WISCONSIN UNITED
for MENTAL HEALTH

An estimated 0.5 to 3.7 percent of females suffer from anorexia nervosa in their lifetime.  Symptoms of anorexia nervosa include:

• Resistance to maintaining body weight at or above a minimally normal weight for age and height
• Intense fear of gaining weight or becoming fat, even though underweight
• Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
• Infrequent or absent menstrual periods (in females who have reached puberty)

People with this disorder see themselves as overweight even though they are dangerously thin. The process of eating becomes an obsession. Unusual eating habits develop, such as avoiding food and meals, picking out a few foods and eating these in small quantities, or carefully weighing and portioning food. People with anorexia may repeatedly check their body weight, and many engage in other techniques to control their weight, such as intense and compulsive exercise, or purging by means of vomiting and abuse of laxatives, enemas, and diuretics. Girls with anorexia often experience a delayed onset of their first menstrual period.

The course and outcome of anorexia nervosa vary across individuals: some fully recover after a single episode; some have a fluctuating pattern of weight gain and relapse; and others experience a chronically deteriorating course of illness over many years. The mortality rate among people with anorexia is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population.6 The most common causes of death are complications of the disorder, such as cardiac arrest or electrolyte imbalance, and suicide.

Treatment of anorexia calls for a specific program that involves three main phases:

1. restoring weight lost to severe dieting and purging; [which may require hospitalization where feeding plans address the person's medical and nutritional needs. In some cases, intravenous feeding is recommended.
2. treating psychological disturbances such as distortion of body image, low self-esteem, and interpersonal conflicts; [psychotherapy (often cognitive-behavioral or interpersonal psychotherapy) can help people with anorexia overcome low self-esteem and address distorted thought and behavior patterns. Families are sometimes included in the therapeutic process.]
3. achieving long-term remission and rehabilitation, or full recovery.