WHAT YOU SHOULD
KNOW
Anorexia nervosa---refusal to eat---is not a trivial
disorder. At its worst, it can end in life-threatening
starvation.
Underlying anorexia is a distorted body image and an
unreasonable obsession with weight. When an anorectic looks in
the mirror, she sees a fat person no matter how thin she
actually may be. To reach her "ideal" weight, she follows
increasingly restrictive diets, often supplementing them with
hours of aerobics, weight training, calisthenics, or running.
Food becomes a major preoccupation, even though she eats next
to nothing herself. Because her self image is so far removed
from reality, she fails to realize that there's a problem even
as her body wastes away.
Causes
Despite all the attention this problem gets in the media,
it's actually quite rare. Even among teenage girls---the group
at highest risk---the rate of anorexia is under 1 percent.
Although the disorder can develop in either gender at any age,
it's most likely to strike a young perfectionist with a
negative self image. The heavy dieting that ends in anorexia is
often triggered by stressful changes in circumstances, such as
starting college or a new job, beginning or ending a
relationship, or becoming pregnant.
Signs/Symptoms
Millions of people diet and lose weight without being
anorectic. You should suspect a problem, however, if
you:
-
Have lost at least 25 percent
of your original weight, and have had no physical illness
that would account for it
-
Still think of yourself as
fat
-
Have not had your period for
three months in a row
-
Fear being overweight and
losing control of your diet
-
Feel that staying hungry is
the only way to keep your weight under
control
The malnutrition that accompanies anorexia eventually
triggers a variety of physical symptoms. Among the more common
are:
-
Constipation, digestive
discomfort, and bloating
-
Dehydration, muscle cramps,
and tremors
-
Downy body hair on the face,
back, or arms
-
Flattened
breasts
-
Dull, brittle, thinning
hair
-
Cracked or dry
skin
-
Icy hands and
feet
-
Irregular
heartbeat
-
Brittle bones (in severe
cases)
-
Depression and
anxiety
Care
Because a true anorectic doesn't even realize there's a
problem, counseling and therapy are a must. In most cases,
early cases can be treated in a clinic or doctor's office. You
may need from 1 to 4 appointments a month. Antidepressant
medications sometimes prove helpful.
For advanced cases---those literally in danger of death
from starvation---hospitalization may be necessary to rebuild
normal weight and break destructive diet
habits.
Risks
Without treatment, roughly 10 to 20 percent of anorectics
die from problems brought on by malnutrition. Treatment
substantially improves the odds of survival. The mortality rate
among those undergoing therapy is only 5
percent.
IF YOU'RE HEADING FOR THE
HOSPITAL...
What to Expect While You're
There
You may encounter the following procedures and equipment
during your stay.
-
Taking Vital Signs: These include your temperature,
blood pressure, pulse (counting your heartbeats), and
respirations (counting your breaths). A stethoscope is used
to listen to your heart and lungs. Your blood pressure is
taken by wrapping a cuff around your arm.
-
Blood Tests: You may need blood taken for tests. It
can be drawn from a vein in your hand or from the bend in
your elbow. Several samples may be needed.
-
Heart Monitor: (Also called an electrocardiogram
[e-LEK-tro-KAR-di-o-gram] or EKG). Typically, three to five
sticky pads are placed on different parts of your body.
Each pad has a wire that is hooked to a TV-type screen or
to a small portable box (telemetry unit) that shows a
tracing of each heartbeat.
-
Group Therapy: These meetings are somewhat like a
support group session, allowing patients to share coping
strategies. The meetings are run by medical
staff.
-
Individual Therapy: This is a time for you to meet
alone with your therapist to discuss ways of dealing with
the illness.
-
Family Meetings: In these sessions, medical staff
will prepare you and your family for your return
home.
-
Medicine:
-
Tranquilizers: Hospitalization and a forced end to
dieting can be highly stressful. To reduce the anxiety,
these medications can be given by IV, in a shot, or as a
pill.
-
Antidepressants: For some people, these medications
can relieve the compulsion to diet. They are usually given
as a pill.
After You
Leave
-
If your doctor prescribes a
medication, be sure to take it regularly, exactly as
directed, even if it seems to have no effect.
Antidepressants, in particular, may take weeks to begin
working.
-
The medication may cause
drowsiness. Don't use heavy equipment or drive until you
know how the medication affects you.
-
Avoid alcohol while taking
antidepressants or tranquilizers. The combination can cause
extreme drowsiness and other serious
problems.
-
You may find it helpful to
practice such stress-reduction techniques as deep
breathing, muscle relaxation, meditation, or
biofeedback.
-
Group therapy or an informal
support group can make a big difference. Sharing feelings
and strategies can help you cope.
Call Your Doctor
If...
-
You're unable to sleep or
find that you're sleeping more than usual.
-
Your medicine makes you
drowsy, keeps you awake, or affects your
appetite.
Seek Care Immediately
If...
-
You begin to have thoughts of
suicide.
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