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Anorexia Nervosa is an eating disorder. It is a psychological condition that involves a person's refusal to eat sufficient food to maintain a minimum normal weight for age and height. Anorexia Nervosa is an illness that can have serious effects on many body systems and requires treatment by a qualified health professional.

Anorexia Nervosa is a psychological disorder with multiple causes. Such causes can be related to problems at home, school or work. From the outside, anorexia appears to be all about food and weight. It is generally believed, however, that Anorexia is strongly influenced by low self-esteem, feelings of inadequacy and worthlessness and the problems that these feelings cause in coping with the pressures of daily living.

A person suffering from Anorexia Nervosa will often begin by losing weight in the normal manner. Unfortunately, instead of stabilizing at a healthy weight, the person may then go on to deliberately deny himself or herself food. Anorexia causes a distorted perception of body weight or shape i.e. the person thinks they are fat even when they are very thin.

The person will often resort to a number of methods to induce weight loss. Diet tablets, excessive exercise, laxatives, diuretics and even self-induced vomiting may be used at one time or another. Many sufferers who are anorexic are also bulimic. Bulimia Nervosa is defined as the consumption of extremely large quantities of food in short periods of time (binging), following self-induced vomiting or the use of diuretics or cathartics (purging).

Anorexia Nervosa is relatively uncommon, but occurs worldwide. Up to 90% of people with Anorexia Nervosa are women. Almost all cases of Anorexia in women occur after puberty and before menopause. The typical girl with Anorexia is in her late teenage years. A genetic component is likely, as women are up to 12 times more likely to develop anorexia if a family member has the illness.

Young men sometimes suffer from the disease and should be treated as seriously as girls. Anorexia in males often seems to relate to boys with a need to overachieve. Decreased interest in sex or fears around sex and preoccupation with body building, weight lifting, or muscle toning can occur in male Anorexia sufferers. Trouble with sleeping, depression and lowered testosterone levels in males may be associated with this ailment. A female suffering from Anorexia may stop having periods, which can lead to difficulty with conceiving. Anorexia Nervosa can also lead to impaired digestion, amenorrhoea (lack of menstrual periods), irregular heart beats and reduced bone density.

Dieting may be a problem when there is:
• Denial of dieting.
• Reluctance to display weight loss.
• A need to eat less when with others.
• A change in personality/social withdrawal.
• Devastation at the thought of gaining weight.

Dramatic weight loss may cause the following physical signs and symptoms:
• Amenorrhoea or absence of menstruation.
• Hair loss.
• Intolerance to the cold.
• Dry, peeling rash.
• Low blood pressure.
• Slowed heart rate.
• Lowered body temperature.

This patient must be under the care of a Doctor at all times as with this illness there may be a complex interplay between biological, psychological and social factors. The patient needs careful monitoring and care. Psychiatric counselling may be needed to help control this ailment. Treatment at some stage may include hospitalisation. A person with Anorexia may induce vomiting after eating, so it may be necessary to closely monitor the person's actions. To encourage a healthy body image and relationship to food the person may require family therapy, individual counselling or group counselling.

This condition is very difficult to treat with a simple "diet" as the person is usually resistant to suggestions to eat and has already developed severe food restrictions. Sometimes he/she can mask the condition by eating a meal then inducing vomiting immediately after eating. One suggestion is to encourage the person with Anorexia to eat with other members of the family. Encourage nutritious snacks between meals and concentrate initially on a quantity of foods they feel comfortable eating. New foods can be added in later when the effects of starvation on their mental outlook have subsided. Encourage the use of normal foods, rather than "diet" foods or low fat foods. Ensure some protein is eaten daily and if possible include seafood and red meat for zinc. Present the food in an appetising way. Protein supplements contain all the essential amino acids and are easy to digest. Nutrition counselling by a Dietician may be helpful.

• Zinc studies have shown that zinc deficiency is common in Anorexia sufferers. Zinc also can aid in enhancing sense of smell and appetite.
• B group vitamins can be deficient in Anorexia and supplementation can be beneficial.
• Gentian can improve appetite and digestion.
• Hypericum can be useful in the treatment of depression and anxiety, which can occur in people with Anorexia.

Lots of love and understanding is necessary for Anorexic patients. Usually the whole family has to be involved to help these patients. Their confidence usually has to be built up. Any other underlying problems in lifestyle and general health may have to be examined. When given adequate support and treatment, most people with Anorexia recover and lead normal lives.

Ask your MedAux Pharmacist for advice:
1. If there is any doubt on how to take any medication, ask your Pharmacist.
2. Follow the Diet Hints.
3. Do not eat junk food, sugar and refined carbohydrates as these foods are harder to digest and do not provide the necessary nutrients for good health.
4. Do not drink any caffeinated drinks. They include tea, coffee and cola. Caffeine increases nervous tension and can suppress appetite.
5. Moderate any alcohol consumption as this puts extra strain on the liver. Alcohol dependence has been associated with some eating disorders.
6. Have regular gentle exercise without over exercising.
7. Have adequate rest and relaxation and try to avoid unnecessary stress.
8. If the diet is considered inadequate, include vitamin C, the B Group vitamins and zinc to enhance the immune system of the body. Zinc deficiency can lead to a reduction in the sense of smell and taste. Some studies have shown that magnesium might be useful.

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