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22 / 02 / 2018
Anorexia Nervosa
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Eating disorders - Anorexia nervosa - Bulimia nervosa - Binge eating disorder

Eating disorder is a newly recognized condition that probably affects millions. People with eating disorder frequently eat large amounts of food while feeling a loss of control over their eating. This disorder is different from binge-purge syndrome (bulimia nervosa) because people with binge eating disorder usually do not purge afterward by vomiting or using laxatives. Eating disorders are characterized by a preoccupation with weight that results in severe disturbances in eating and other behaviors. These disorders include anorexia nervosa, bulimia nervosa and binge eating disorder.

  • Anorexia nervosa. Essentially self-starvation, this disorder involves a refusal to maintain a minimally normal body weight. In severe cases, anorexia can be life-threatening.
  • Bulimia nervosa. This involves repeated episodes of binge eating, followed by ways of trying to purge the body of the food or of expected weight gain. People can have this condition and be of normal weight.
  • Binge eating disorder. This is characterized by frequent episodes of overeating without purging.

Other variations of eating disorders occur, such as purging without bingeing, chewing and spitting without purging, and anorexic behavior with less severe weight loss.

The exception is binge eating disorder, which appears to affect almost as many males as females.

Treatments for eating disorders may involve nutrition education, psychotherapy, family counseling and medications.

Anorexia - loss of appetite

It affect the most

It is most common among adolescents, adults and elderly people and is more prevalent among females. Male adults who have a busy schedule or have tensed personalities usually get affected.

Causes of Anorexia

The causes are
  • Acute febrile illness

  • Chronic infections: Tuberculosis

  • Decreased metabolic function as in:
    Addison's disease, (Primary hypoadrenalism)
    Hypothyroidism, (decreased thyroid function)
    Simmond's disease. (Adult Panhypopituitarism.)    

  • Local causes such as:
    Decreased Hydrochloric acid secretion
    Carcinoma of stomach
    Chronic gastritis
    Pernicious anemia

  • Psychic causes: Mental worry, fear, Anorexia nervosa.

  • Deficiency of vitamins: Particularly B-complex.

  • Physiological anorexia occurs due to:
    Inactive life
    Irregular eating and drinking
    Excess of carbohydrate food in between meals.

Symptoms of Anorexia

The symptoms are
  • Loss of appetite.

  • Loss of weight (if chronic).

  • Loss of texture of hair - rough and easily falling.

  • Muscle wasting.

  • Absence of menses.

  • If near or during puberty, the adult sexual characteristics may be absent or delayed.

Related signs

The signs are
  • Pale, wrinkled face

  • Sunken abdomen (Inverted saucer-like)

  • Sunken eyes may have dark circles.

  • Swollen ankles

  • Mental apathy and confusion.


The investigations carried out are
  • Complete Blood count

  • Blood Smear.

  • ESR .

  • Chest X-ray.

  • Specific tests for other Systemic causes.

Treatment measures

 Drugs generally used are
  • Appetizers 

  • Multivitamins.

  • Anabolic steroids, if required.

  • Specific treatment: Depends on the underlying cause.


The prognosis depends on the underlying cause

Anorexia prevention

 It can be prevented by following
  • Proper food habits from childhood.

  • Keeping the atmosphere relaxed at meal times.

  • Counseling teens to get rid of the fad of becoming thin.

  • Informing them about the risks of starvation.

  • Having at least one complete meal with the family.

  • Being imaginative when preparing food, especially for children.

  • Avoiding too many snacks and excessive fluids between meals.

  • Telling them about the importance of proper weight gain according to age and nutrition.

  • Planning proper diet program, may be with the help of a dietician.

  • Having mental peace and calmness; emotional support by family and friends.

  • Taking psychologist's help.

Important things one should know about Anorexia

The important things that one should know are
  • Diet should consist of appetizing food and intake of sweets between meals should be avoided.

  • One should not hurry while having meals.

  • Regular exercise is necessary.

  • Intake of fresh air.

  • Avoidance of smoking and alcohol. 

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.

In no event will the be liable for any decision made or action taken in reliance upon the information provided through this web site.
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Dr. Eddy Bettermann M.D.

Mob: +60.17 545 1784         +66.89 8550 5066





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