Neuropsychic anorexia and bulimia

3,716 per 1 million population per year. Women suffer from anorexia 20 times more often than men. Among girls of school age is 1-2% (in the upper strata of the population above).

[1], [2], [3], [4], [5], [6], [7], [8], [9]

Causes of anorexia

Up to 10% of girls who have sisters are affected. However, it is necessary to emphasize the importance of family behavioral status, and not direct genetic influence. It is extremely rare in this situation, a hypothalamic tumor is diagnosed, although at first it is believed that one has to deal with neuro-psychical anorexia (from this point of view, suspicious cases when amenorrhea precedes weight loss). Some researchers see a ruthless desire to lose weight struggle for self-control with the goal of becoming a person in society. Of great importance in the emergence of the disease are dietary problems in early childhood, very great attention of parents to nutrition issues and family relationships that leave this person without a sense of adequate social significance, without a sense of identity. For the hypothesis that the main problem with this disease is psychosexual immaturity, there are few reasons.

[10], [11], [12], [13], [14]

Symptoms of anorexia

Symptoms of anorexia usually appear at the age of 16-17 years (12 years in boys), often following a strict diet. The patient begins to attach very great importance to reducing body weight (this becomes an overvalued idea), and she begins to feel that she is repulsively complete, while in fact there is emaciation. Patients in these cases often resort to increased physical exercise, taking laxatives and inducing vomiting. The patient sees his main virtue embodied precisely in the form of the body and its mass. In such patients, episodes of "binge eating" can occur, followed by self-recurrence, the recall of repeated vomiting and isolation - the patients hide from others their painful idea of losing weight. (Note: if binge eating is not accompanied by loss of body weight, then bulimia nervosa is diagnosed.)

Somatic complications of "binge overeating"

Most often it is gastric rupture, metabolic complications associated with excessive (self-induced) vomiting.

Diagnosis of anorexia

Below are the diagnostic criteria for neuro-psychiatric anorexia in accordance with DSM-III-R.

1. Body weight is more than 15% below ideal.
2. Fear of obesity even with great leanness.
3. The correct perception of the mass of one's own body is broken (that is, a person feels full even when thin).
4. Amenorrhea: menstruation was absent for more than three cycles, provided that the patient does not take any appropriate tablets.

[15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25]

Treatment of anorexia

It may be necessary to hospitalize a patient to restore normal body weight. As the body weight regains, patients should be returned to their place of residence. Family therapy seems more effective than treatment by the method of psychoanalysis. If the problem is "binge overeating", then this condition can be corrected using the behavioral method of psychotherapy. For example, a patient may agree to eat only in one of the rooms at home and eat only during lunch, or agree not to eat at home and during shopping, or agree to buy only the products that she usually buys when it happens full. You can also help purchase products accompanied by a friend. It is also advisable to take only the amount of money that can be enough only for the products indicated in the list available to the patient.

Prognosis of anorexia

About 2% of patients with anorexia die (from exhaustion), in 16% the body weight remains well below normal for another 4-8 years.