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Anorexia Nervosa
Published in Charles Theisler, Adjuvant Medical Care, 2023
Anorexia means loss of appetite and is an eating disorder. Anorexia nervosa is a potentially life-threatening disorder that is characterized by being drastically underweight and having an intense fear of becoming fat. The disorder is diagnosed when a person weighs at least 15% less than his or her normal or ideal body weight. Sufferers see themselves as fat even when they are very thin. Thus, there is typically very little eating, often to the point of starvation, excessive exercise, and a distorted body image. Malnutrition is a core feature of anorexia nervosa. Severe malnourishment can lead to multiple organ damage or death.
Psychological Medicine
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Harrison Howarth, Jim Bolton, Gary Bell
The causes of anorexia nervosa are multifactorial, involving physical, psychological and social factors. Physical: Family and twin studies indicate a genetic susceptibility to anorexia nervosa.Psychological: There are no definite personality types associated with the eating disorders, although certain traits, such as low self-esteem and perfectionism, are more common.Social: Social and cultural pressures on women influence attitudes to weight and shape.
Psychiatry and social medicine
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
Clinical features of anorexia nervosa include excessive physical activity and dieting because of a morbid fear of being fat; accompanying this there is apparent misperception of bodily appearance (patient overestimating the size of thighs etc.) and amenorrhoea. Electrolyte imbalance results from vomiting, from water overloading and from abuse of diuretics or laxatives. T3 and T4 levels may be low with a normal TSH, in keeping with the patient's state of starvation.
Emerging therapeutic targets for anorexia nervosa
Published in Expert Opinion on Therapeutic Targets, 2023
Also rikkunshito, a traditional Japanese medicine, known to enhance/stimulate ghrelin signaling [114], should be further investigated in the context of anorexia nervosa. In cisplatin-treated rats, rikkunshito prevented the reduction of plasma ghrelin levels by inhibiting ghrelin’s desacylation leading to an increased acyl/desacyl ghrelin ratio, likely contributing to the attenuated decrease in food intake [115]. In humans rikkunshito has only been tested in patients with chemotherapy-induced anorexia so far, also inducing desired effects such as reduced nausea and emesis and increased appetite [116]. This should be tested in patients with anorexia nervosa as well. Lastly, it should also be investigated whether liver-enriched antimicrobial peptide-2 (LEAP2), an endogenous peptide inhibiting ghrelin-induced activation of the ghrelin receptor and thereby e.g. the ghrelin-induced food intake [117] likely acting as an inverse agonist [118] plays a role in the pathogenesis of anorexia nervosa as well and/or therefore blockade of LEAP2 might be a treatment strategy as recently suggested [119].
Mindfulness in persons with anorexia nervosa and the relationships between eating disorder symptomology, anxiety and pain
Published in Eating Disorders, 2021
Julie P. Dunne, Judith Shindul-Rothschild, Laura White, Christopher S. Lee, Barbara E. Wolfe
Anorexia nervosa (AN) is a serious, psychiatric illness associated with numerous medical and psychological comorbidities, and negative impacts on cognitive, emotional, social and physical functioning (Arcelus, Mitchell, Wales, & Nielsen, 2011; Smink, van Hoeken, Oldehinkel, & Hoek, 2014; Ulfvebrand, Birgegård, Norring, Högdahl, & von Hausswolff-juhlin, 2015). Treatment of AN is challenging as there are few pharmacological options, and none approved by the United States Food and Drug Administration (FDA) (Mitchell, Roerig, & Steffen, 2013). Family-based treatment is effective for children and adolescents with AN (Loeb & le Grange, 2009), but there are limited empirically based options available for adults (Herpertz et al., 2011). Alternative therapies, such as mindfulness, are now starting to be examined.
The intestinal microbiota and metabolites in patients with anorexia nervosa
Published in Gut Microbes, 2021
Petra Prochazkova, Radka Roubalova, Jiri Dvorak, Jakub Kreisinger, Martin Hill, Helena Tlaskalova-Hogenova, Petra Tomasova, Helena Pelantova, Martina Cermakova, Marek Kuzma, Josef Bulant, Martin Bilej, Kvido Smitka, Alena Lambertova, Petra Holanova, Hana Papezova
Anorexia nervosa (AN) is a complex eating disorder characterized by self-starvation, excessive weight loss, modified body self-perception, and an intense fear of gaining weight. This severe psychiatric illness is one of the most common chronic diseases with onset in female adolescence, usually gradually associated with various medical and psychiatric comorbidities. AN has the greatest mortality rates of any psychiatric disorder in young females. According to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), patients with AN can be classified as restrictive or binge-eating/purging subtypes. While the restrictive subtype is characterized by starvation and frequent physical hyperactivity, the binge-eating/purging subtype is defined by self-induced vomiting and misusing laxatives, diuretics, or enemas.1