Anorexia Nervosa

Under the guidance of ,

Dr. K.Ravishankar
M.Pharm,ph.D
Professor, And Principal,
Sri Sai Aditya College Of Pharmaceutical Sciences And Research ,
Surampalem.

By
V K C KIRAN PULLELA
Reg No. 133H1S0610
Contents
Introduction
Causes
Risk Factors

Symptoms

Possible Complications

Diagnosis

Treatment
References

Introduction
Anorexia nervosa is an eating
disorder that makes people
lose more weight than is
considered healthy for their
age and height.
Persons with this disorder
may have an intense fear of
weight gain, even when they
are underweight. They may
diet or exercise too much or
use other ways to lose
weight.
Introduction
Subtypes of Anorexia Nervosa
Two Subtypes
Restricting Subtype
place severe restriction on the amount and type of food
they consume
Restricting certain types of foods (e.g. carbohydrates,
fatty foods)
Counting calories
Skipping meals
Obsessive rules and rigid thinking (e.g. only eating food
that is one colour)
Excessive exercise.

Introduction
Binge Eating/Purging Subtype
In addition to severe food restriction, the person
will also have binge eating/purging behaviour.
These behaviours include:
Binge eating eating a large amount of food
accompanied by a feeling of loss of control
Self induced vomiting, deliberately misusing laxatives,
diuretics or enemas to compensate for eating food
Causes
multifactorial with a combination
of biological, psychological, and
sociocultural factors.
disturbances in a number of
different neurotransmitters
including serotonin,
norepinephrine, and dopamine
Less efficient transport of Ghrelin
to the brain
Gene, transporter, receptor
Polymorphisms
Some infections like Lyme Disease
(Caused by Borrelia Spp)




Biophysical Model for Anorexia Nervosa
Risk Factors
Age: Often begins during the pre-teen or teen years or
young adulthood.
Sex: More common in females, but may also be seen in
males.
Hereditary factors.
Being more worried about, or paying more attention
to, weight and shape
Having an anxiety disorder as a child
Having a negative self-image
Having eating problems during infancy or early
childhood

Symptoms
To be diagnosed with anorexia, a person must:
Have an intense fear of gaining weight or becoming
fat, even when he/she is underweight
Refuse to keep weight at what is considered normal
for her age and height (15% or more below the
normal weight)
Have a body image that is very distorted, be very
focused on body weight or shape, and refuse to admit
the danger of weight loss
Have not had a period for three or more cycles (in
women)
Symptoms
Behavioral:
Cutting food into small pieces or moving them
around the plate instead of eating
Exercising all the time, even when the weather is
bad, they are hurt, or their schedule is busy
Going to the bathroom right after meals
Refusing to eat around other people
Using diuretics, laxatives, diet pills
Suicidal tendency
Symptoms
Other Symptoms:
Fatigue
Insomnia
skin that is yellow or blotchy
Lanugo (very fine, soft, and usually unpigmented on
the body)
hair thinning or falling out
Constipation
Amenorrhea
Xeroderma
Hypotension
Symptoms
Other Symptoms:
Hypotension and/or orthostatic hypotension
Bradycardia or tachycardia
Depression
enlargement of the salivary glands (caused by
excessive vomiting)
Swollen joints
Halitosis (Bad Breath) from vomiting or starvation-
induced ketosis.
Abdominal Distension
Rapid mood swings

Possible Complications
leads to death in 10% of cases (estimate)
Osteoporosis (Serious)
Leucocytopenia, which leads to increased risk of infection
Hypokalemia, which may predispose to arrhythmias
dehydration
malnutrition
Seizures due to fluid or sodium loss from repeated diarrhea
or vomiting
Thyroid gland problems
Tooth decay
Increased risk of infertility
Diagnosis
Tests should be done to help find the cause of weight loss, or see
what damage the weight loss has caused. Many of these tests will
be repeated over time to monitor the patient.
Albumin
Bone density test to check for thin bones (osteoporosis)
Complete Blood Count
Electrocardiogram (ECG or EKG)
Electrolytes
Kidney and Liver function tests
Total protein
Thyroid function tests
Urinalysis
Tests for any underlying infections which are likely to cause
anorexia
Treatment
Medical and nutritional intervention
Nutritional rehabilitation
Weight restoration
Reversal of the acute medical complications
Psychological intervention
family psycho education
interpersonal therapy
family therapy
Pharmacological treatment
SSRIs:
Fluoxetine
Sertraline
Paroxetine
Fluvoxamine
Citalopram
there are some recent reports that the atypical neuroleptic medications such
as Risperidone, Olanzapine, and Quetiapine may be effective in adolescents
with anorexia nervosa

References
http://www.webmd.com/mental-health/anorexia-
nervosa
http://www.nlm.nih.gov/medlineplus
PubMED Health
http://www.ncbi.nlm.nih.gov/
http://peds.stanford.edu/Rotations/adolescent_m
edicine/documents/EDArticle.pdf