Anorexia – a disease which cornerstone the psychological frustration which is shown persuasive aspiration to weight loss, fear of obesity is. Patients with anorexia resort to loss of weight by means of diets, starvation, wearisome physical exercises, washing of a stomach, enemas, a vomiting call after food. At anorexia the progressing weight reduction, a sleep disorder, a depression is observed, there is sense of guilt at meal and starvation, inadequate assessment of the weight. A consequence of a disease – violation of a menstrual cycle, muscular spasms, pallor of skin, feeling of cold, weakness, arrhythmia. In hard cases – irreversible changes in an organism and a lethal outcome.
Anorexia (in translation from Greek – "there is no appetite", an – a negative prefix, orexis – appetite) - the disease which is characterized by violation of work of the food center of a brain and shown lack of appetite, refusal of food.
High danger of anorexia consists in specific features of a disease.
- Anorexia – a disease with high mortality – perishes to 20% of total number of patients. And, more than a half of deaths are a consequence of suicide, heart failure owing to the general exhaustion of an organism becomes the reason of natural death of the anorexic generally.
- Nearly 15% of the women who were fond of diets and weight loss bring themselves to development of obsessional neurosis and anorexia, most of anorexics – teenagers and young girls. Anorexia and bulimia – a scourge of professional models, these diseases suffers from 72% of the girls working at a podium.
- Anorexia can turn out to be consequence of reception of certain medicines, especially in excess dosages.
- Like alcoholics and addicts, patients with anorexia do not recognize presence at themselves of any violations and do not perceive gravity of the disease.
Classification of anorexia
Anorexia is classified by the emergence mechanism:
- neurotic anorexia (negative emotions stimulate overexcitation of a cerebral cortex);
- neurodynamic anorexia (strong irritants, for example, painful, oppress the nervous center in brain bark which is responsible for appetite);
- psychological anorexia or nervous kakheksiya (the refusal of food is caused by a mental disorder – depressions, schizophrenia, a syndrome of persuasive states, the supervaluable idea of weight loss).
Also anorexia can turn out to be consequence of insufficiency of a hypothalamus at children and Kanner's syndrome.
Risk factors of anorexia
Existence of various chronic diseases of bodies and systems can promote development of anorexia. It:
- endocrine frustration (hypophysial and hypothalamic insufficiency, hypothyroidism, etc.);
- diseases of a gastrointestinal tract (gastritis, pancreatitis, hepatitis and cirrhosis, appendicitis);
- chronic renal failure;
- malignant new growths;
- chronic pains of any etiology;
- long hyperthermia (owing to chronic infections or exchange frustration);
- dental diseases.
Anorexia can be caused in small children by violation of the mode and rules of feeding, a persistent overfeeding. It is most widespread among women (in the majority – young girls) nervous anorexia. Cumulative influence of fear of excess weight and much the lowered self-assessment promotes development of psychological rejection of food, persistent refusal of its use.
Subconsciously anorexia becomes the most obvious way of disposal of fears of excess weight and loss of appeal. The teenage mentality, inclined to instability, fixes the idea of weight loss as supervaluable, and the girl loses feeling of reality, ceases to perceive critically herself and a condition of the health.
Girls anorexics can also at an obvious lack of body weight up to a starvation, consider themselves thick and continue to refuse to an organism necessary nutrients. Sometimes patients realize the exhaustion, but, feeling subconscious fear of meal, cannot overcome it. During anorexia there is a vicious circle – lack of nutrients the centers of a brain which are responsible for appetite regulation oppress, and the organism ceases to demand substances necessary for it.
Food frustration to which anorexia belongs, – one of the most widespread psychosocial diseases as very many people use satisfaction of an instinct of saturation as sublimation of missing positive emotions. The food becomes the only means of obtaining psychological benefits, it is accused of psychological failures, going into other extremes – refusal of food.
The behavior at nervous anorexia can be two types (and the same person can act in both ways in different timepoints):
- strong-willed, strict observance of diets, posts, any techniques of starvation;
- against the background of attempts to regulate food there are attacks of an uncontrollable overeating (bulimia) to the subsequent stimulation of clarification (vomiting, enemas).
As a rule, excess physical activity up to that time practices, muscular weakness will not develop yet.
Symptoms of nervous anorexia
Manifestations from food behavior:
- persuasive desire to lose weight, despite insufficiency (or compliance to norm) weight;
- fatfobiya (persuasive fear of excess weight, completeness);
- the obsessions connected with food, fanatical calculation of calories, narrowing of interests and their focusing on questions of weight loss;
- the regular refusal of food motivated by lack of appetite or recent acceptance of food, restriction of its quantity (the argument – "I is already full");
- transformation of meals into a ritual, especially careful chewing (sometimes without chewing a proglatyvaniye), laying in the small portions, cutting by small pieces;
- write avoiding of the actions connected with reception, psychological discomfort after food.
Other behavioural signs:
- aspiration to the increased physical activity, irritation if it is impossible to execute exercises with an overload;
- the preferable choice of spacious baggy clothes (to hide the imaginary excess weight);
- thinking type, aggression, rigid, fanatical, not capable to flexibility, in upholding of the beliefs;
- tendency to avoiding of society, privacy.
- depression of mentality, depression, apathy, decline in the ability to concentration, working capacity, leaving in, obsession with the problems, discontent with, the appearance and the progress in weight loss;
- often – psychological lability, sleep disorders;
- feeling of loss of control over the life, inability to vigorous activity, futility of efforts;
- the anorexic does not consider that he is sick, refuses need of treatment, persists in refusal of food;
- body weight considerably (more than 30%) below age norm;
- weakness, dizziness, tendency to frequent faints;
- growth of a fine and soft pushkovy hair on a body;
- decrease in sexual activity, women have a frustration of a menstrual cycle up to an amenorea and an anovulyation;
- weak blood circulation and, as a result, constant cold sense.
Physiological changes at long refusal of food
Dystrophy, and then kakheksiya – the physiological state which is characterized by the expressed organism exhaustion becomes result of a long absence of receipt in an organism of necessary nutrients. Kakheksiya symptoms: bradycardia (the slowed-down warm rhythm) and the expressed hypotonia, pallor of integuments with apikalny cyanosis (a posineniye of fingers, a nose tip), a hypothermia, hands and legs cold to the touch, are inclined to hypersensibility to low temperature.
Dryness of skin and decrease in its elasticity is characteristic. On all body there is soft and fine pushkovy hair while on the head hair become dry and fragile, the hair loss begins. Subcutaneous fat is practically absent, the atrophy of muscular tissue, dystrophic changes of internals begins. At women develops . Emergence of hypostases, hemorrhages is possible, quite often develop a psychopathia, in the started cases sharp violation of water-salt exchange leads to heart failure.
Treatment of nervous anorexia
Borderlines at anorexics are, as a rule, caused by deep pathological violations of a homeostasis therefore the emergency help for the persons which arrived with symptoms of an acute heart failure at considerable exhaustion is correction of a water and electrolytic state, restoration of ionic balance (recovery of the contents of potassium in serum). Appoint mineral and vitamin complexes, high-calorie food with the high content of protein. At refusal of food – parenteral introduction of nutrients.
However these measures correct consequences, but do not eradicate the psychological reason, do not treat anorexia. To start psychotherapy, it is necessary to inform of all gravity of a disease the patient's relatives and to convince of need of treatment. Considerable difficulty is presented by belief of the anorexic available at it a mental disease and need of treatment. The patient has to carry out voluntarily measures for treatment of anorexia, compulsory therapy can be inefficient and simply impossible.
In most cases (apart from early stages, without the expressed exhaustion) anorexia treat in the conditions of a hospital, the first task is restoration of normal body weight and a metabolism. The freedom of action and movements in a hospital for anorexics is very limited also additional encouragement in the form of walk, patients receive meetings with relatives and friends as an award for observance of a diet and a set of weight. Patients by agreement with the attending physician define these measures of remuneration, proceeding from their appeal and the interest in receiving encouragement. The technique of such encouragement is considered quite effective at moderately expressed anorexia, however in the hard started cases this way can not give effect.
Basic therapy of anorexia – psychological assistance, support, correction of persuasive states, derivation of mentality from obsession with appearance, weight and food, disposal of feeling of inferiority, development of the personality and respect for, abilities to accept itself and the world around. For teenagers family therapy is recommended.
The forecast at anorexia
As a rule, the active psychotherapy course borrows from one to three months, in parallel there is a normalization of weight. At the correct treatment patients and after the end of therapy continue to eat and put normally on weight, but cases of a recurrence of anorexia are frequent. Some patients pass on several psychotherapeutic courses and continue to come back to a vicious way of a disease. The absolute recovery is noted less than at a half of the persons having anorexia.
Very seldom a set of excess weight, obesity can become by-product of therapy.