Anorexia Nervosa - Signs and Symptoms

Signs and Symptoms

Same woman after final day of her 3rd straight 40 day water fast.

Anorexia nervosa is an eating disorder characterized by attempts to lose weight, sometimes to the point of starvation. A person with anorexia nervosa may exhibit a number of signs and symptoms, the type and severity of which may vary in each case and may be present but not readily apparent. Anorexia nervosa, and the associated malnutrition that results from self-imposed starvation, can cause severe complications in every major organ system in the body.

Hypokalaemia, a drop in the level of potassium in the blood, is a sign of anorexia nervosa. A significant drop in potassium can cause abnormal heart rhythms, constipation, fatigue, muscle damage and paralysis.

Between 50% and 75% of individuals with an eating disorder experience depression. In addition, 1 in 4 individuals who are diagnosed with anorexia nervosa also exhibit obsessive compulsive disorder.

Symptoms for a typical patient include:

• Refusal to maintain a normal body mass index for their age
• Amenorrhea, the absence of three consecutive menstrual cycles
• Fearful of even the slightest weight gain and takes all precautionary measures to avoid weight gain and becoming overweight
• Obvious, rapid, dramatic weight loss
• Lanugo: soft, fine hair growing on the face and body One theory is that this is related to hypothyroidism as a similar hypertrichosis occurs in hypothyroidism.
• Obsession with calories and fat content of food
• Preoccupation with food, recipes, or cooking; may cook elaborate dinners for others, but not eat the food themselves
• Dieting despite being thin or dangerously underweight
• Rituals: cuts food into tiny pieces; refuses to eat around others; hides or discards food
• Purging: uses laxatives, diet pills, ipecac syrup, or water pills; may engage in self-induced vomiting; may run to the bathroom after eating in order to vomit and quickly get rid of the calories (see also bulimia nervosa).
• May engage in frequent, strenuous exercise
• Perception of self to be overweight despite being told by others they are too thin and, in most cases, underweight.
• Becomes intolerant to cold and frequently complains of being cold from loss of insulating body fat or poor circulation resulting from extremely low blood pressure; body temperature lowers (hypothermia) in effort to conserve energy
• Depression: may frequently be in a sad, lethargic state
• Solitude: may avoid friends and family; becomes withdrawn and secretive
• Cheeks may become swollen because of enlargement of the salivary glands caused by excessive vomiting
• Swollen joints
• Abdominal distension
• Bad breath (from vomiting or starvation-induced ketosis)
• Hair loss or thinning
• Fatigue

Dermatologic signs of anorexia nervosa

xerosis cutis	telogen effluvium	carotenoderma	acne vulgaris	hyperpigmentation
seborrhoeic dermatitis	acrocyanosis	chilblains	petechiae	livedo reticularis
interdigital intertrigo	paronychia	generalized pruritus	acquired striae distensae	angular stomatitis
prurigo pigmentosa	edema	linear erythema craquele	acrodermatitis enteropathica	pellagra

Possible medical complications of anorexia nervosa

constipation	diarrhea	electrolyte imbalance	cavities	tooth loss
cardiac arrest	amenorrhoea	edema	osteoporosis	osteopenia
hyponatremia	hypokalemia	optic neuropathy	brain atrophy	leukopenia