Anorexia Nervosa

     There are many clinical signs and symptoms in these clients.  Some of them include fatigue, dizziness, and fainting spells.  There may be irregular heart rhythms, low blood pressure, and dehydration.  Low blood pressure in these patients may accompany slow heart rhythms, orthostatic hypotension, and disturbance of the human heart’s electrical system. Menstrual irregularities may occur too.  Specifically, they cease menstruation altogether or suffer from its irregularities (1, 2).

     Indeed, myocardial atrophy is the structural hallmark of this illness.  There may be a decline of the left ventricular volume of the heart.  For some reason, there is mitral valve prolapse in many patients who have anorexia nervosa.  The explanation for this is not clear (1, 2).

      There also tends to be an array of mental health problems such as substance use disorder, anxiety, and depression.  The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is still the major format to follow with these cases along with history, physical, and laboratory data.  The list of findings in these individuals may include electrolyte imbalance, dysfunction of the kidneys, damage of the brain, and bone loss.  Should these ominous findings occur, death of the patient may take place unless emergency care quickly enters the picture.  In fact, one-fifth of these deaths happen from anorexia nervosa because of suicide (1, 2).

     Another important matter is the presence of osteoporosis and osteopenia.  Young men who have anorexia nervosa may suffer from loss of bone mineral density.  They may also have low serum levels of testosterone (1, 2).

     One must not confuse bulimia with anorexia nervosa (AN).  One major difference is that bulimic patients tend to hold onto their weight.  For those with anorexia nervosa, the reverse is true.  In fact, they have very little interest in going to clinics for help and evaluation.  Individuals with bulimia may eventually have excessive weight (1, 2).

     Despite the well-known occurrence of these two disorders, health care personnel remain unclear on some issues.  For example, these disorders have biological, environmental, and psychological components.  They also tend to have obsessive-compulsive personality traits.  Additionally, girls and women feel that society pressurizes them to maintain low body weights.  Another item that hospital staff have observed over many decades is that anorexia nervosa mainly develops during the teen years.  The occurrence of it is still more common in women than men.  Moreover, few cases take place in those who are at least 40 years of age.  In any event, these women may deal with neglect, physical abuse, and sexual assault.  Obviously, many of them do not have a good support system.  Moreover, there is psychological pressure which may leave them with exercise or modeling as their livelihood (1, 2).

     Anorexia nervosa is a distressing disorder which has likely been present for centuries.  Much progress has taken place over the last century, and diagnosis and management have also progressed.

1. Cost, J., Krantz, M., and Mehler, P.  (2020).  Medical complications of anorexia nervosa.  Cleveland Clinic Journal of Medicine, 87, 361-366.
2. Mayo Clinic.  (2020).  Anorexia nervosa (AN). 
3. Kay, D. and Leigh. D.  (1954).  The natural history, treatment and prognosis of anorexia nervosa, based on a study of 38 patients.  From the Bethlem Royal and Maudsley Hospitals.
4. Copyright 2020.  All rights reserved.  Michael Koger, Sr., M.D. 

 The information contained in this article is for educational purposes only, and one should not use it for diagnosis or treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.