Health Topics

There are two subgroups of behavior aimed at controlling weight:

Restricting Type

Severely limits the caloric intake of food, especially carbohydrates and fat containing foods.

Binge-eating / Purging Type

Induces vomiting and/or takes large amounts of laxatives, diet pills, or diuretics. May also binge eat regularly.

The following are the most common symptoms of anorexia. However, each child or adolescent may experience signs differently. Symptoms may include:

• rapid or extreme weight loss
• frequent weigh-ins
• expresses feeling fat, even when very thin
• preoccupation with food preparation
• uncomfortable eating at family or social gatherings
• unusual eating behaviors or rituals
• excessive exercise

The following are the most common physical symptoms associated with anorexia - often that result from starvation and malnourishment. However, each child may experience symptoms differently. Symptoms may include:

• absence of menstrual periods 
• fatigue
• intolerance to cold temperatures
• dizziness or fainting spells
• abdominal pain
• constipation
• trouble sleeping

Persons with anorexia may also be socially withdrawn, irritable, moody and/or depressed. The symptoms of anorexia nervosa may resemble other medical problems or psychiatric conditions. Always consult your adolescent's physician for a diagnosis.

Parents, teachers, coaches, or instructors may be able to identify the child or adolescent with anorexia, although many persons with the disorder initially deny any symptoms. However, an adolescent's physician, child psychiatrist or a qualified mental health professional usually diagnoses anorexia nervosa.

A detailed history of the child's behavior from parents and teachers, clinical observations of the child's behavior and sometimes, psychological testing contribute to the diagnosis. Parents who note symptoms of anorexia in their child or teen can help by seeking an evaluation and treatment early. Early treatment can often prevent future problems.

Anorexia, and the malnutrition that results, can injure nearly every organ system in the body, increasing the importance of early diagnosis and treatment. Anorexia can be fatal. Consult your child's physician for more information.

Specific treatment for anorexia nervosa will be determined by the adolescent's physician based on:

• age, overall health and medical history
• extent of symptoms
• tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• ability of the family to participate in treatment

Anorexia is usually treated with a combination of individual therapy, family therapy, behavior modification and nutritional rehabilitation. Treatment should always be based on a comprehensive evaluation of the adolescent and family. The frequent occurrence of medical complications and the possibility of death during the course of acute and rehabilitative treatment requires both your child's physician and a nutritionist to be active members of the management team. Parents/family play a vital role in the treatment process.

Medical complications that may result from anorexia include, but are not limited to, the following:

Heart

While it is difficult to predict which patients might have life-threatening cardiac complications from their illness, most patients suffer some heart changes including:

• arrhythmias (irregular heartbeat)
• bradycardia (slow heartbeat)
• hypotension (low blood pressure)
• weakened heart muscle leading to decreased exercise endurance

Blood

Low white blood cell count (infection fighting cells) and low red blood cell count (oxygen carrying cells) occurs in up to 50 percent of anorexic patients. In addition, there may be abnormalities in other blood tests, such as the potassium (K+), Calcium (Ca), Phosphorous (Phos) and Magnesium (Mg).

Stomach and Intestines

Normal movement in the intestinal tract slows down leading to fullness, bloating, nausea and constipation.

Kidneys

The kidney loses its ability to concentrate urine, leading to frequent urination. Dehydration can occur easily as the injured kidney is unable to compensate for decreased drinking and eating behavior. Low carbohydrate, high protein diets can be especially dangerous to the kidney in these patients.

Hormones

Amenorrhea (loss of the menstrual cycle) is one of the hallmark symptoms of anorexia. It can even occur before severe weight loss (because of irregular nutrition) and can continue even after normal weight is restored. Reduced levels of estrogen, testosterone, and growth hormones may explain growth retardation and delayed pubertal changes seen in anorexic patients. Normal nutrition usually restores normal growth.

Bones

People with anorexia nervosa are at an increased risk for stress fractures and broken bones. When the onset of anorexia occurs before peak bone mass is formed (usually mid to late teens), a greater risk of osteoporosis (bone loss) exists.