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Eating Disorders: Anorexia

Anorexia nervosa affects 0.5% to 1% of women in the United States during their lifetime. Apart from drastic weight loss, the effects of anorexia include failure to menstruate, a slowdown of the body’s metabolism, and other physical and psychological changes described in starvation victims.

  • Body temperature drops and skin is cool to the touch.
  • Hands and feet look purple from changes in circulation.
  • The face and body may have an orange tinge from changes in the way the liver handles vitamin A and related compounds found in yellow and orange foods.

Despite a woefully inadequate intake of calories, those with anorexia are often remarkably animated and energetic. They may exercise for hours on end to burn off the calories from something they’ve eaten. Many have trouble sleeping. Most are severely constipated because the body’s metabolism slows down and the intake of food, fluid, and fiber is not enough to keep the bowel moving. Some people with anorexia drink large amounts of water or find ways to add weight with hidden metal objects under clothing before medical examinations to try to hide weight loss.

Without treatment, a person with anorexia develops severe nutritional deficiencies. In extreme cases (up to 5 out of every 100) the final result is death due to abnormal heart rhythm causing a massive heart attack or other effects of starvation.

Concerned Parents

If you suspect that your child is starving herself, or if someone brings it to your attention, quickly seek professional help. You might be wrong or overly worried, but you might be right, and early identification and treatment improve outcomes. Anorexia is a life-threatening condition, and one of its signs is the inability to acknowledge the problem and its seriousness. Anorexia hinders a person’s ability to make rational decisions concerning her own health. One of the most promising approaches to treatment is a method that puts parents in charge of refeeding their child, with education, therapy, and support provided by a specially trained team. Inpatient therapy may be required for more severe cases. However, outpatient behavioral management that focuses on nutritional rehabilitation and normalizing eating behavior with the help of a multidisciplinary team is generally regarded as the best approach after the patient is medically and nutritionally stable. Other psychiatric problems may be identified and should be evaluated and treated by an experienced mental health professional.

Phases to Recovery

A person under treatment for anorexia nervosa often passes through 3 phases.

  1. First, the eating disorder itself is the focus of attention.
  2. Second, an improvement in dietary intake is offset by a shift in attitude; the anorexic becomes hostile and sullen.
  3. Finally, the anorexic begins to eat more normally and is more pleasant and cooperative.

A successful transition from the second to third phase indicates the best chance of long-term recovery; in other words, eating normally and maintaining an appropriate weight. At this stage there is restoration of physical and psychological health. About one third of anorexics have long term problems coping with food and accepting a normal weight. The younger the child is when anorexia develops, the poorer the chances of recovery. Early intervention has a better prognosis. The disease and treatment are relatively long lasting and long term, but most individuals will get better.

Last Updated
Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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