ANOREXIA NERVOSA IN CHILDREN AND ADOLESCENCE

Anorexia nervosa means literally «nervous loss of appetite.» Actually, however, persons with this condition-almost always female from upper- and upper-middle-class homes-do not lose their appetites. Rather, they willfully suppress the urge to eat in an unhealthy desire to lose more and more weight. In short, they starve themselves because they mistakenly believe that they are fat and need to diet.

After a certain point, anorexia nervosa leads to the cessation of menstruation. It also causes the destruction of healthy muscle and organ tissue that the body must use as an energy source in the absence of food. Ultimately, anorexic patients may starve themselves to death.

Anorexia nervosa is considered to be principally caused by serious psychological problems. Anorexic youngsters are usually obedient, successful children who try to do everything expected of them by parents, teachers, and friends. As a result, the anorexic’s strenuous dieting and exercising may represent a desire to gain absolute control over at least one part of her life.

Anorexics may also try to deny the onset of adulthood by dieting away all the signs of mature femininity: breasts, curved hips, and rounded thighs. The lack of menstrual periods, too, is a reminder of childhood. In addition, the current preoccupation with thinness as the ideal of attractiveness fuels the anorexic’s desire to starve herself to the «perfect» weight. Frequently, the condition arises after a casual remark that the girl is slightly overweight.

The anorexic’s fear of becoming fat is accompanied by a distorted body image that makes it impossible for her to realize how unattractively thin she has become. Often when an anorexic looks in the mirror, she perceives herself as fat when in reality she is exceedingly thin.

The anorexic develops an aversion to eating which cannot be overcome by threats or appeals to reason. The dieting is accompanied by overly vigorous exercise to burn off the few calories that she does consume. Although she refuses to eat more than tiny amounts of certain foods, she is often obsessed with the subject of food and will prepare elaborate meals for others.

Often the anorexic may go on an eating binge after which she forces herself to vomit. Excessive use of laxatives is also common.

After a certain percentage of body fat is lost, menstruation will automatically cease. Fine, downy hair may begin to grow all over the patient’s body.

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