Anorexia

• This is a psychogenic condition, a syndrome of self-imposed starvation.
• The patient voluntarily restricts food intake fearing weight gain.
• Anorexia nervosa is a disease that involves an IRRATIONAL FEAR of over-weight and occurs with the obsessive refusal to accept food.
• Let us emphasize that the word "anorexia" is misleading since the syndrome does not concern a disorder of the patient’s appetite (the appetite is not affected until late in the course of the disease).
• Anorexia nervosa can occur in all age groups, it is more common in teens between 13 and 20 years (1 boy every 10 girls that are suffering).

• If the body is not nurtured properly, its resistances are reduced, it’s weakened and sickened.
• Some children, especially girls, challenge their health.
• Because they have extremely thin models as role models, they literally starve in order to look like them. 
• While persuading themselves that they supposedly ate a lot.
• <300 calories / day

• Thinning hair
• Brittle nails
• Reduced iron in blood
• Fainting
• Unstable  teeth
• General weakness of the muscular and nervous system

A) Denial of the individual to maintain his/hers weight over the minimum limit according to his/hers  age and weight

• maintenance of body weight 15% lower than expected
• Body Mass Index below 16 (severe anorexia) and from 16 to 18.4 the individual is diagnosed with anorexia or is severely underweight.

B) Intense fear of gaining weight or becoming obese, even when his/hers weight is below the normal.

C) Disturbance in the way the person perceives his/her weight and body shape, or denial of the seriousness of being underweight.

D) In women, amenorrhea, ie absence of at least three consecutive menstrual periods.

Anorexia nervosa occurs in two different types:

A) Restricting type anorexia:

• The restricting type anorexia is characterized by a prolonged and strict abstinence from food.
• Patients with restricting type anorexia are usually introverted and refuse to admit that they feel hungry and anxious.

B) Binge eating / purging type anorexia:

• The binge eating / purging type anorexia is characterized by sporadic episodes of overeating followed by artificial purging.
• Patients with binge eating / purging type anorexia are characterized by openness, indicating frequent that they feel anxiety, depression and guilt, admit that they have a large appetite and tend to be older than patients with restricting type anorexia.

• Severe weight loss (weight <85% of normal or weight loss over 10% of original)
• BMI <17
• Absence of menstruation for at least 3 months
• Distorted perception of weight and body shape
• Excessive Exercise
• Induced vomiting - Use of laxatives or diuretics
• Social isolation - withdrawal from friends
• Emotional instability, irritability, anger
• Difficult in sleeping
• Amenorrhea in women and reduced sexual desire in men
• Poor peripheral circulation
• Soft, downy hair covering the body
• Perfectionism and phyco-compulsoriness
• Low self-esteem

• Restoration of weight at the weight target. Initial diet can sum up to 500 calories.
• Restore normal diet.
  • Evaluation and restoration of nutritional status of individuals
  • Provision of psychological support
  • Working relationships of trust and cooperative spirit
  • Nutritional retraining
  • Configuration balanced dietary behaviour.
• Diagnosis and treatment of medical complications due to starvation.
• Identification of denials and disfunctional thoughts, opinions and beliefs.
• Intervention to the family aiming their cooperation and to avoid their involvment.
• Psychotherapeutic intervention to enhance autonomy, facilitate the formation of identity, support the process of self-esteem and dealing with the feeling of worthlessness.
• Preventive intervention and education to prevent recurrence.