History of Anorexia Nervosa
Anorexia Nervosa is derived from the Greek word orexis, meaning appetite. Literally it means a "nervous loss of appetite." The first descriptions of the disorder appeared in the medical literature in the 1870's. Before that time self-starvation was primarily considered either a symptom of physical distress or a religious rite. Ernest-Charles Lasegue and Sir William Withey Gull were among the first to report cases of "anorexie hysterique" or "anorexia hysterica" which closely resembled today's anorexia nervosa.
Epidemiology of Anorexia Nervosa
Anorexia Nervosa has lifetime prevalence rates of approximately .5-1%. There are many people who do not meet the diagnostic criteria for anorexia nervosa, but exhibit some symptoms. Prevalence rates for men are approximately one tenth of the rates for women. Ongoing research has also suggested a rise of eating disorders around the world among non-Caucasian groups.
Risk Factors for Anorexia Nervosa
Anorexia Nervosa is a multi-determined illness. A variety of environmental and genetic factors may play a role in increasing the risk of developing this disorder. Several of these risk factors include:
Gender
Anorexia Nervosa predominantly affects womenDieting
Studies among adolescents have found that engaging in dieting is a predicter of later eating disturbances as well as fear of weight gain, negative body image, and body dissatisfactionCertain Personality Characteristics
These include negative self-evaluation, low self-esteem, obsessionality, perfectionism, and neuroticismAthletic Competition
Involvement in certain competitive athletic environments may be correlated to the development of eating disorders. More specifically, ballet dancers and people who do a large amount of aerobic activity while being at a low weight throughout adolescence are at increased risk.Genetics
Twin studies suggest that genetics may be a risk factor in developing anorexia nervosa
Associated Abnormalities of Anorexia Nervosa
Physical, cardiac and laboratory abnormalities
Cold intolerance, bradycardia, hypotension, growth of soft, downy hair (lanugo), diminished gastrointestinal motility, bone density lossEndocrine abnormalities
Regulation of nearly all endocrine systems are altered in Anorexia Nervosa, including thyroid abnormalities and amenorrhea (loss of menstrual period)
Assessment of Anorexia Nervosa
Individuals with the best prognosis have the disorder identified early and pursue treatment soon thereafter. Assessment of anorexia nervosa should include gathering information about the disturbed eating behaviors and thoughts related to eating, shape and weight that are necessary to meet DSM-IV criteria for the disorder. Physical and medical status should also be assessed. Additionally, co-morbid diagnoses should be assessed. It is also important to rule out other psychiatric or medical conditions that may cause weight loss.
