cannot truthfully answer the questions in the text.

Secondly, this test predominantly detects anorexia nervosa, while all other types require additional diagnostics.

This test can be taken by absolutely anyone online. For a more accurate diagnosis, various studies may be prescribed:

• blood, stool and urine tests;
• gastroscopy;
• MRI of the head;
• sigmoidoscopy;
• X-ray contrast examination of the digestive tract;
• esophagomanometry;
• X-ray;

The last resort will be a consultation with a psychotherapist. Through an interview and based on laboratory results, he makes a final diagnosis, determines the stage and prescribes treatment.

Treatment

Comprehensive treatment of anorexia involves the use of a variety of techniques. Not all of them show high effectiveness, but with careful adherence to medical instructions and a positive attitude of the patient himself, recovery occurs (albeit not as quickly as we would like). This is a rather complex disease, so at the first symptoms you should immediately contact a psychotherapist. Only they can pull the patient out of the hole into which he has fallen.

Psychotherapy

• Visualization of the final result: the patient is told in detail about the consequences of anorexia.
• Cognitive restructuring: combating negative thoughts and obsessions.
• Controlling your own behavior.
• Correction of distorted consciousness.
• Monitoring: the patient records his eating behavior in full detail, on the basis of which conclusions are drawn and errors are eliminated.
• Increased self-esteem.
• Resolving family conflicts (in the treatment of anorexia in children and adolescents).

Nutritional rehabilitation

• Exercise therapy for the formation of a beautiful body (the purpose of the exercises is to build muscle mass).
• Bed rest.
• Diet therapy.
• Creating motivation for recovery.
• Emotional and physical support from family and friends.

Drugs

• Vitamin complexes.
• Neuroleptics.
• Selected vitamins and microelements: folic and ascorbic acid, B12, iron, zinc, magnesium, calcium, potassium.
• Drugs that increase appetite: Elenium, Frenolone, Pernexin, Peritol, anabolic steroids like Primobolan.
• Tablets for normalizing metabolism: Polyamine, Berpamin.
• Antidepressants: Zoloft, Coaxin, Ludiomil, Paxil, Fevarin, Fluoxetine, Chlorpromazine, Cipralex, Eglonil.

Folk remedies

With the permission of your doctor, you can use various folk remedies at home to restore normal appetite. However, you need to be extremely careful with them. Some herbs are too aggressive for various organs and systems that are already affected. Therefore, watch for contraindications for each such recipe.

Calming (drink before bedtime):

• valerian;
• nettle;
• Melissa;
• mint;
• dandelion.

Appetite stimulants (drink half an hour before each meal):

• St. John's wort;
• centaury;
• mint;
• sagebrush.

Treatment must be comprehensive. Even well-proven psychotherapy does not always work and give the desired effect without the same antidepressants (for the nervous form of the disease).

It is a fact. Experts say that it is impossible to cope with anorexia on your own. Patients, even if they understand that not everything is all right with them, cannot force themselves to eat normally. This is due to the fact that their ideas about food and weight are too distorted and require professional correction.

To overcome anorexia, the patient himself needs to make a lot of effort. It is not enough to strictly follow medical recommendations; you need to overcome yourself every day and change your own consciousness and attitude towards yourself. This is incredibly difficult and requires support from family and friends. A few tips will speed up your recovery.

First of all, with anorexia, you need to normalize your diet. If possible, consult with a nutritionist who has a medical education: he can create an individual menu for the near future, taking into account the characteristics of the course of the disease.

Every 2-3 days you need to increase the daily calorie content of food consumed by 50 kcal until it reaches the norm - 1,300 kcal for women and 1,500 kcal for men, and this is the lower level. With the same consistency, it is necessary to increase portion sizes by 30-50 g.

For the first 2 weeks, the basis of nutrition should be liquid and pureed dishes, crushed foods, and drinks. Next, vegetables and fruits (in any form) are gradually introduced into the diet. After another week, protein foods (boiled chicken breast, eggs, milk, seafood), a minimum of carbohydrates (oatmeal, brown rice), and a small amount of natural sweets (dried fruits and honey) are allowed.

Formation of new eating habits: adherence to the regime, fractional meals, calculation of the balance of food and drink and daily caloric intake, refusal of harmful foods.

Without normalizing your diet, it is almost impossible to get rid of anorexia. And this point can be realized only after correction of the patient’s consciousness and personal orientation.

Physical activity in advanced stages of the disease is excluded. You will need to join the sport gradually, with the permission of your doctor.

Consequences

Unfortunately, many of the consequences of anorexia will haunt a person throughout his life, even if the disease is completely cured. Recovery of the body can take from 6 months to several years.

The most common complications are:

• alopecia;
• arrhythmia;
• rapid, abnormal weight gain up to obesity;
• dystrophy;
• slow metabolism;
• impotence, decreased libido, infertility;
• obsessive-compulsive disorder;
• osteoporosis;
• serious digestive problems;
• reduction in brain mass.

If we talk about forecasts, then a fatal outcome is quite possible. Death from anorexia occurs either due to failure of vital organs or due to suicide.

Prevention

If a person has recovered from anorexia and returned to a normal lifestyle, he will still have to constantly fight this syndrome. As practice shows, even psychotherapy does not guarantee complete recovery. In 30% of cases the disorder returns. To prevent this from happening, you need to carry out prevention:

• see a psychotherapist;
• follow the principles of proper nutrition;
• monitor your BMI so that it does not go beyond the normal range;
• avoid stressful situations;
• exercise moderately;
• actively communicate;
• find a hobby you like (preferably not modeling).

Even if an anorexic patient has managed to recover, he is simply obliged to follow these preventive measures in order to avoid relapse of the disease. Doctors warn that repeated failure in most cases ends in death.

Special cases

Although anorexia is most often diagnosed in teenage girls and young women, it affects both children and men. The course of their illness varies somewhat.

In children

It proceeds completely differently than in adults. The main difference is in the mechanism of its development. For them, it is primarily a somatogenic disorder, which is diagnosed against the background of other diseases. These could be basic allergies, thrush, stomatitis, worms, otitis media, rhinitis and other diseases that so often affect children of different ages.

Therefore, if there is a long and persistent refusal to eat with a persistent decrease in weight in a child, parents should first of all send him for a full medical examination, identify the disease and treat it. After this, with the help of psychotherapy, anorexia in most cases is completely cured.

In men

Very similar to a child's room. This eating disorder in them is also primarily due to a special physiological state. Psychogenic causes are rarely noted because representatives of the stronger half of humanity are accustomed to restraining their emotions and not showing them.

Their nervous system is still stronger in relation to excess weight. If men discover it, they do not rush to induce vomiting or go on a diet. Some go to the gym, others continue to calmly sip beer in front of the TV. That's the solution to the problem. According to statistics, among those who suffer from anorexia, only 5% are men, and 3.5% are initially suffering from mental disorders.

According to statistics. Among men suffering from anorexia, more than 50% are schizophrenics, and another 25% are of non-traditional sexual orientation. Having a type of psyche that is as close as possible to that of women, and distinguished by a reverent attitude towards their own appearance, the latter get used to going on newfangled diets and deliberately refusing to eat.

Additional Information

For prevention, as well as during treatment in the initial stages, illustrative examples of what this disease leads to can be used. To do this, patients are given relevant reading (mainly biographical) and viewing (fiction and popular science) on this topic.

Books

• A. Kovrigina. 38 kg. Life in “0 calorie” mode.
• A. Nikolaenko. Deadly diet. Stop anorexia.
• A. Terrina. Happinnes exists! The story of my struggle with ANO.
• E. Goncharova. Anorexia. The disease of our time, or Why you shouldn’t chase fashion.
• J. Wilson. Girls in pursuit of fashion.
• Justine. This morning I stopped eating.
• I. K. Kupriyanova. When is it dangerous to lose weight? Anorexia nervosa is a disease of the 21st century.
• I. Kaslik. Skinny.
• K. Panic. NRXA, I love you!
• K. Reid. I'm slimmer than you!
• M. Tsareva. A girl with hungry eyes.
• Portia de Rossi. Unbearable Lightness: A Story of Loss and Growth.
• S. Sussman. Dieting.
• F. Ruse. 0%.

Movies

• Anorexia (2006).
• Battle for Beauty (2013).
• God Help the Girl (2014).
• Weight (2012).
• Hunger (2003).
• To the Bone (2017).
• Ideal figure (1997).
• For the Love of Nancy (1994).
• When Friendship Kills (1996).
• The Bony Hand of Beauty (2012).
• Beautiful (2008).
• The Best Girl in the World (1981).
• First love (2004).
• Life, Interrupted (2009).
• Superstar: The Karen Carpenter Story (1998).
• Dance is more valuable than life (2001).
• Thin and Thick (2017).
• Thin Life (2017).

Famous people who died from anorexia

• Ana Carolina Reston - Brazilian model, 22 years old;
• Debbie Barem - British writer, died at 26;
• Jeremy Glitzer - male model, 38 years old;
• Isabelle Caro - French model, 28 years old;
• Karen Carpenter - American singer, 33 years old;
• Christy Heinrich - American gymnast, 22 years old;
• Lena Zavaroni - Scottish singer, 36 years old;
• Luisel Ramos - Uruguayan model, 22 years old;
• Mayara Galvao Vieira - Brazilian model, 14 years old;
• Peaches Geldof - British model, journalist, 25 years old;
• Hila Elmaliah - Israeli model, 34 years old;
• Eliana Ramos is a Uruguayan model, 18 years old.

Over the past few years, anorexia has taken a huge number of people hostage, most of whom are teenage girls with an unbalanced psyche. The danger is that many patients refuse to consider themselves as such and do not voluntarily undergo treatment. All this ends not only in dystrophy and protein-energy deficiency - deaths with such a diagnosis have become far from uncommon. Statistics showing an ever-increasing number of people suffering from this syndrome makes us think about the standards of beauty imposed by society, the victims of which are primarily teenagers.

Nowadays, there are very high demands on the appearance of boys and girls. Women, of course, pay particular attention to their appearance. They are very demanding of their appearance, sometimes they want the almost impossible. The standard of modern beauty is an ideal, slim, fit, sexy figure. This idea is imposed on us by television programs, videos on the Internet, and photographs in magazines.

Images of thin models impose on many women the idea that thinness and beauty are equivalent concepts. Women who are unhappy with their figure are willing to go to great lengths to achieve the desired result. But some of them get too carried away with this idea and go too far. Therefore, when losing weight, you need to understand that there is such a disease as, which in its symptoms is practically no different from the behavior of an ordinary woman who is simply losing weight.

Very few women are naturally deprived of an ideal body, such is nature. For this reason, many representatives of the fairer sex are trying to get rid of extra pounds, folds, and centimeters. They are ready to use various tools in this fight, which are not always harmless. Teas and diet pills, fasting, exhausting physical activity can be used, all this can have a very disastrous result. In this article we will tell you in detail how to distinguish normal weight loss from anorexia, as well as the reasons for which this disease occurs and what symptoms it manifests.

What is anorexia?

Anorexia is a disease in which normal eating behavior is disrupted, which is expressed in too much attention to one’s weight and in the desire to almost completely limit oneself from eating food. Women who suffer from anorexia are so afraid of gaining excess weight that they are ready to drive themselves to the point of exhaustion.

Alas, this disease mainly occurs in young girls, and sometimes in teenagers. This is explained by the fact that they are the ones who are most susceptible to environmental influences. Girls with anorexia so deplete their body with various diets, or even refusing food, that their weight drops fifteen to twenty percent below what it should be. In some cases, weight may decrease even more. But even under such circumstances that the girl’s weight is greatly reduced and her general well-being suffers, the girl, looking at herself in the mirror, sees herself still very fat. She continues to make every effort to get rid of the “extra weight” that she needs, on the contrary.

This disease is very, very dangerous for young girls, as their body is not yet fully formed and continues to grow and develop. As a result of trying to lose weight, others see not a healthy, beautiful girl, but a ghost with bruises under her eyes, pale skin and many concomitant diseases. When the body intensively grows and develops, various functional systems of the body are formed - endocrine, nervous, musculoskeletal, cardiovascular; it needs many nutrients, vitamins, and minerals. A teenager, instead of giving all this to the body in the right quantities, torments it with starvation, this brings irreparable harm to the young, developing body.

Anorexic symptoms

Most often, girls and women who develop anorexia refuse to admit that they have this disease. It is very important for close friends to detect the signs of anorexia in a timely manner. If this does not happen, then the obsession with getting rid of excess weight will bring very disastrous results - the girl’s health is under great threat, and in some cases, her life. The most important and first sign of anorexia in a woman is a significant obvious weight loss, sometimes in a very short period of time. But, unfortunately, this symptom becomes visible only when the exhaustion of the body approaches a dangerously critical level. It may simply seem to many that the girl decided to get rid of excess weight in a very harmless way.

Another manifestation of anorexia is a significant reduction in the portion of food that a woman eats and loss of appetite. These signs should never be ignored. Some girls may refuse to eat at all, while finding many different excuses, which sometimes look very plausible - she’s tired, her stomach hurts, she’s eaten recently. But despite this, a person who suffers from anorexia can happily talk about different diets, food, weight loss methods, and calories. In addition, women with anorexia can spend a long time in the kitchen, while preparing a wide variety of dishes. They themselves do not want to use them.

It may seem to many that anorexics are not interested in food at all. But this is not really true - they think about food almost all the time. But as soon as it comes to putting these thoughts into practice, this desire instantly disappears somewhere. The patient's general condition worsens as the disease progresses. This manifests itself in various symptoms of disrupted functioning of many systems in the body.

• The condition of nails and hair is deteriorating. Hair becomes dull, loses its shine, and splits severely. And no hair balms, even the best ones, help improve the condition of your hair. This process is due to the fact that the body does not have enough minerals and vitamins that are needed to maintain hair in excellent condition. The same applies to nails, they become brittle and thin, sometimes peeling.
• Very high fatigue. The patient develops severe weakness and gets tired easily. The girl is just waking up and is already starting to feel tired. This happens not because of strong physical activity, but because the body does not receive the necessary energy, and it begins to take it from its internal resources, which are limited. If the cases of the disease are severe, the girl may become very drowsy, she may begin to faint regularly.
• Disappearance of menstruation or. The mechanism by which this symptom occurs is not entirely clear; it is most likely influenced by the lack of nutrients that the body needs. For this reason, hormonal levels fail. Amenorrhea is a serious disorder, which indicates that the girl needs urgent medical help.
• The condition of the skin changes. In patients with anorexia, the face becomes pale and blue circles appear under the eyes. The reason for this is iron deficiency anemia, which is mandatory for this disorder. Anorexia very often causes kidney problems. The skin of the sick girl's legs and arms acquires a characteristic bluish tint. It occurs due to poor microcirculation of the skin. For this reason, a woman is often cold; her body can often be covered with a layer of short and thin hair. The body thus tries to maintain heat and protect itself from hyperemia.
• Various diseases develop. The body lacks essential minerals, vitamins, proteins, carbohydrates, fats, and nutrients. This is a kind of stress for the body, and it is very difficult to predict exactly how it will react to this. Many women experience problems with the gastrointestinal tract, develop osteoporosis, and disrupt the functioning of the endocrine and nervous systems.

Causes of anorexia

Many people are interested in the reasons for this disease. An important fact is that there are several types of anorexia: mental, nervous and primary. Primary anorexia in women occurs due to various physiological and organic pathologies. This may be neurological disorders, malignant tumors, hormonal dysfunction and other diseases. Mental anorexia occurs due to various psychiatric pathologies. These could be delusions, depression, schizophrenia, catatonic stupor. But when most people use the term “anorexia,” they still mean anorexia nervosa. There are many reasons why anorexia nervosa occurs. These include family characteristics, problems communicating with others, and personal difficulties. Basically, the wide range of problems that cause anorexia include:

• Dysfunctional family. Such a family has an unhealthy mental climate. All family members become irritated with each other or hide their emotions greatly. One family member or several of its members most often have various types of addiction - drug addiction, alcoholism, gambling addiction, and so on. Everyone thinks exclusively for themselves and does not take into account each other's needs. A child in such a family is left to his own devices, or is under the authoritarian control of his parents. In such conditions, most often one of the family members, usually a teenage girl, suffers from anorexia.
• Too low self-esteem and impaired perception of one's own body. All girls with anorexia consider themselves fat and ugly. Even if a girl has very little weight, and her bones stick out, it still seems to her that she is very fat and has a lot of extra pounds. But, most likely, this opinion is not the result of anorexia; the real reason is that in life such girls consider themselves passive, uninteresting, weak, stupid and ugly. They want to achieve at least something in life, that is, to have a beautiful figure, in their opinion.
• Negative atmosphere around eating. The source of such a reason lies, as a rule, in early childhood. Many parents consider it necessary to feed their baby, despite his reluctance to eat. They forcefully begin to push food into the child, and the child, in turn, develops a gag reflex and develops a negative attitude towards eating food. For this reason, anorexia can occur already in early childhood, and sometimes it can hide and make itself felt in adolescence or adulthood, if there is the influence of additional factors.
• Unmet need for acceptance and love. In this case, the disease occurs because the girl strives to please other people. Very often this can happen to those girls who suffered from excess weight. When they begin to lose weight, they begin to notice how other people begin to show sympathy and be drawn to them. This fact reinforces the positive result of losing weight in a person, and they quickly continue in the same spirit. Very soon the disease begins to become pathological.
• Perfectionism. Obsessiveness and fixation in behavior. With long-term weight loss, this trait has very serious consequences. Even if it begins as a completely normal and healthy process, then a very high desire for perfection can provoke a girl to become fixated on this idea, on the idea of ​​losing weight. She will constantly seem not beautiful enough for herself. And in order to appear beautiful to yourself and others, you need to eat less and less (according to people with anorexia).
• Fighting some obstacles. Some doctors believe that the basis of the disease anorexia is the girl’s desire to overcome some difficulties; the difficulties are their own constant appetite. By refusing to eat, the girl believes that she has overcome this difficulty and it brings her pleasure. This process brings the girl victory over herself and has an important meaning in her life. This is why it is so difficult for girls suffering from anorexia to give up such pathological behavior.

Girls, if your figure does not suit you in some way, and you are planning to get rid of extra pounds with the help of some effective diet, then before that, think carefully about whether it is worth it? Are you ready to risk your own health for the sake of invented beauty?

If you still decide to improve and correct your body and overcome extra pounds, then do it wisely, do not forget about the limits in such a struggle. Assess the current situation soberly, because the line between anorexia and ordinary harmless weight loss is very, very thin. It is very easy to cross, so if your friends or relatives have any doubts about your health, it is better to once again seek advice from a specialist. If nature has not blessed you with an ideal figure, then this is not a reason to fall into despair.

You need to know that you can be attractive, charming, beautiful and attract attention without an ideal appearance. Much more important than a flat stomach is charisma and self-confidence! Be healthy and love yourself for who you are!

Anorexia (anorexia - an - prefix of denial, orexis - appetite) in modern society has become quite widespread artificially among young girls and women. In pursuit of beauty and the desire to look thinner, women resort to exhausting fasting, low-calorie diets, artificially induce vomiting and resort to frequent gastric lavage.

Facts about the disease:

CAUSES OF ANOREXIA

The disease anorexia mainly occurs against the background of mental disorders when trying to achieve the so-called “ideal figure”, while a person cannot leave the feeling that his body weight is too large at any value.

Factors influencing the development of the disease:

• Intoxication of the body.
• Diabetes.
• Anemia.
• Alcoholism and drug addiction.
• Thyrotoxicosis.
• Hormonal imbalances.
• Immunological disorders.
• Depressive states.
• Disorders in the functioning of the endocrine system.
• Chronic kidney dysfunction.
• Diseases of the gastrointestinal tract.
• Tumors with a malignant course.
• Prolonged hyperthermia.
• Inflammatory processes in the mouth and dental damage.
• Damage to the body by helminths.
• Overdose of medications (drugs with high caffeine content, sedatives, antidepressants, tranquilizers).

Among the rare but significant factors, hereditary predisposition is additionally identified. Early onset of menstruation in girls and improperly selected dietary nutrition during this period can also provoke the progression of this disease.

Psycho-emotional stress against the background of extremely low self-esteem often leads to the fact that a person begins to provoke the appearance of this disease through his conscious and unconscious actions.

CLASSIFICATION OF THE DISEASE

The fight against anorexia has helped to identify the following forms of the disease.

By type:

• Primary - the disease is detected in adolescents against the background of hormonal imbalances, malignant neoplasms and neurological pathologies.
• Mental - the illness manifests itself against the background of complex psychiatric disorders.
• Morbid-mental- patients feel severe weakness when aware of the feeling of hunger while awake; during sleep they may experience a so-called “ravenous appetite”.
• Medicinal - occurs when medicinal drugs are used during the treatment of a wide range of diseases; the intentional use of medicinal products that block the feeling of hunger is often found.
• Nervosa is currently the most common type of anorexia; the disease occurs against the background of an unhealthy desire to lose weight. This type of disease develops in several stages:
  • initial- occurs over a period of 2 to 4 years, characterized by an obsessive search for defects in one’s body;
  • anorectic- this stage is characterized by weight loss, which can be about 50%;
  • cachectic- characterized by sudden weight loss, lack of subcutaneous fat, disrupted menstrual cycle, degenerative changes;
  • reduction stage- recovery stage, at this stage the patient can either completely recover from anorexia or go into a state of deep depression against the background of gaining weight.

SYMPTOMS

With anorexia, a person quickly loses about 15% of his initial body weight, and one of the main symptoms of the disease is a complete lack of appetite.

A person in this condition constantly experiences severe weakness and is tired for no reason; in women, the menstrual cycle is significantly disrupted, while men may suffer from sexual dysfunction.

Other symptoms of anorexia:

• insomnia;
• obsessive desire to lose weight;
• excessive concern about your body weight;
• problems in identifying feelings (patients cannot distinguish hunger from sadness);
• periodic fluctuations in body weight (from 3 kilograms per month);
• unreasonable aversion to previously favorite foods;
• unhealthy craving for laxatives;
• painful muscle spasms;
• muscle atrophy;
• a very narrow layer of fat under the skin;
• increased brittleness of nails;
• dry and brittle hair.

When meeting people with sunken eyes and a clear blue color underneath, whose stomach is strongly retracted and their ribs protrude, we can confidently say that they suffer from this disease.

The disease can be aggravated by tooth loss and low blood pressure. Patients are characterized by sudden changes in mood and frequent fainting with loss of consciousness.

Neurological anorexia has a number of additional symptoms that are unique to it.

Symptoms of neurological anorexia:

• constant chills due to poor blood circulation in the body;
• body temperature below 36.6 degrees;
• atypical growth of vellus hair along the body;
• constant craving for increased physical activity;
• severe irritability when it is impossible to achieve set goals;
• When choosing clothes, preference is given to overly spacious, oversized, baggy items.

Patients often exhibit insatiable aggressiveness when defending their beliefs regarding their own weight, which ultimately develops into agoraphobia. This process ultimately leads to a feeling of loss of control over the course of one’s life.

DIAGNOSTICS

Despite the fact that a disease such as anorexia is perceived in modern society as a permissible and acceptable state of the body, we must not forget that it is still an illness that requires careful diagnosis and appropriate treatment.

The main method for diagnosing anorexia is measuring body mass index. This procedure involves searching for the ratio of body weight to height squared. Normal BMI values ​​range between 18.5 and 25. Any value less than 16 indicates anorexia.

Other diagnostic methods:

• Clinical analysis of urine and blood.
• Determination of hormonal levels.
• Radiography.
• Gastroscopy.
• Esophagomanometry.
• Electrocardiogram.

Diagnosis of patients with anorexia requires mandatory examination by a psychotherapist.

TREATMENT

Patients with anorexia undergo complex treatment, which is aimed at restoring their somatic condition and gradually gaining normal body weight.

Treatment of anorexia begins with consultations with a psychotherapist, who must make the patient believe in the danger of this disease and force him to begin a course of treatment. Therapeutic therapy is carried out in a hospital setting under the constant supervision of the treating staff.

Course of therapeutic therapy:

• Constant psychological assistance.
• Return to normal eating.
• Working on gaining healthy body weight.
• Withdrawal from a depressive state.
• Psychotherapy with family members.
• Constant care.
• Patient support.

Drug treatment:

• Antidepressants.
• Multivitamin complexes.
• Neuroleptics.
• Antipsychotic drugs.
• Atypical neuroleptics.
• Hormonal substances.

When treating, one should take into account the fact that anorexia is a disease for which drug treatment is recommended in very limited dosages. This is due to the fact that the removal of chemicals from the body can be complicated due to the severe weakening of the body and its inability to independently cope with such tasks.

Therapeutic nutrition begins with the intake of low-calorie foods in limited doses with a gradual increase. In severe cases of anorexia, intravenous administration of nutrients into the body is allowed.

DANGEROUS COMPLICATIONS

The main complications that this disease leads to:

• disorders in the work of the cardiovascular system;
• serious swelling of the limbs due to a lack of proteins in the body;
• disruptions in the digestive system;
• increased bone fragility, frequent fractures;
• reduction of brain mass, irreversible disturbances in its functioning;
• severe prolonged depression, “loss of self,” pre-suicidal mood;
• disrupted functioning of the endocrine system;
• loss of reproductive function;
• hypovitaminosis.

Anorexia is the cause of most suicides among teenagers.

Cases have been recorded in which people who recovered from anorexia began to eat intensely, which ultimately led to the development of another disease - bulimia.

PREVENTION OF ANOREXIA

Considering that during anorexia the body is subjected to extremely high stress, and the treatment process does not in all cases end with recovery, persons prone to the disease are recommended to follow a set of preventive measures aimed at avoiding serious manifestations of this disease.

Preventive measures:

• regular consultations with a psychotherapist;
• balanced food, high nutritional culture;
• avoiding severe stress;
• any diets must be agreed with a nutritionist;
• moderate alcohol consumption, complete cessation of smoking and drug use.

PROGNOSIS FOR RECOVERY

Taking into account the fact that the disease hides a dangerous mental disorder, the prognosis for recovery is not entirely favorable. Quite often, patients experience relapses of the disease, which can lead to death. Patients must understand what anorexia is and what exactly its danger is in order to successfully fight the disease.

With a favorable psychological atmosphere created by loved ones, the chances of a complete recovery and no relapses in the future are very high.

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