How do aneroxics stay skinny?
Anorexia nervosa was not officially classified as a
psychiatric disorder until the third edition of DSM in
1980. It is, however, a growing problem among adolescent females and its incidence in the United States has doubled since 1970. The rise in the number of reported cases reflects a genuine increase in the number of persons affected by the disorder, not simply earlier or more accurate diagnosis. Estimates of the incidence of anorexia range between 0.5-1% of Caucasian female adolescents.
Over 90% of patients diagnosed with the disorder
as of 1998 were female. It was originally thought that
only 5% of anorexics are male, but that estimate is being revised upward. The peak age range for onset of the disorder is 14-18 years, although there are patients who develop anorexia as late as their 40s. In the 1970s and 1980s, anorexia was regarded as a disorder of upper- and middle-class women, but that generalization is also changing. More recent studies indicate that anorexia is increasingly common among women of all races and social classes in the United States.
Anorexia nervosa is a serious public health problem not only because of its rising incidence, but also because it has one of the highest mortality rates of any psychiatric disorder. Moreover, the disorder may cause serious long-term health complications, including congestive heart failure, sudden death, growth retardation, dental problems, constipation, stomach rupture, swelling of the salivary glands, loss of kidney function, osteoporosis, anemia and other abnormalities of the blood.
Anorexics who are not severely malnourished can be treated by outpatient psychotherapy. The types of treatment recommended are supportive rather than insight-oriented, and include behavioral approaches as well as individual or group therapy. Family therapy is often recommended when the patient’s eating disorder is closely tied to family dysfunction. Self-help groups are often useful in helping anorexics find social support and encouragement. Psychotherapy with anorexics is a slow and difficult process; about 50% of patients continue to have serious psychiatric problems after their weight has stabilized.
Medications
Anorexics have been treated with a variety of medications, including antidepressants, anti-anxiety drugs, selective serotonin re uptake inhibitors, and lithium carbonate. The effectiveness of medications in treatment regimens is still debated. However, at least one study of Prozac showed it helped the patient maintain weight gained while in the hospital.
Prevention
Short of major long-term changes in the larger society, the best strategy for prevention of anorexia is the cultivation of healthy attitudes toward food, weight control, and beauty (or body image) within families.