Sara is a sixteen-year-old girl. Joey is a seventeen-year-old boy. They have been best friends since kindergarten. They do everything together. So it was not surprising to their parents that they were both going on the same diet in an attempt to lose ten pounds each. Sara wanted to lose the weight for winter ball and Joey needed to lose it for wrestling. They knew if they motivated each other, they would accomplish their goal. However, what neither one of them nor their parents expected was that “a simple diet” would turn into a horrific illness that would almost take both their lives. Sara lost a total of forty pounds in four months and, over the course of one year, was in and out of the hospital eight times due to medical instability. Joey lost twenty-five pounds in three months, suffered from fainting spells, severe dehydration, and a heart attack that nearly killed him. Neither one of them wanted to lose that much weight. They both reported that “things spun out of control” and that “it just happened.”
Anorexia Nervosa (AN) is a serious psychiatric illness characterized by persistent weight loss through restriction of food or purging behavior. Of all the psychiatric disorders, AN has the highest mortality rate with approximately half of the deaths due to medical consequences from self-starvation and the other half due to suicide. AN is not only a female disorder as once thought; however, it is more common in females than males. Females between the ages of fifteen and twenty-four are at the highest risk for acquiring the illness. According to the National Association of Anorexia Nervosa and Associated Disorders, AN is currently estimated to occur in up to 5 percent of all teenage girls in the United States of America and is listed as the third most common chronic illness in adolescent females. Seven million women and one million men suffer from eating disorders in our country.
There are many consequences both medical and psychological that are associated with AN. The most common health problem is severe malnutrition, which affects many of the systems in the body, such as the circulatory, reproductive, and digestive systems. The illness affects the muscles in the body. Perhaps the most important muscle affected is the heart. The heart slows down to conserve energy in the body’s state of malnutrition. An irregular heartbeat is very common in individuals diagnosed with AN and can cause reduced blood flow in the body and a drop in blood pressure. If the heart slows down too much, it could eventually stop and the individual with AN could go into congestive heart failure or cardiac arrest.
Bone density is affected when the female with AN ceases to have her menstrual period. AN causes a decrease in the production of reproductive hormones. Girls with AN stop menstruating due to the lack of nutrition in their bodies, which places them at risk for infertility. When a female menstruates, certain hormones are released that allow calcium to be deposited into bones. Therefore, when the individual with AN stops having her period, calcium depletion causes bones to become porous and susceptible to fractures and breaks in the short term. In the long-term, it causes severe bone loss and risk of osteoporosis. AN also affects the digestive system. Metabolism is slowed down to conserve food and energy and the digestive process is often disrupted resulting in severe bloating and severe constipation.
In order to be diagnosed with AN, patients need to report distorted body image or deny the seriousness of their current low body weight. They place undue influence of body weight or shape on their self-evaluation and have an intense fear of weight gain. Individuals with AN almost always perceive themselves as being much heavier than they actually are in terms of their body size and body shape. This misperception inevitably leads to the fear of gaining weight; a fear that is so intense, the restriction of food or purging behaviors are maintained and supported inexorably.
