Anorexia Nervosa, Which Mainly Affects

Anorexia nervosa, which mainly affects young women, is characterized by refusal to maintain body weight, intense fear of gaining weight, and feelings of being fat even when the individual is emaciated (Gold).

One feature of this disorder is 'paradoxical satiety,' which means that individuals feel full when they fast, but become intensely hungry when they begin to eat (Gold). Secondary effects include cessation of menstruation, hair loss, and upper respiratory infections. Complications of anorexia nervosa and other eating disorders include "cardiovascular disturbances, electrolyte imbalances, endocrine abnormalities, gastrointestinal problems, and iatrogenic problems" (Gold). Furthermore, laboratory evaluation often reveals decreased serum levels of albumin, globulin, calcium, potassium and sodium, and typically, the white and red blood cell counts are also decreased (Gold). Although denial by the patient can make treatment difficult, focus should be on weight gain and reduction of depression (Gold).

Throughout history, there are accounts of women who refused to eat. For example in 1689, a British physician reported on two patients, one male and one female, suffered from 'nervous consumption' (Gold). In 1874, two physicians, Laseque and Gull, named the disorder 'anorexia nervosa, and described it as extreme emaciation associated with increased activity, episodes of binge eating, amenorrhea and low body temperature (Gold).

Anorexia nervosa primarily affects young women, with onset typically between the ages of 12 and 25 years, however numerous cases of new onset anorexia in elderly men and women have been reported (Gold). The prevalence of this disorder varies between 2 and 5% among adolescent and young adult women, and carries a mortality rate of 5% in the first two years, yet among untreated patients, mortality can approach 20% (Gold).

A perfectionist lifestyle, punctuated by one or more performance-related stresses, predisposes an individual to anorexia nervosa, as does a family history of the disorder in female relatives (Gold). Moreover, individuals of upper-middle socioeconomic status are most often affected (Gold).

The typical anorectic individual has a distorted body image and has an obsessive need to maintain an ultra-thin silhouette. Regardless of the degree of emaciation, she sees herself as obese, yet, her perception of the physical appearance of others remains accurate (Gold). For example, a patient's drawings of family members are generally undistorted, while those of herself show an exaggeratedly obese figure (Gold).

Although anorexia nervosa typically affects females, according to the National Association of Anorexia and Associated Disorders, this disorder also affects over 1 million males per year (Hayes). Despite this statistic, anorexia nervosa is usually misdiagnosed or overlooked by both mental health and medical practitioners because of the misperception that it is a female disorder (Hayes). In fact, males account for 5-10% of reported cases of anorexia nervosa (Hayes). Research suggest that males who develop anorexia nervosa and other eating disorders differ from females in three major areas of dieting behaviors: 1) while females diet because they feel fat, males diet because they have been overweight at some point in their lives; 2) males more often than females diet to attain certain goals in sports or to avoid some type of sports-related injury that would be related to a weight gain; 3) there is a greater preponderance of men who diet to avoid potential medical problems (Hayes). Generally, males believe that dieting and exercise will allow them to fell more masculine and more in control, which will lead to greater respect from others (Hayes).