Anorexia Nervosa

Anorexia nervosa is a relatively common psychiatric disorder that particularly affects teenage girls, but it can also occur in boys. Despite being a psychic disorder, anorexia nervosa has a devastating effect on human organism and seriously disrupts both physical and mental development. Serious cases of the disease result in severe starvation and death.


The causes of anorexia nervosa are not entirely clear. It is a psychiatric condition with some genetic predisposition and some influence of outer factors. The affected girls gain an obscure and usually incorrect feeling of being fat and try to lose some weight at all cost. It is possible that the modern cult of skinny models, whose computer-modified images we see in most magazines, has a very important effect. Similarly, the girl may be influenced by a negative comment about her appearance or weight. The other interesting fact is that anorexia nervosa affects rather intelligent girls trying to have good results in school or in sport.


The affected person tries to lose weight by drastic reduction of caloric intake in the diet and by an excessive physical exercise. The girls often secretly vomit, abuse laxatives and drink excessive amount of water. The disease manifests with weight loss and decrease of the body mass index (BMI). However, even the weight loss does not change the feeling of being fat. Other symptoms reflect the malnutrition. The girls usually lose their menstruation periods and become infertile. Menstruation and fertility is by nature quite reasonably attributed to those sexually mature women who have a chance to carry a child. The organism of women with anorexia nervosa is seriously weakened and does not have enough nutrients to ensure successful pregnancy. In addition, the women suffer from lack of minerals, vitamins and proteins. The biggest danger, however, is the occurrence of abnormal heart rhythms (arrhythmias) that can cause sudden death of the patients. Weakened immunity is a common cause of frequent infections.


The diagnosis is confirmed by cooperation of an internal physician with a psychiatrist. An important part of the diagnosis is to exclude causes of involuntary weight loss, especially cancer diseases.


The treatment must consist of adequate nutrition and psychiatric help. It is not wise to try to overcome the disease without a help of the psychiatrist. The parents can force the girl to eat, but they can not guard her for 24 hours a day. The sick are usually intelligent and deceitful – they pretend to eat, vomit secretly, throw the food away, etc. Intensive psychiatric care in an inpatient department with a strict control of the food intake is often the only way to cope with anorexia nervosa. The feeding of malnourished patients with anorexia nervosa must be very careful and respect some medical rules; otherwise there is a high risk of the so-called refeeding syndrome.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources