Causes of anorexia in women - what is the trigger for the onset of anorexia? Anorexia - symptoms and signs.

Often dreams of a slim and attractive body turn into terrible health consequences.. Oddly enough, but most often those who do not need to lose weight want to. Such girls are guided by the images imposed by modern canons of female beauty: exquisite sunken cheeks, clearly defined cheekbones and a slender figure. Such aspirations lead to a terrible disease called anorexia, what it is, how the disease manifests itself and why it is dangerous, we will consider in this article.

Anorexia refers to neuropsychiatric disorders, which is characterized by an obsessive desire to lose "extra" weight.

Anorexia is a mental disorder characterized by a conscious refusal to eat in order to normalize one's own weight. The desire to find an ideal body can reach mania, this leads to the fact that the girl reduces the amount of food consumed, and subsequently completely refuses it. In such women, the need to eat causes cramps, nausea and vomiting, and even the smallest portion can be perceived as gluttony.

With this disease, the girl experiences a distortion of her own perception, it seems to her that she is fat, even when the weight reaches a critical point. Anorexia is a very dangerous disease that leads to pathologies of internal organs, mental disorders, and in the most severe cases, death of the patient.

Causes of the disease

Despite the fact that there is more and more data on anorexia, it is quite difficult to answer the question of what kind of disease anorexia is and what causes it. There are a number of factors that can trigger the disease. The causes of anorexia can be the following:

1. Genetic. The study of information about human DNA has revealed certain loci in the genome that significantly increase the risk of developing anorexia. The disease develops after a powerful emotional shock, with excessive physical exertion or malnutrition. If there are no provoking factors in the life of a person with a similar genome, he will remain healthy.
2. Biological. This category includes: overweight, early regulation and pathology of the endocrine nature. An important factor is the increased level of specific lipid fractions in the patient's blood.
3. Hereditary. The risk of anorexia increases in people who have a family history of people with mental disorders. In addition, the chances of the disease increase in those whose relatives suffered from alcoholism or drug addiction.
4. Individual. The disease is more common in people with certain personal qualities. The desire to comply with the canons of beauty, the lack of a clear life position, uncertainty and the presence of complexes increase the risk of a mental disorder.
5. Gender and age. Most often, the disease manifests itself in adolescence, much less often after twenty-five years. In addition, in more than ninety percent of cases, anorexia affects the fair sex.
6. Social. Living in a society where the standard of female beauty is a slender body, has big influence to the diet. Young girls, trying to follow such criteria, refuse to eat a full meal.

Signs and symptoms of anorexia appear against the background of fear of imaginary obesity

Stages of anorexia

First stage. At the initial stage, it seems to the girl that she is overweight, because of which she is constantly subjected to ridicule and humiliation, which leads to a depressive state. A young woman is obsessed with the issue of losing weight, which is why the results of constant weighing occupy all her thoughts. It is very important not to miss the first symptoms of the disease, because at this stage anorexia is successfully treated, without consequences for the woman's body.

Second stage. With the advent of this stage, the patient loses his depressive mood, and is replaced by a firm conviction that he is overweight. The desire to get rid of extra pounds is strengthened. Self-weight measurements are made every day, and at the same time, the bar of the desired weight is getting lower and lower.

Third stage. The onset of this stage is indicated by a complete refusal of food, a forced intake of food can cause disgust and vomiting. At this stage, the girl can lose up to fifty percent of her original weight, but she will be sure that she is still fat. Any talk about food leads her to aggression, and she herself claims that she feels great.

Varieties of anorexia

This disease may be preceded by various factors, in connection with this, the following types of anorexia are distinguished:

mental- occurs with mental disorders in which there is no feeling of hunger. Such pathologies include schizophrenia, paranoia, some types of depression, etc. In addition, the development of this species can be influenced by alcohol and drug addiction.

symptomatic- develops against the background of a severe somatic disease. In particular, in diseases of the lungs, gastrointestinal tract, hormonal or genitourinary system. The loss of hunger arises from the need for the body to direct all its forces to fight the disease, and not to digest food.

nervous- another name for this type of "psychological". In this case, the girl consciously refuses food, being afraid to gain even one extra kilogram. This type is especially dangerous in puberty. We will consider the symptoms and treatment of anorexia nervosa below, but among the main signs of the disease, the following should be highlighted:

• attempts to get rid of the accepted food, by inducing vomiting;
• increased exercise in order to reduce weight;
• taking fat-burning and diuretic medications.

More than 80% of all cases of anorexia appear between the ages of 12-24

Medicinal- this type of disease manifests itself with prolonged use of medications aimed at weight loss. Antidepressants, diuretics, laxatives, psychotropic drugs, as well as drugs that give a feeling of satiety with small portions eaten can also provoke anorexia.

Symptoms and signs of anorexia

The following symptoms may indicate that the disease has already begun to have a devastating effect on the body of a woman:

• regular talk about weight loss;
• exclusion from the diet of high-calorie foods;
• hunger strikes;
• frequent depression.

If it was not possible to determine anorexia at this stage, then more pronounced symptoms of the disease appear. The amount of food consumed is significantly reduced, but the amount of fluid drunk increases. Many girls artificially induce vomiting after each meal, which in most cases leads to bulimia. In order to quickly lose the hated kilograms, enemas, diuretics and laxatives are often used.

By the beginning of the third stage of anorexia, there are changes in the appearance of the girl that cannot be overlooked. The skin becomes thinner, begins to peel off, tone and elasticity are lost. Dystrophy of muscle tissue occurs, and the subcutaneous fat layer completely disappears. The bone skeleton is clearly visible through thin skin. Teeth deteriorate, hair and nails become brittle and lose their luster.

Significant disturbances also occur in the internal organs, the level of blood pressure drops significantly, the body temperature drops, the pulse rate decreases, becoming below normal. Gastritis, ulcers and lazy bowel syndrome develop, pathological changes occur in the heart muscle. The girl increasingly falls into despondency and apathy, she is haunted by fatigue and impotence.

Consequences of the disease

Conscious starvation leads to catastrophic consequences for all internal organs and systems.

1. cardiac muscle. Blood flow slows down, blood pressure levels decrease. The level of essential minerals and trace elements in the blood drops. Such changes lead to electrolyte imbalance and arrhythmia, and in the most severe cases to complete cardiac arrest.
2. Hormonal system. The level of prolactin, the stress hormone, increases, and the growth hormone, on the contrary, becomes less. Decreased amount of hormones involved in reproductive functions women. In this regard, there are interruptions in the menstrual cycle, in some cases there is a complete absence of it. In the later stages, it cannot be restored even after the course of treatment.
3. Skeletal system. Deficiency of calcium and vital minerals leads to a decrease in bone mass, mineral density decreases, bones become brittle.
4. Digestive system. There is a slowdown in the functions and processes of digestion, the body is in an energy-saving mode. An ulcer, gastritis develops, constipation and swelling can torment.
5. Nervous system. In the most extreme cases, nerve damage can occur, convulsions, seizures, and limbs become numb. As a result, it becomes the cause of mental and mental disorders.
6. Blood. The blood becomes thicker, the blood supply worsens. Lack of vitamins and minerals leads to anemia.

In addition to the above problems, degenerative changes occur in the liver, the body becomes dehydrated, weakness and fainting appear.

The most terrible complication of anorexia is the launch of the body's mechanisms to self-destruct

Treatment

Due to the fact that the first signs of anorexia in girls, as a rule, go unnoticed, and they themselves do not accept advice and deny the problem, therapy begins at the stage when the patient is taken to a medical institution in critical condition. It is not uncommon for relatives to call an ambulance even when a woman is dying.

Therapeutic measures to stabilize the condition of the anorexic include force-feeding through a dropper. First of all, doctors must find out the cause that led to such a serious condition. Having determined the factor that caused the disease, a course of drug treatment is prescribed. After the patient's condition stabilizes, psychologists and nutritionists begin to work with her.

Anorexia is an extremely dangerous disease that can be fatal.

Girls who are faced with a problem are often not able to solve it on their own. It is very important that relatives and close people pay attention to the patient's condition in a timely manner and begin treatment until pathological changes occur in the body.

Valeria was a very strong and educated person, but the disease could not win

From a computer monitor, from a TV screen, from glossy pages, we are increasingly frightened by photos of people suffering from a terrible disease called anorexia nervosa. This eating disorder is not only life-threatening, but also fatal. In about 5% of cases, anorexia is fatal. You need to understand that the first signs of anorexia do not appear immediately. Times have changed. Anorexia nevrosa is the brainchild of the 20th century. Rubens' forms have not been held in high esteem for a long time, but here is the “beauty standard” for young fashionistas. Initially, there is an obsessive desire to lose weight. And in any way! These are all kinds of diets up to the complete refusal of food, and taking various “magic” pills, and exercising in the gym to exhaustion, and all kinds of “cleansing” of the body. There is a devastating fear of gaining weight. Here it is impossible to cross the line between the norm and pathology, a healthy desire to say goodbye to extra pounds and a pathological obsession to lose weight. It is important not to miss the first symptoms of anorexia.

What is important to remember

The psychology of anorexia includes three main "whales". These are the symptoms of an altered psyche:

• biased perception of one's own body;
• panic fear of gaining excess weight;
• categorical refusal to maintain normal body weight.

What needs to be understood

The psychology of anorexia includes such an abnormal condition as the need to feel hungry. This desire can cause addiction, similar to drug addiction. The patient is focused only on thoughts about food, its calorie content, weight loss methods, all kinds of diets. Family, work, friends and hobbies fade into the background. Dropping kilograms, the anorectic can no longer stop, he wants to lose weight more and more! Dissimulation is a characteristic feature of the psychology of anorexia. This is the name of the patient's desire to hide his health problems. Usually relatives and friends learn about the disease after six months - a year.

What is worth learning

The greatest wisdom is self-acceptance. You need to learn to appreciate, respect and love yourself the way you are now. Everyone, without exception, has the right to be happy today!

Who is sick with Anorexia Nevrosa

Out of every thousand young people, 3-10 people suffer from anorexia. Women among all patients - 95%. Photos of slender beauties with fashionable parameters “90-60-90” force girls from school to exhaust themselves with diets in pursuit of the slender beautiful figure glorified in their dreams.

Photos of top models with a perfect figure "demolish the roof" for both young and adults. True, little girls often ask the question ““. Meanwhile, Anorexia nervosa is an occupational disease of fashion models. Suffice it to recall the 22-year-old Brazilian supermodel Ana Carolina Reston. With a height of 172 cm, she weighed only 40 kg. The developed acute liver failure did not leave her a chance to survive.

12-25 years is the typical age of patients. This is the third most common chronic disease in adolescents, when height and body weight are far from ideally correlated. The role of hereditary factors in the development of the disease has been proven. It has been observed that persons suffering from anorexia nervosa are usually born to elderly parents, usually well off.

Only 30 years ago it was believed that anorexia nervosa could develop exclusively in women. Practice shows that for eighteen women with anorexia, there is one man.

Anorexia can have specific causes. It has been proven that people with zinc deficiency in the body suffer from anorexia more often. There are drugs, the uncontrolled use of which leads to loss of appetite. Medications that cause anorexia:

• psychostimulants (for example, amphetamine);
• caffeine;
• chemotherapy drugs in cancer patients;
• sympathomimetics (eg ephedrine);
• some antibiotics;
• this property is also attributed to senna, a laxative that is very often used by anorectics.

Patients themselves often call some kind of severe stress the cause of the disease, but this is not the cause of anorexia, but only a starting point.

Symptoms of anorexia

So, it is clear that anorexia nervosa is a disease that is better to prevent than to cure. Whether you belong to a risk group, a table of optimal weight will help determine the height and weight of the body today. The symptoms of anorexia are not just low weight. The first signs of anorexia usually begin with a weight equal to "height-125".

Isabelle Caro, writer, actress

What are the signs or symptoms of anorexia?

It is these symptoms that will help in time to lend a helping hand to a sick person. Here they are:

• The first sign of anorexia is dysmorphomania, when women develop a painful conviction that they have an imaginary physical defect. For example, a girl is sure that she is “fat”, and it is impossible to dissuade her of this.
• Weight is 25% less than the age norm. A table that takes into account height, body weight, body type and gender will help you calculate your optimal weight.
• Violation menstrual cycle and amenorrhea (absence of menses) in women. In the blood serum, the level of estradiol drops markedly.
• Anemia is a decrease in hemoglobin in the blood. This is manifested by pallor of the skin, fainting, bruising under the eyes.
• Passion for laxatives, diuretics and emetics.
• Long stay in the toilet, which may indicate constipation or emptying the stomach with the help of forced vomiting.
• Increased sensitivity to cold, light and sound.
• The appearance of a large amount of hair on the face and body.
• and pain in the abdomen.

Constipation is one of the early signs of anorexia. The rate at which food is absorbed by the body is very slow. The constant intake of laxatives and the forced vomiting that is caused lead to a violation of the water and electrolyte balance, which also provokes stool retention.

When the body does not receive the calories it needs for a long time, it begins to "devour" itself. Creepy thing, right? All metabolic processes in the body slow down, because it chronically experiences energy hunger. This results in the following symptoms:

• bad mood, irritability, up to suicide;
• memory impairment and slowing of mental activity;
• constant desire to lie down, sleep;
• lack of interest in men;
• skin problems, brittle nails and hair loss;
• atrophy of the mammary glands;
• painful constipation;
• fluctuations in blood pressure, often lowering, pain in the region of the heart, bradycardia (rare pulse 40-50 in 1 minute);
• fainting, dizziness, headaches;
• inflammation of the parotid and submandibular lymph nodes;
• tooth decay and gum disease.

As can be seen from the symptoms, anorexia nervosa destroys both the mind of a person and his body.

Complications and side diseases of unhealthy thinness worsen the condition of women like a snowball. Photos of patients with anorexia are simply shocking. Having growth above average, their weight does not exceed 40-50 kg!

Diagnostic Tests for Anorexia Nervosa

Anorexia nervosa- multiple organ disease. Therefore, a thorough medical examination of patients will be justified.

Test 1

After passing this simple test, each person will be able to determine whether he has a predisposition to anorexia nervosa or not. It is enough to truthfully answer the following questions:

• Do you consider yourself a fat person, even if others do not think so?
• Do you hide from others that you eat very little?
• Are you afraid of gaining excess weight?
• Do family and friends worry that your eating habits have changed and you are rapidly losing weight?
• Do you vomit or "cleanse" your bowels when you feel like you've eaten too much or overeaten?
• Do you feel satisfied during fasting or body cleansing?
• Does your weight affect your self-esteem?

If you answered yes to these questions, hurry to a specialist for qualified help.

Test 2

A biochemical blood test will help diagnose anorexia. An increase in somatotropic hormone and cortisol and a decrease in T3 with a normal concentration of TSH and T4 are characteristic. There are low levels of glucose, potassium, magnesium and sodium, high level cholesterol.

Test 3

The urinalysis shows elevated ketones, which means the body is burning fat as its only source of energy.

Test 4

In the general blood test, a decrease in hemoglobin and leukocytes is noted.

Test 5

ECG in anorectics shows serious disturbances in the work of the heart - vascular system. A variety of arrhythmias are noted.

Test 6

A fecal occult blood test may be positive. This indicates the presence of big problems with the intestines.

Test 7

There is a table that takes into account the height and weight of a person and determines his optimal weight. BMI (body mass index) will help with this. It is calculated simply: body weight in kilograms divided by height in meters squared. If the BMI is below 17.5, this may indicate the presence of anorexia.

Test 8

Women of childbearing age who suffer from anorexia cannot become pregnant. A pregnancy test will never show the cherished two stripes!

Treatment of anorexia nervosa

The treatment of anorexia is long and difficult. To change the attitude towards oneself and the world around is the main task in the treatment of anorexia. Patients begin to feel that anorexia nervosa has become their "friend" and gives a feeling of high from the ability to control the volume of food eaten. Most sick women stubbornly deny that they have a problem, and therefore deny the need for treatment.

Alas, even the started competent treatment of painful thinness does not guarantee a "happy ending". But you can not turn away from women in trouble! Alone, anorexia nervosa will remain undefeated. It is necessary to start treatment only when a person understands that he is sick, objectively assesses how his height and weight correlate. Ideally, if there is a professional psychologist nearby for the entire treatment, who will not judge, but will help restore a healthy attitude towards your body and food. Talking about diets, slimness and weight loss should be tabooed. One of the principles of treatment is changing the circle of communication.

The process of re-feeding should take place very carefully and slowly, gradually and slightly increasing the caloric content of the food eaten per day. For treatment, intravenous infusions and fractional nutrition through a tube that is inserted directly into the stomach are also used.

Western doctors recommend that relatives during treatment keep patients under constant control, avoid prolonged seclusion in the toilet, especially monitor going to the toilet after about a couple of hours after eating, patients often arrange themselves with washing from both ends.

There is no effective medical treatment for eating disorders yet. The drug of choice is fluoxetine, an antidepressant. The neuroleptic Zyprexa (Olanzapine) in low doses acts as an adjuvant in the psychotherapy of anorexia nervosa.

By learning to love yourself, having patience, anorexia can be defeated! You can't despair! Let only happy faces in love with life always look from your photos!

Dear friends! The medical information on our website is for informational purposes only! Please note that self-medication is dangerous for your health! Sincerely, Site Editor

Often the desire to gain harmony turns into serious health problems. Surprisingly, most often those who don’t really need it try to lose as much weight as possible: girls and women with normal weight become victims of their own ideas about a beautiful figure, which leads to a disease called “anorexia”.

What is anorexia disease?

Passionate, reaching a manic desire to lose weight leads to the fact that a woman suppresses her appetite, gradually reduces the amount of food, and then completely refuses it, and the need to take it causes disgust, nausea and vomiting. Even a small portion of food is perceived as overeating. All this is an anorexia disease, which gives rise to a number of ailments associated with disruption of the body systems and mental disorders.

How does anorexia start?

As a rule, there are no obvious reasons for losing weight in females who subsequently suffer from this disease. Most of them are teenage girls and young women who are not burdened with extra pounds, but are convinced that they simply need to lose weight. Often, relatives, friends, loved ones tell them about the same. The main phrase in a conversation with them: "I'm fat."

Gradually, the desire to lose weight becomes manic, and this obsession replaces common sense, even when patients with anorexia look at themselves in the mirror: there they stop noticing the emaciated body, often representing a skeleton covered with skin, mutilated limbs, the face of a man exhausted by hunger. The disease begins to progress and moves from stage to stage, aggravating the condition of the diseased.

Stages of anorexia

Anorexia is a dangerous mental illness that can lead not only to loss of health, but also to death. The disease can have a latent course: the development of the disease occurs gradually, and the sick person, if measures are not taken for treatment, gradually “extinguishes”, without noticing it. At the same time, he is in full confidence that he needs to continue to lose weight.

1. At the first stage, a person begins to imagine that he has excessive fullness, because of which he has become the object of ridicule and humiliation, which causes extreme depression. He is constantly concerned about the issue of weight loss, so weighing and its results occupy him most of all - these are the first symptoms that indicate that anorexia is beginning to develop. Stage 1 of the disease is treatable, so it is important not to miss it.
2. When stage 2 sets in, anorexia is characterized by the patient's determined mood to lose weight: depression goes away, but there is a firm belief that the patient is really overweight, which simply needs to be gotten rid of. Weighing becomes a daily procedure, while the weight loss bar drops lower and lower.
3. If the patient no longer feels the need for food, categorically refuses food, he develops a stable aversion to it, it can be argued that stage 3 has come: anorexia causes weight loss up to 50%. But this does not stop the patients: they continue to insist that their weight remains large enough. Talking about food now only causes irritation, and they themselves assure that they feel great.

Anorexia - causes

The causes of anorexia are not as few as it might seem at first glance, because the history of the disease is different for everyone. That is why different experts define the causes of its occurrence in their own way. Some believe that the failure that occurred in the work of the digestive system of the body is to blame for everything, according to others, the disease appears against the background. However, a deep study of the nature of the disease allows us to identify the following causes of anorexia:

• the desire to imitate the "catwalk models", considering them the standard of beauty;
• lack of a firm life position, insufficient personality development;
• frequent depression and stressful conditions, conflicts with relatives and peers, a feeling of anxiety that does not go away;
• chronic diseases of the gastrointestinal tract;
• response to the reception medicines;
• alcoholism and drug addiction.

Signs of anorexia

The fact that the disease begins its destructive effect may already be indicated by the first signs of anorexia:

• constant talk about the need to lose weight;
• rejection of high-calorie foods;
• for some, the beginning of hunger strikes;
• recurring depression.

If at this stage assistance, including psychological, is not provided, signs of the second stage of the disease soon appear:

• the set of products in the diet is sharply reduced, but the amount of water drunk increases;
• food eaten is often forcibly disposed of, causing vomiting;
• enemas are often used to speed up weight loss;
• diuretic and laxative drugs are actively used.

In the third stage, changes occur that become visible to the naked eye:

• the skin becomes thin, flabby and flaky;
• muscle tissue becomes thinner, and the fat layer disappears completely;
• the bones of the skeleton are visible through thin skin;
• teeth deteriorate;
• hair and nails become dull and brittle.

There are disturbances in the activity of internal organs: there is a drop in blood pressure and body temperature, the pulse becomes much lower than normal. Perhaps the development of gastritis and intestinal lethargy, marked dystrophy of the heart muscle. There is increased weakness and fatigue, unwillingness to study or work.

Symptoms of anorexia in girls

According to experts, in girls, the disease can indicate itself before clinical signs appear. At the same time, they often do not pay attention to them, attributing them to the most different reasons feeling unwell: physical and mental overwork, family conflicts, problems at work, not realizing that this manifests its symptoms of anorexia and manifests itself in this way:

• mood swings;
• manifestations of unmotivated aggression;
• tendency to provoke conflicts;
• irritation towards adults who are overweight.

Types of anorexia

If the psychology of anorexia is known, then ways to overcome it with timely detection are possible, and due to the fact that the disease has various factors of occurrence, several of its types are distinguished:

• mental, which appears with nervous overload and mental disorders that contribute to loss of appetite and as a result of taking psychotropic drugs or alcohol;
• symptomatic, which is a sign of severe somatic damage to one or more body systems;
• nervous, or psychological, caused, like mental stress, and characterized by a conscious refusal of food and dissatisfaction with one's own body;
• medicinal, which was the result of exceeding the norms for taking various drugs.

Primary anorexia

According to experts, the origins of anorexia lie in childhood and are most often associated with a violation of the child's diet. If he ate at different times, he was overfed or used tasteless or inedible foods, forced to eat by force, the foundations of the disease were laid in childhood. The primary stage lays the foundations of the disease that adults with anorexia will feel on themselves.

Anorexia nervosa

If the primary symptoms can be perceived as the first bell about the onset of the disease, then the manic, unhealthy desire to lose weight at any cost is already perceived as the beginning of a mental disorder. This type of anorexia is extremely dangerous in adolescence, but if timely measures are taken to correct behavior, recovery is possible. This is anorexia nervosa, the symptoms of which confirm the seriousness of the problem:

• the desire to be sure to get rid of the food eaten through and washing the intestines;
• increased physical activity leading to weight loss;
• taking fat-burning and diuretic drugs.

Psychogenic anorexia

The disease is similar to anorexia nervosa, however, as a rule, it is caused by some serious mental trauma and is accompanied by neurosis, hysteria and impaired functioning of individual body systems and the occurrence of diseases caused by nervous disorders. Mental anorexia occurs as a response to serious mental trauma, leading not only to the refusal of food, but also to the appearance of paranoid deviations of the mental state.

drug anorexia

Medication anorexia can occur with certain medications that are not associated with weight loss or are specifically taken for weight loss. In order not to provoke the disease, it is necessary to know the drugs that cause anorexia. Among them: antidepressants, diuretics, laxatives, psychotropic drugs and drugs that increase the feeling of satiety with minimal meals.

Anorexia - treatment and consequences

Treating anorexia is not easy, because it is based on many psychological problems. The main difficulty will not even be treatment, but the ability to convince the patient of its need, and this is an extremely difficult task. If it is solved, then with the help of psychologists, psychiatrists, nutritionists and therapists, the disease can be defeated, but this process will be quite long.

Each individual case will have its own recipes for how to treat anorexia. The consequences of anorexia can be the most tragic, this disease gradually kills a person not only mentally, but also physically: destruction occurs protective systems organism, their working capacity gradually fades away, the psyche passes into a twilight state and the death of the patient becomes a natural result.

Before we turn to the consideration of the features of anorexia, let us dwell on what the indicated condition is, to which it can lead, that is, protein-energy malnutrition (abbr. PEN).

PEU is defined as a nutritional state resulting from an energy imbalance, as well as an imbalance of proteins and other types of nutrients, which in turn leads to an undesirable effect on functions and tissues, as well as similar clinical outcomes. In the case of anorexia, PEU occurs against the background of inadequate food intake (although along with it, body conditions such as fever, drug treatment, dysphagia, diarrhea, chemotherapy, heart failure, radiation therapy and other effects on it leading to PEU) .

Symptoms of protein-energy malnutrition manifest themselves in a number of ways. Meanwhile, it is against its background that weight loss occurs in adults (not too noticeable with obesity or general swelling), and in children there are no changes in terms of weight gain and growth.

Let us dwell on a generalized consideration of the symptoms of the disease that interests us initially. Actually, with anorexia (i.e., in the absence of appetite), patients lose weight, and this disease itself can be a companion of another type of disease (oncological, somatic, mental, neurotic diseases). Lack of appetite is persistent, accompanied by nausea, in some cases vomiting occurs as a result of attempts to eat. In addition, there is increased satiety, in which the feeling of fullness in the stomach, even with a small amount eaten.

The listed symptoms can act both as the only manifestations of anorexia, or be the leading manifestations general condition patient, or be accompanied by many other complaints. Diagnosis in this case directly depends on what symptoms of anorexia are accompanied.

Anorexia can occur in a number of conditions, we highlight some of them:

• neoplasms of a malignant type, which have a different nature of manifestation and their own different features of localization;
• diseases of the endocrine system (hypopituitarism, thyrotoxicosis, diabetes mellitus, Addison's disease, etc.);
• alcoholism, drug addiction;
• helminthiasis;
• depression;
• intoxication.

Remarkably, the very definition of "anorexia" is used not only in the designation of the symptom that it represents (decreased appetite), but also in the definition of the disease, which in particular is "anorexia nervosa".

Anorexia determines a fairly high mortality rate for patients. In particular, on the basis of some data, it is possible to determine its rate of 20% for all patients with anorexia. Remarkably, in about half of the indicated percentage of cases, mortality is determined by the suicide of patients. If we consider natural mortality against the background of this disease, then it occurs due to heart failure, which, in turn, develops due to general exhaustion achieved by the body of a sick person.

In about 15% of cases, women, being carried away by weight loss and diets, reach a state in which they develop an obsessive state in combination with anorexia. In most cases, anorexia is diagnosed in adolescents, as well as in young girls. Like the victims of drug addiction and alcoholism, anorexics do not recognize the fact that they have any kind of violation, nor do they perceive the severity of the disease itself.

Anorexia can manifest itself in the following varieties:

• Primary anorexia . In this case, we consider the lack of appetite in children due to various reasons, as well as the loss of hunger due to hormonal dysfunction, a malignant tumor, or neurological pathology.
• Anorexia mental (or nervous cachexia, anorexia nervosa). In this case, mental anorexia is considered as a condition with refusal to eat or with a loss of hunger due to suppression of appetite against the background of psychiatric diseases (catatonic and depressive states, the presence of delusional ideas about possible poisoning, etc.).
• Anorexia mental morbid . In this case, patients with anorexia have a painful feeling of weakening and loss of the ability in the waking state to be aware of the feeling of hunger. The peculiarity of this type of condition lies in the fact that in some cases they are faced with almost "wolf" hunger in a dream.
• drug anorexia . In this case, conditions are considered in which patients lose their sense of hunger, provoking this loss either unconsciously (when treating a particular type of disease) or intentionally. In the latter case, efforts are aimed at achieving the goal of weight loss through the use of appropriate drugs, in which the loss of hunger occurs. In addition, in this case, anorexia acts as a side effect when using certain stimulants, antidepressants.
• Anorexia nervosa . In this case, it means a weakening of the feeling of hunger or its complete loss, which arose as a result of a persistent desire to lose weight (often such a desire does not find an appropriate psychological justification) with excessive restriction of patients in relation to food intake. This type of anorexia can provoke a number of serious consequences, among which metabolic disorders, cachexia, etc. appearance, in other cases, the results achieved cause them a sense of satisfaction.

We considered the states of mental anorexia and painful mental anorexia in sufficient detail for a general description of these conditions (in particular, this concerns its painful form; mental anorexia is characterized by a complex picture of the clinic, determined on the basis of a concomitant psychiatric disease). Therefore, below we will consider the remaining forms of the disease (respectively, with the exception of the forms indicated).

Primary anorexia: symptoms in children, treatment

This type of anorexia is in fact a serious problem that exists within the framework of modern pediatrics, and this problem is caused by the fact that it occurs quite often, and it is not so easy to treat. Poor appetite in a child - such a complaint often accompanies a visit to the attending physician, and, you see, it does not lose its relevance. Signs (symptoms) of anorexia in a child can manifest themselves in different ways: some children cry when it is necessary to sit down at the table, thereby refusing this need, others start a real tantrum, spitting out food. In other cases, children may eat only one of the dishes every day, or even their meal is accompanied by severe nausea with vomiting.

It should be noted that anorexia in children can be not only primary, but also secondary, in the latter case it is caused by concomitant diseases of the gastrointestinal tract and other systems and organs that are relevant for a small patient. Secondary childhood anorexia in its own symptoms is considered strictly individually, depending on the disease that accompanies it, but we will focus on primary anorexia that occurs against the background of eating disorders in healthy children.

As those main factors, the impact of which leads to the development of the form of anorexia we are considering, the following are distinguished:

• Eating disorders. As our readers probably know, the development of the food reflex, as well as its consolidation, is ensured precisely by the regime in which, accordingly, certain feeding hours are observed.
• Allowing the child to consume easily digestible carbohydrates during periods of intervals between the main feeding. These carbohydrates include sweets, sweet soda, chocolate, sweet tea, etc. Because of this, in turn, there is a decrease in the excitability of the food center.
• Food that is the same own composition, the same type of menu in feeding. For example, feeding exclusively on dairy products or fatty foods, or carbohydrates, etc.
• The transfer of a disease of a particular etiology by a child.
• Large portions for feeding.
• Overfeeding a child.
• Sudden change in climate.

Anorexia nervosa in children, as one of the forms of primary anorexia, occupies a special place, it is caused by force-feeding. So, for example, in many families, the refusal of a child to eat is equated almost to drama, which is why parents and family members go to various tricks in order to still feed him. Various methods are used, ranging from distracting the child (which means, for example, distraction with music, fairy tales, toys, etc.), and ending with tough measures, which, again, are designed to ensure the peace of the parents due to the fact that during their implementation, the child - ate "as it should."

Any of the listed methods (naturally, these are only two directly opposite options, it may be allowed to use various activities leading to the same result under consideration) lead to a sharp decrease in the excitability of the food center, and also ensure the development of a negative form of the reflex in the child. This reflex manifests itself not only in the form of a negative reaction to the need for feeding with concomitant pushing away of the spoon and the occurrence of vomiting, but also in the form of a manifestation of a specific reaction, which, again, consists in the appearance of vomiting, but occurring even with the mere sight of food.

In removing the child from the state of anorexia, it is necessary to focus on the following step-by-step actions (before that, it is important to determine what the error that led to this condition is):

• Provision of nutrition according to age, however, with a reduction in portions by a factor of three. In addition, foods that stimulate appetite are additionally introduced (this measure is acceptable if anorexia is eliminated in children from 1 year old): garlic, salted vegetables, etc. Carbohydrates and fats (sweets, sweets, etc.) should be excluded from the child's diet.
• With the return of appetite, the volume of servings can be gradually increased, leaving proteins normal and excluding half of the fats from the norm established in accordance with age.
• Further, a return to the original diet is provided, the fats in it should also be limited.

To the general recommendations regarding primary anorexia in children, we add the following. So, by the first half of the day, it is necessary to give children protein foods and fatty foods, including carbohydrate foods, including dairy products, in the diet of the second half of the day. Gradually, it will be possible to make the transition to a standard diet.

With physical or emotional overwork, it is important to postpone the meal for the time following the child's rest. No less important is such a moment as concentrating on a meal, without any distractions. The introduction of new dishes into the standard diet is carried out in small portions, in particular, attention should be paid to the design and presentation.

Beautiful dishes are important, in comparison with the volume of the serving, the dishes should look larger - this will allow the child to “deceive” that there is not much food. If the child refuses food - do not force him, wait next period feeding. Do not force a child with anorexia to eat completely, hungry pauses in this case have their own benefits. In a situation where the child is sick, in no case do not scold him, on the contrary, try to distract him, waiting for the next feeding. In it, if possible, try to offer the child a choice of several options for dishes, however, the "golden mean" is no less important - you also do not need to reduce food intake to a restaurant meal.

In conclusion, we note that parents mistakenly treat hyperactive games with their interruption for eating. This kind of entertainment for the child should be planned for the period following the main meals.

Anorexia nervosa: symptoms

Anorexia nervosa, first of all, is common in adolescents (girls), who lose about 15-40% of their weight from the norm against its background, and, unfortunately, cases of anorexia nervosa in this category of patients are only becoming more frequent. The basis of the condition under consideration is that the child is dissatisfied with his own appearance, which is complemented by an active, but, as a rule, hidden desire to lose weight. To get rid of excess, in their opinion, weight, adolescents sharply limit themselves in nutrition, provoke vomiting, use laxatives, and exercise intensively.

Hence the desire to take a standing position, and not a sitting one, which, in their opinion, provides a greater expenditure of energy. The perception of one's own body is distorted, a real horror appears associated with the possibility of obesity, an acceptable result for themselves, patients with anorexia see only low weight.

As a result, children lose weight, and in many cases reaching critical levels, many develop a negative food reflex. Moreover, this reflex in many reaches such a form that even after the teenager's own conviction of the need to take food, attempts to do so lead to vomiting. All this causes exhaustion, as well as poor tolerance for high / low temperatures, the appearance of chilliness, and blood pressure decreases. There are changes in the menstrual cycle (menstruation disappears), body growth stops. Patients become aggressive, it is difficult for them to freely orient themselves in the surrounding space.

Anorexia nervosa develops in several stages.

• Initial (or primary) stage

Its duration is about 2-4 years. A characteristic syndrome for this period is the syndrome of dysmorphomania. V general plan this syndrome implies the presence in a person of a painful belief, which is delusional or overvalued, regarding the presence of one or another imaginary (exaggerated or overestimated) defect. In the case we are considering with anorexia, such a defect is overweight, which, as is clear from the definition of the syndrome, may not be such at all. Such a belief in one's own excess weight in some cases is combined with a pathological idea regarding the presence of a different type of shortcomings in appearance (the shape of the ears, cheeks, lips, nose, etc.).

The determining factor in the formation of the syndrome under consideration is that the sick person does not correspond to the “ideal” chosen for himself, which can be anyone, from a literary hero or actress to a person from his inner circle. The patient strives for this ideal with all his nature, accordingly, imitating him in everything, and, above all, in external features. In this case, the importance of the opinions of others regarding the results achieved by the patient is lost, however, it is the critical remarks perceived by him from the environment (relatives, friends, teachers, etc.) that are extremely acute due to increased vulnerability and sensitivity that can only “incite” towards achieving the goal.

• anorexic stage

The beginning of this stage is accompanied by an active desire aimed at correcting the appearance, conditionally the effectiveness of weight loss is reduced to the loss of 20-50% of the original mass. Secondary somatoendocrine shifts are also noted here, changes occur in the menstrual cycle (oligomenorrhea or amenorrhea, i.e., a decrease in menstruation in girls or its complete cessation).

The means by which results in weight loss are achieved can be very different, patients, as a rule, hide them at first. Here, as already noted, many actions are performed while standing, in addition, patients can tighten the waist using cords or belts (“to slow down the absorption of food”). Due to excessive efforts in performing certain exercises (for example, “flexion-extension”), in combination with increasing weight loss, the skin is often injured (the area of ​​​​the shoulder blades, the sacrum, the area of ​​​​the waist, the area along the spine).

During the first days of food restrictions, patients may not be hungry, but often, on the contrary, it is extremely pronounced in the initial stages, which makes it difficult to refuse food and you have to look for other ways to achieve the goal (actual weight loss). These methods often include the use of laxatives (much less often - the use of enemas). This, in turn, causes weakness of the sphincter, and the possibility of rectal prolapse (sometimes quite significant) is not excluded.

An equally common companion of anorexia nervosa in the pursuit of weight loss is artificially induced vomiting. Predominantly, this method is used consciously, although an accidental arrival at such a decision is not ruled out. So, in the latter case, the picture may look like this: the patient, unable to restrain himself, eats too much food at once, as a result, due to the overcrowding of the stomach, it becomes impossible to keep food in it. It is because of the resulting vomiting that patients have an idea about the optimality of this method of release from food before its absorption.

As part of the earlier stages of the disease, vomiting with its characteristic vegetative manifestations causes a number of unpleasant sensations in patients, but further, due to the frequent induction of vomiting, the procedure is greatly simplified. So, patients can simply perform an expectorant movement for this (you can simply tilt the torso for this), pressing on the epigastric region. As a result, everything that was eaten is thrown away, while there are no vegetative manifestations.

Initially, they carefully compare what they eat with the amount of vomit, then gastric lavage is done. Artificially induced vomiting is inextricably linked with bulimia. Bulimia implies an irresistible feeling of hunger, in which there is practically no saturation. Patients in this case can be absorbed great amount food, and often it can be inedible. When eating a huge amount of food, patients experience euphoria, vegetative reactions appear.

Then they provoke vomiting, after which they wash the stomach, then “bliss” sets in, a feeling of indescribable lightness in the body. In addition to this, patients feel confident that their body is completely freed from what they have eaten, as evidenced by washing water of a light shade, without a taste characteristic of gastric juice.

And although significant weight loss is achieved, patients practically do not experience physical weakness, moreover, they are very active and mobile, their working capacity remains normal. The clinic of manifestations of anorexia within the framework of this stage often comes down to the following disorders: palpitations (tachycardia), asthma attacks, excessive sweating, dizziness. These symptoms occur after eating (after a few hours).

• cachectic stage

In this period of the disease, somatoendocrine disorders become predominant. Following the onset of amenorrhea (a condition, as we have indicated, in which there is no menstruation), patients lose weight even more rapidly. Subcutaneous fatty tissue within this stage is completely absent, there is an increase in dystrophic changes affecting the skin and muscles, against which myocardial dystrophy also develops. Conditions of hypotension, bradycardia, some loss of skin elasticity, a decrease in temperature and blood sugar levels are not excluded, in addition, signs of anemia are also noted. Nails become brittle, teeth are destroyed, hair falls out.

Due to prolonged malnutrition and eating behavior, a number of patients are faced with a worsening of the clinical picture of gastritis, enterocolitis. Physical activity maintained during the initial stages should be reduced. Instead, the predominant conditions are asthenic syndrome, and with it - adynamia (muscle weakness and a sharp decline in strength) and increased exhaustion.

Due to the complete loss of a critical condition, patients still continue to refuse food. Even with an exceptional degree of exhaustion, they often continue to claim that they are overweight, and sometimes, on the contrary, they are satisfied with what results they have achieved. That is, in any case, a delusional attitude to one's own appearance prevails, and the basis for this, apparently, is an actual violation of perception regarding one's body.

With a gradual increase in cachexia, patients often stay in bed and become inactive. Blood pressure is within the limits of extremely low indicators, constipation occurs. Against the background of water and electrolyte disorders, painful muscle cramps can occur, in some cases it comes to polyneuritis (numerous nerve damage). Lack of medical attention at this stage can be fatal. Often, the hospitalization required in severe cases of this condition occurs in a coercive manner, because patients do not realize how serious their condition has become.

• reduction stage

As part of the stage of withdrawal from the previous state, cachexia, asthenic symptoms, fixation on the emerging pathologies of the gastrointestinal tract, and fear of getting better take the leading positions in the clinic of the condition of patients. A slight weight gain is accompanied by an actualization of dysmorphomania, an increase in a depressive state, and a desire for a repeated scheme of "correction" of one's own appearance.

The improvement of the somatic state leads to the rapid disappearance of weakness with the appearance of extreme mobility, within which there is a desire to perform complex physical exercises. Here, patients can start taking laxatives in large doses, and after trying to feed them, attempts are made to artificially vomit. Accordingly, for these reasons, they need careful supervision in a hospital setting.

So, let's summarize what symptoms of anorexia occur in patients, dividing them into certain groups:

• Eating behavior
  • obsessive desire to get rid of excess weight, regardless of the real state of affairs (even with an existing lack of weight);
  • the appearance of obsessions directly related to food (counting calories consumed, focusing on everything related to the possibility of losing weight, narrowing the range of interests);
  • obsessive fear of the appearance of excess weight, obesity;
  • systematic refusal of food under any pretext;
  • equating a meal with a ritual, with concomitant thorough chewing of food; dishes consist of small pieces, served in small portions;
  • the presence of psychological discomfort associated with the completion of the meal; avoiding any activities in which there is a possibility of a feast.
• Behavioral responses of a different type:
  • adherence to increased physical activity, the appearance of irritation as a result of the inability to achieve certain results in them during overload;
  • a tendency to solitude, the exclusion of communication;
  • fanatical and rigid type of thinking without the possibility of compromise, aggressiveness in proving one's own innocence;
  • the choice of clothes in favor of baggy outfits, due to which you can hide "extra weight".
• Physiological manifestations of anorexia:
  • frequent dizziness, weakness, tendency to faint;
  • significant lack of weight in comparison with the indicators of the age norm (from 30% or more);
  • the appearance of fluffy soft hair on the body;
  • circulatory problems, against which there is constant hunger;
  • decreased sexual activity, women experience menstrual disorders, reaching amenorrhea, anovulation.
• Mental state in anorexia:
  • apathy, depression, reduced ability to concentrate, reduced efficiency, self-immersion, dissatisfaction with oneself in all areas (weight, appearance, weight loss results, etc.);
  • a feeling of impossibility of control over one's own life, the futility of any efforts, the impossibility of being active;
  • sleep disturbances, psychological instability;
  • rejection of the existing problem of anorexia and, as a result, the need for treatment.

Drug anorexia: symptoms

As we noted in the general description of the disease, drug anorexia occurs either at an unconscious level, which occurs in the treatment of a disease when taking certain drugs, or intentionally, when such drugs are used for a specific purpose aimed at getting rid of excess weight. Also, anorexia can occur as a side effect, which occurs when taking stimulants, antidepressants.

At the moment, doctors are quite serious about the problem associated with side effects when taking medications with a specific effect. Long-term therapy with the use of such drugs determines the possibility of curing quite serious, and in some cases even fatal diseases, while returning to an active lifestyle. However, the harm caused by this immune system, becomes the cause of the development of a different type of disease, whose result can be no less terrible. This, in particular, includes one of the results of taking drugs in a significant amount, drug anorexia that interests us.

In the light of such an effect achieved with the use of drugs, in domestic medical practice a definition was introduced for it under the name "drug disease". It should be noted that this definition implies not only drug anorexia, but also other diseases that occur against the background of the corresponding exposure, and these are endocrine diseases, allergies, Addison's disease, asthenia, drug addiction, etc. Almost any drug can lead to a drug disease, accordingly, this does not exclude the possibility of developing drug-induced anorexia against such a background.

Symptoms of drug anorexia, in general, fall under the generalized picture of this disease. So, this includes nausea and lack of appetite, the presence of pain in the epigastric region, general exhaustion of the body. There are also frequent urge to vomit, there is a rapid satiety when eating, this is accompanied by a feeling of fullness in the stomach. Patients with anorexia in this form strongly deny existing problem by continuing to use drugs that cause weight loss. In the latter case, the signs of drug anorexia become decisive for this disease, therefore it is important to pay attention to them in time, thereby preventing progression.

Anorexia in men: symptoms

Anorexia, although it is considered to a greater extent as a female disease due to the desire of the beautiful half to achieve "ideal" parameters, meanwhile, is not an exclusively female disease. Anorexia in men is a common and growing phenomenon, moreover, male bulimia is also connected to this condition, and men experience bulimia three times more often than women.

Male anorexia, the symptoms of which we will consider, still basically contains the desire to achieve ideals in terms of one's own complexion. Obsessed with it, men exercise hard, deliberately refusing food and tracking calories. Remarkably, the age of males attaches this disease to a younger group. So, the first symptoms of anorexia, manifested in a decrease in muscle muscles, are increasingly found in schoolchildren.

Similar to the female self-perception, male anorexia combined with bulimia is reduced to weight control and relapses due to full stomach with the intention to get rid of what they have eaten by artificially inducing vomiting. After this, a feeling of guilt appears, against which, in turn, psychosomatic disorders develop.

The difference between male anorexia and female anorexia lies in the fact that it generally develops at a later age (despite the initially indicated tendency to increase the incidence of this disease in schoolchildren). Moreover, anorexia, the symptoms of which are diagnosed in men, in many cases is inherently associated with the relevance of schizophrenic processes for them.

There are certain risk factors for this disease in men, we highlight them:

• the presence of a problem of excess weight in childhood;
• engaging in exhausting sports (in this case, runners have a higher risk of developing anorexia in comparison, for example, with weightlifters, football players);
• the presence of a hereditary predisposition to mental illness;
• features of culture (when fixing the environment on the external physical appearance, diets, etc.);
• a type of activity in which it is important to be “in shape” (artists, male models, etc.).

Before the onset of the disease, patients, as a rule, have problems in the form of short stature, underdevelopment of the vascular and muscular systems, problems associated with the gastrointestinal tract, appetite disorders, and intolerance to certain types of food.

There is also a certain picture that future anorexics fall under, in addition to these problems. So, they are brought up mainly in "hothouse" conditions, parents protect them as much as possible from certain difficulties. In view of such dependence on parents, there is a constant shifting on the shoulders of the environment of their own problems. As they grow older, such men are dominated by lack of sociability and isolation, emotional coldness (which determines the presence of schizoid features). It is also possible to evaluate themselves as incompetent, helpless and intolerant individuals (which, in turn, determines the presence of asthenic personality traits in them). Symptoms of anorexia in women in terms of personality manifestations determine the predominance of their hysterical traits.

Remarkably, some men with anorexia are initially convinced of their own excess weight, but in this case, such a belief is delusional, that is, we are talking about false judgments that cannot be corrected. Accordingly, such beliefs are appropriate for them even if without this there is a problem of underweight. When fixing on fictional fullness, anorexic men stop responding to really existing, and often ugly defects in their appearance.

As already indicated, weight loss is achieved through the same measures as in women, that is, by refusing to eat, inducing vomiting and excessive physical exertion, due to which the result is determined in the form of pronounced emaciation. It should be noted that artificially induced vomiting does not cause a severity similar to female vomiting. As for the refusal of food, it is either formally motivated or completely absurd (purification of the soul and body; food is a hindrance in activity and in general in life, etc.).

The development of anorexia in men determines for them the subsequent addition of a different type of signs of schizophrenia. The signs of schizophrenia in this case are manifested in a violation of thinking, self-absorption, in the narrowing of the usual range of interests.

In addition, of course, anorexia in men can also manifest itself as an independent disease, which determines for it the generally recognized symptoms of this condition.

Anorexia during pregnancy

In women who have previously experienced anorexia, including bulimia, as a form of eating disorder, attempts to get pregnant are comparable to serious difficulties. The basis for this statement is the fact that it is these patients who are twice as likely to resort to artificial insemination, which, accordingly, indicates the negative impact of eating disorders in the future on reproductive function.

Based on the results of one study, it is known that for 11,000 cases with a history of eating disorders, 39.5% of women need about more than 6 months to conceive, while only a quarter of women have a similar problem without eating disorders . 6.2% of those with a history of eating disorders are in vitro fertilization clinics, while 2.7% of the total indicated number in this case did not have problems in the form of anorexia and bulimia in the past. Remarkably, most often pregnancy with anorexia is unplanned, respectively, not in all cases this disease is comparable to infertility.

In case of malnutrition during pregnancy, a miscarriage can occur, the possibility of developing gestational diabetes is not excluded - a disease that passes after childbirth, unlike other types of diabetes that are chronic, characterized by high blood glucose levels.

During pregnancy, women gain about 10-13 kg, which is necessary to ensure the normal development of the child. In most cases, pregnant women consume about 2000 kcal per day, by the last trimester - about 2200 kcal. With the existing anorexia, it is quite difficult to come to terms with such facts.

In the event of a violation of the body mass index (BMI) during pregnancy, there is a risk of having a small child, which is especially likely with concomitant smoking. Also, against this background, there is a risk of premature birth.

Diagnosis

In general, the diagnosis of anorexia is based on a comparison of general symptoms within the following criteria:

• changes accompanying the condition that occurred before the age of 25 (deviations are possible, including on the basis of gender);
• weight loss within 25% or more of the indicator serving as a starting point for diagnosis;
• the absence of any organic disease, which acts as the main cause of weight loss;
• a perverted approach to eating and to one's own weight;
• absence/presence of a concomitant mental illness;
• the presence of at least two manifestations from the following list:
  • lanugo (appearance of very thin hair on the body);
  • amenorrhea;
  • episodes of bulimia;
  • bradycardia (a condition in which the heart rate at rest is 60 beats per minute or less);
  • vomiting (possibly - intentionally caused).

Treatment

Treatment of anorexia in some cases is possible without reaching the stage of development of severe forms of complications, which only accompanies a speedy recovery, often at a spontaneous level. Meanwhile, in most cases, the disease is not recognized by patients, respectively, there is no appeal for help. Severe forms imply the need for complex therapy, this includes inpatient treatment, drug therapy, and psychotherapy (including for family members of the patient). In addition, a normal diet is subject to restoration, in which an increase in the calorie content of the food consumed by the patient is gradually achieved.

As part of the first stage of treatment, the somatic condition is subject to improvement, in which the process of weight loss is suspended and the threat to life is eliminated, the patient is removed from cachexia. As part of the next, second stage, they are guided by treatment with the use of medications in combination with psychotherapy methods while distracting the patient from the existing fixation on appearance and weight in particular, on developing self-confidence, acceptance of the surrounding reality and oneself. Anorexia, the video and photo of which is available in our article, also determines the possibility of achieving some effect in "reaching out" to the patient, in particular, to his perception of the situation and possible results with further progression of the disease.

Relapse of anorexia is a frequent stage in this disease, due to which several courses of treatment are often required. Rarely side effect therapy becomes overweight or obese.

Over the past 5 years, the number of patients diagnosed with anorexia has increased almost 10 times! 40% of them are teenagers aged 11 to 16, another 35% are models, actresses and other public people. In connection with such a catastrophic situation in the United States and Western Europe, numerous studies have been conducted on this disease, which annually leads to nervous and physical exhaustion, and also claims the lives of thousands of people around the world.

It's time to find out what kind of deviation it is, what are its causes and development mechanisms, and most importantly, whether it is treated and how effective modern therapeutic methods are.

What it is?

Anorexia is not just a disease. In all reference books, it is listed as a syndrome. The difference is that the mechanisms of development of the latter are not yet well understood and are the subject of close study by scientists around the world. In this regard, the effectiveness of the methods of treatment of such pathologies is questioned and is not guaranteed. Indeed, psychotherapy, which is today the main tool in the fight against this disease, does not give positive results in all cases.

The essence of anorexia is the lack of appetite, despite the body's need for nutrients. Most often, a person comes to a conscious refusal of food due to a mental disorder against the background of internal complexes about his own figure and excess weight. By accustoming themselves not to eat, constantly exhausting the body with diets, patients bring the body and mind to complete exhaustion. Much less often, this happens unconsciously and is dictated by the presence of other, no less serious diseases (for example, schizophrenia, various kinds of intoxication, cancer, etc.).

difference from bulimia

Along with, anorexia is considered an eating disorder. According to many models, they suffered from both at the same time, although the manifestations of these diseases are completely different.

Bulimia is characterized by uncontrollable bouts of hunger. After long and exhausting diets, patients break down and eat a huge amount of food at a time. And after they realize what happened, they become ashamed of such behavior. This leads to artificial induction of vomiting, the abuse of laxatives and enemas, just to get rid of the consumed food. Then the weekdays of exhausting diets begin again until a new breakdown.

Anorexia is not characterized by such bouts of hunger, with this diagnosis, appetite is almost completely absent. And if, with bulimia, the body occasionally, but still receives and even manages to absorb at least some nutrients during such breakdowns, here exhaustion is diagnosed much earlier, and more deaths are noted.

Interesting fact. In the course of research, scientists have established a relationship between the type of eating disorder and the nature of the person who suffers from it. People who are emotionally unstable and impatient, who find it difficult to restrain themselves, are prone to bulimia. Among anorexics, on the contrary, there are many closed and stubborn people who find it difficult to prove something. This explains the difficulty of treating the latter.

Causes

The causes are so diverse that in some cases it is extremely difficult to identify them. Most often, depression is the main provoking factor, but such a formulation is not enough for successful treatment. Psychotherapy digs much deeper and seeks to identify more root problems.

Mental

Age factor: adolescence and adolescence are at risk, and the lower bar has been falling lower and lower in recent years. Excess weight in childhood, entailing problems with the environment (pressure from parents, name-calling classmates).

The presence of a negative example in the family: relatives with anorexia, bulimia, or obesity, as well as those suffering from depression, alcoholism, drug addiction. Tensions in the family, too strict parents, because of which the child strives to meet high standards and becomes depressed if he does not reach them. Lack of parental attention.

Wrong eating habits: eating unhealthy foods in in large numbers, non-compliance with the diet.

Low self-esteem, self-doubt, internal complexes, feelings of inferiority. Perfectionist-obsessive personality type. Mental illness, neurological pathology. Divorce of parents. The formation of personality, when a teenager tries to prove to himself and others that he has willpower and he can consciously refuse food in order to meet the expectations of society.

Hobbies, hobbies, profession requirements: actors, models, musicians, singers and other public people.

Physical

These include:

• alcoholism, drug addiction;
• aneurysm;
• anemia;
• Addison's disease;
• gastritis, pancreatitis;
• helminths;
• hemochromatosis;
• hepatitis, cirrhosis of the liver;
• hypopituitarism;
• hormonal dysfunction;
• zinc deficiency;
• dysfunction of neurotransmitters responsible for eating behavior (dopamine, serotonin, norepinephrine);
• prolonged coma;
• malignant tumors;
• leukemia;
• lymphoma;
• excess weight;
• neurosurgical operation;
• digestive problems, gastrointestinal diseases;
• early onset of menstruation in girls;
• sarcoidosis;
• diabetes mellitus type I;
• syndromes of Kanner, Sheehen, Simmonds;
• thyrotoxicosis;
• brain injury;
• schizophrenia;
• eclampsia.

genetic

Not so long ago, genetics was practically not considered as one of the possible causes of anorexia, considering the latter to be a purely mental and social syndrome. However, not so long ago (in 2010), large-scale studies were conducted in the United States, which involved not only patients with such a diagnosis, but also their closest relatives of at least 2 people. The DNA responsible for eating behavior has been studied. The results surprised many: obsessions about losing weight and refusing to eat were often determined at the chromosomal level. They found a brain-derived neurotrophic factor gene that differed from the rest in its sensitivity to this disorder.

It is involved in stimulating appetite and satisfying hunger in the hypothalamus, and also controls the level of serotonin in the body. The researchers concluded that people may be genetically predisposed to anorexia. This lies in the inheritance of dysfunctions of neurotransmitter systems, a certain type of personality and a number of mental disorders. Moreover, in most cases, such heredity may not manifest itself throughout life. But as soon as she receives a push from the outside (diseases, depression, taking powerful drugs, a long diet), she manifests herself in all her “glory”.

Other

Uncontrolled intake of anorexigenic drugs for the purpose of losing weight. A side effect of the use of certain drugs - hormones, psychostimulants, glucocorticosteroids.

Single stressful events that occurred in the 4-6 months before the onset of the eating disorder: this could be the death of a loved one or physical (sexual) abuse.

Dream of becoming a model. An obsession with thinness, which is perceived as the ideal of modern beauty. Persistent propaganda of certain standards of beauty in the media, passion for social networks.

Facts, facts... Sad statistics blame the family for everything, arguing that it is in childhood that anorexia is rooted. As practice shows, teenagers suffering from this disorder have seen enough of their mother (aunt, sister) losing weight and were not accustomed to proper nutrition.

Classification

There are different types of anorexia. Due to the fact that the mechanisms of its development have not yet been fully studied, several classifications of this syndrome are adhered to in medical circles. They are based on the factors that provoked its appearance.

Classification No. 1

• Somatogenic (primary) - develops against the background of other physical pathologies and diseases.
• Functional-psychogenic (secondary) - due to stress and mental disorders.

Classification No. 2

• Neurotic - strong negative emotions lead to powerful excitation of the cerebral cortex.
• Neurodynamic - inhibition of the center of appetite in the hypothalamus due to the strongest irritants of a non-emotional nature (most often - pain).
• Neuropsychiatric (or cachexia) - persistent, conscious refusal of food, a sharp restriction in the amount of food consumed, due to a mental disorder.

Classification No. 3

• Medicinal - develops against the background of taking anorexigenic drugs for the purpose of losing weight, it can be a side effect of other medications (most often antidepressants, psychostimulants, hormones).
• Mental - a mental disorder accompanied by loss of appetite: it develops against the background of schizophrenia, paranoia, advanced stages of depression.
• Symptomatic - a sign of a serious somatic disease: lungs, gastrointestinal tract, hormonal system, in the field of gynecology;
• Nervous (psychological) - conscious restriction of oneself in food, fear of weight gain, distorted perception of one's own body.

There are different codes for different types of anorexia in the ICD. Correct and accurate diagnosis allows you to choose the most effective methods treatment in each individual case.

Clinical picture

At first, anorexics do not appear to be such, because today most women are dieting and taking care of their own weight. Is it possible to suspect a model that seeks to reach the ideal parameters of the body using all sorts of methods, in an eating and mental disorder? After all, this is her profession, and she must look good and take care of her own body. But over time, when a person can no longer stop and continues to lose weight, it is impossible not to notice.

The very first signs of anorexia:

• BMI falls below the normal value of 18.5;
• refusal to eat;
• weight and figure become an obsession (with the nervous form of the disease).

It is impossible to say exactly at what weight anorexia begins, because this is too an individual parameter, which also depends on height. For example, 44 kg for a height of 154 cm is still the norm, and the same body weight with a height of 180 cm is already a pathology. Therefore, first of all, BMI is calculated and compared with normal values. If he sank below the bottom bar - it's time to sound the alarm.

Determination of body mass index:
I (BMI designation) \u003d m (body weight in kg) / h 2 (height in meters).

Common symptoms for all forms:

• discomfort after eating;
• muscle weakness and cramps;
• low body weight, which only decreases over time;
• restriction of food consumed under any pretext;
• refusal to get better;
• constant feeling of cold and chills due to circulatory disorders;
• fear of food;
• depressed, depressed state;
• phobia of being overweight.

This is just the beginning. Over time, the patient's condition worsens more and more, and this is noticeable in his appearance, health and broken psyche.

Mental condition

These symptoms are primarily characteristic of anorexia nervosa:

• apathy;
• insomnia at night and drowsiness during the day;
• fast fatiguability;
• depression;
• prolonged examination of one's naked (or in underwear) body in the mirror;
• daily weighing;
• unhealthy fascination with topics related to weight;
• incorrect goal setting: “I want to lose weight from 45 kg to 30 kg” (and this is with a height of 180 cm);
• instability of mood;
• refusal of common meals (for example, adolescents do not go to the school cafeteria and, under any pretext, do not attend family meals);
• lack of appetite;
• a complete eating disorder: they eat either only standing, or only crushed, pureed foods, or only cold, or only raw, and other oddities;
• irritability, aggressiveness, a constant feeling of resentment towards others;
• decreased libido;
• social isolation, cessation of communication.

Appearance

• Alopecia;
• paleness or yellowness of the skin;
• bleeding gums, caries, loss and destruction of teeth;
• weight loss, dystrophy of muscle mass, unhealthy thinness;
• splitting and brittle nails.

Health

• Algodysmenorrhea;
• anemia;
• gastritis;
• dizziness;
• delayed physical development in adolescence and childhood: growth stops, girls do not enlarge their breasts and menstruation does not occur, boys do not develop genitals;
• leukopenia, leukocytosis;
• hormonal imbalance;
• fainting;
• cessation of menstruation in women;
• problems with the gallbladder;
• indigestion;
• spontaneous gag reflex after eating;
• failure of the liver and kidneys;
• cardiac arrhythmia;
• thrombocytosis;
• endocrine disorders: amenorrhea in women, impotence in men, increased cortisol levels, insufficient production of thyroid hormone, problems with insulin secretion;
• enterocolitis.

Unlike other diseases, anorexia is insidious in that the patient himself, due to mental reasons, is not aware of the disease and does not see even its most striking symptoms. His mind is so imbued with obsessive ideas that even among the bones covered with skin (such a picture is observed in the last stages), he manages to see fat folds.

through the pages of history. In Soviet psychiatry, anorexia in its own way clinical manifestations and methods of treatment was practically equated with another mental illness - schizophrenia. Now such an understanding of the syndrome in medicine has gone, but the comparison of these two conditions has not stopped. Recently, cases of the development of schizophrenia against the background of anorexia have become more frequent (a person raves about obsessive ideas about his body and the excess weight that he allegedly suffers from).

stages

Doctors call three stages of development of anorexia with their corresponding symptoms.

1. Dysmorphomanic (initial) stage

• Prolonged examination of one's body in a mirror, often with locked doors.
• Obsessive thoughts about one's own inferiority.
• Food restrictions, search for and compliance with the most.
• Depression, anxiety.
• Constant talk about food, diets, models.
• Weight loss - not yet critical, but already noticeable.

2. Anorexic

• The fasting continues and does not end in any way: the patient does not agree to all the persuasion of relatives to establish nutrition, believing that he leads a normal life.
• Inadequate assessment of the degree of their weight loss (considers their weight to be normal).
• Refusal of sexual life.
• Noticeable weight loss of 20%.
• Complete loss of appetite: for the whole day the patient may not remember food.
• The first signs of concomitant diseases appear: hypotension, bradycardia, alopecia, adrenal insufficiency.
• With nervous forms of anorexia, unbearable physical activity is added to diets.
• Reducing the volume of the stomach.

3. Cachectic

• Deficiency of vitamins and microelements.
• Dystrophy of the body and internal organs.
• Violation of water and electrolyte balance.
• Unhealthy thinness, weight loss by 50% of the original figure.
• Dehydration.
• Swelling of the whole body.
• Inhibition of the functions of almost all body systems.

As a rule, the first stage proceeds almost imperceptibly and, with timely support from relatives and relatives, it may not develop further into a pathological condition. But the latter often ends in death (sometimes due to suicide) and is very difficult to treat. Even if a person manages to get out, the consequences will haunt him all his life.

Diagnostics

As the main diagnostic tool for detecting the disease is an anorexia test, the name of which is "Attitude to eating". The first part consists of 26 general and easy questions. The second is only out of 5, but they involve monitoring your own eating behavior over the past 6 months. This method has several significant disadvantages, due to which it is not always possible to rely on it in an accurate diagnosis.

First, the patient in most cases cannot objectively assess his own eating behavior. Accordingly, he cannot truthfully answer the questions of the text.

Secondly, this test mainly detects anorexia nervosa, while all other types require additional diagnostics.

This test can be taken by absolutely anyone online. For a more accurate diagnosis, various studies can be prescribed:

• blood, stool and urine tests;
• gastroscopy;
• head MRI;
• sigmoidoscopy;
• radiopaque study of the digestive tract;
• esophagomanometry;
• x-ray;

The last resort will be a consultation with a psychotherapist. Through an interview and based on the results of laboratory tests, he makes a final diagnosis, determines the stage and prescribes treatment.

Treatment

Comprehensive treatment of anorexia involves the use of a variety of techniques. Not all of them show high efficiency, but with careful observance of medical prescriptions and a positive attitude of the patient himself, recovery occurs (although not as quickly as we would like). This is a rather complex disease, therefore, at the first symptoms, you should immediately contact psychotherapists. Only they can pull the patient out of the hole in which he fell.

Psychotherapy

• Visualization of the final result: the patient is told in detail about the consequences of anorexia.
• Cognitive restructuring: dealing with negative thoughts and obsessions.
• Controlling your own behavior.
• Correction of distorted consciousness.
• Monitoring: a record by the patient of his eating behavior in all details, on the basis of which conclusions are drawn and errors are eliminated.
• Increasing self-esteem.
• Resolution of family conflicts (in the treatment of anorexia in children and adolescents).

Alimentary rehabilitation

• Exercise therapy for the formation of a beautiful body (the purpose of the exercises is to build muscle mass).
• Bed rest.
• Diet therapy.
• Creating motivation for recovery.
• Emotional and physical support from family and friends.

Preparations

• Vitamin complexes.
• Antipsychotics.
• Separate vitamins and microelements: folic and ascorbic acid, B12, iron, zinc, magnesium, calcium, potassium.
• Appetite enhancing drugs: Elenium, Frenolon, Pernexin, Peritol, anabolic steroids like Primobolan.
• Tablets for the normalization of metabolism: Polyamine, Berpamin.
• Antidepressants: Zoloft, Coaxin, Ludiomil, Paxil, Fevarin, Fluoxetine, Chlorpromazine, Cipralex, Eglonil.

Folk remedies

With the permission of the attending physician at home, you can use various folk remedies to restore normal appetite. However, you need to be extremely careful with them. Some herbs are too aggressive for various organs and systems that are already affected. Therefore, follow the contraindications for each such prescription.

Calming (drink before bedtime):

• valerian;
• nettle;
• Melissa;
• mint;
• dandelion.

Appetite stimulants (drink half an hour before each meal):

• St. John's wort;
• centaury;
• mint;
• sagebrush.

Treatment must be comprehensive. Even well-established psychotherapy does not always work and gives the desired effect without the same antidepressants (for the nervous form of the disease).

It is a fact. Experts say that it is impossible to cope with anorexia on your own. Patients, even if they understand that they are not all right, cannot force themselves to eat normally. This is due to the fact that their ideas about food and weight are too distorted and require professional correction.

To defeat anorexia, the patient himself needs to make a lot of efforts. It is not enough to follow medical recommendations exactly, you need to overcome yourself every day and change your own consciousness and attitude towards yourself. This is incredibly difficult and requires support from family and friends. A few tips will speed up your recovery.

First of all, with anorexia, you need to normalize nutrition. If possible, a consultation with a nutritionist who has a medical education: he can draw up an individual menu for the near future, taking into account the characteristics of the course of the disease.

Every 2-3 days, you need to increase the daily caloric content of food consumed by 50 kcal until it reaches the norm - 1,300 kcal for women and 1,500 kcal for men, and this is the lower bar. With the same sequence, it is necessary to increase the portion sizes by 30-50 g.

The first 2 weeks the basis of nutrition should be liquid and pureed dishes, chopped foods, drinks. Then gradually vegetables and fruits (in any form) are introduced into the diet. A week later, protein foods are allowed (boiled chicken breast, eggs, milk, seafood), a minimum of carbohydrates (oatmeal, brown rice), a small amount of natural sweets (dried fruits and honey).

Formation of new eating habits: adherence to the regimen, fractional nutrition, calculation of the balance of zhbu and daily calorie content, rejection of harmful products.

Without the normalization of nutrition, it is almost impossible to get rid of anorexia. And this point can be realized only after the correction of consciousness and personal orientations of the patient.

Physical activity in the advanced stages of the disease is excluded. It will be necessary to join the sport gradually, with the permission of the attending physician.

Consequences

Unfortunately, many of the consequences of anorexia will haunt a person for life, even if the disease is completely cured. Recovery of the body can take from 6 months to several years.

The most common complications are:

• alopecia;
• arrhythmia;
• rapid, abnormal weight gain up to obesity;
• dystrophy;
• slow metabolism;
• impotence, decreased libido, infertility;
• obsessive-compulsive disorder;
• osteoporosis;
• serious problems with digestion;
• reduction in brain mass.

If we talk about forecasts, then a fatal outcome is quite possible. Death from anorexia occurs either due to the failure of vital organs or due to suicide.

Prevention

If a person recovers from anorexia and returns to a normal lifestyle, he will still have to constantly fight this syndrome. As practice shows, even psychotherapy does not guarantee a full recovery. In 30% of cases, the disorder returns. To prevent this from happening, you need to carry out prevention:

• see a psychotherapist;
• observe the principles of proper nutrition;
• monitor BMI so that it does not go beyond the norm;
• avoid stressful situations;
• exercise moderately;
• communicate actively;
• find a hobby to your liking (preferably not a modeling business).

Even if the anorectic was cured, he is simply obliged to follow these preventive measures in order to avoid a relapse of the disease. Doctors warn that a repeated breakdown in most cases ends in death.

Special cases

Although anorexia is most commonly diagnosed in adolescent girls and young women, it affects both children and men. The course of the disease is somewhat different.

In children

It doesn't work at all like it does in adults. The main difference is in the mechanism of its development. In them, this is primarily a somatogenic disorder, which is diagnosed against the background of other diseases. It can be elementary allergies, thrush, stomatitis, worms, otitis media, rhinitis and other diseases that children of different ages so often suffer from.

Therefore, with a long and persistent refusal to eat with a persistent weight loss in a child, parents should first of all send him for a complete medical examination, identify the disease and treat it. After that, with the help of psychotherapy, anorexia in most cases is completely cured.

In men

Very childlike. This eating disorder in them is also due primarily to a special physiological state. Psychogenic causes are rarely noted because representatives of the strong half of humanity are used to restraining their emotions and not showing them.

Their nervous system still stronger in relation to excess weight. If men discover it, they don't run to vomit or go on a diet. Some go to the gym, the latter continue to calmly sip beer in front of the TV. That's all the solution to the problem. According to statistics, among those who suffer from anorexia, men are only 5%, and 3.5% are initially ill with mental disorders.

According to statistics. Among men suffering from anorexia, more than 50% are schizophrenics, and another 25% are of non-traditional sexual orientation. Having a type of psyche that is as close as possible to the female, and distinguished by a reverent attitude to their own appearance, the latter get used to sitting on newfangled diets and consciously refuse food.

Additional Information

For prevention, as well as in the process of treatment in the initial stages, illustrative examples of what this disease leads to can be used. To do this, patients are given to read the relevant (mostly biographical) and look (fiction and popular science) on this topic.

Books

• A. Kovrigina. 38 kg. Living in 0 calorie mode.
• A. Nikolaenko. Death Diet. Stop anorexia.
• A. Terrina. Happinnes exists! The story of my struggle with ANO.
• E. Goncharova. Anorexia. The disease of modernity, or Why you shouldn't chase fashion.
• J. Wilson. Girls in pursuit of fashion.
• Justine. I stopped eating this morning.
• I. K. Kupriyanova. When is it dangerous to lose weight? Anorexia nervosa is a disease of the XXI century.
• I. Kaslik. Skinny.
• K. Panic. NRXA I love you!
• K. Reed. I'm thinner than you!
• M. Tsareva. Girl with hungry eyes.
• Porsche de Rossi. Unbearable Lightness: A Story of Loss and Growth.
• S. Sussman. Dieting.
• F. Ruse. 0%.

Movies

• Anorexia (2006).
• Battle for beauty (2013).
• God help the girl (2014).
• Weight (2012).
• Hunger (2003).
• To the Bone (2017).
• Ideal Figure (1997).
• For the Love of Nancy (1994).
• When Friendship Kills (1996).
• The Bony Hand of Beauty (2012).
• Beautiful (2008).
• The best girl in the world (1981).
• First love (2004).
• Interrupted Life (2009).
• Superstar: The Karen Carpenter Story (1998).
• Dance is dearer than life (2001).
• Thin and Thick (2017).
• Thin Life (2017).

Famous people who died of anorexia

• Ana Carolina Reston - Brazilian model, 22 years old;
• Debbie Barem - British writer, died at 26;
• Jeremy Glitzer - male model, 38;
• Isabelle Caro - French model, 28 years old;
• Karen Carpenter - American singer, 33;
• Christy Heinrich - American gymnast, 22;
• Lena Zavaroni - Scottish singer, 36 years old;
• Luisel Ramos - Uruguayan model, 22 years old;
• Mayara Galvao Vieira - Brazilian model, 14 years old;
• Peaches Geldof - British model, journalist, 25 years old;
• Hila Elmaliah - Israeli model, 34 years old;
• Eliana Ramos - Uruguayan model, 18 years old.

Anorexia over the past few years has taken hostage a huge number of people, most of which are teenage girls with an unbalanced psyche. The danger is that many patients refuse to consider themselves as such and do not voluntarily go for treatment. All this ends not only with dystrophy and protein-energy deficiency - deaths with such a diagnosis have become far from uncommon. The statistics that speak of an ever-increasing number of people suffering from this syndrome make us think about the standards of beauty imposed by society, the victims of which are primarily teenagers.