Anorexia nervosa

Generalizations are never completely accurate, but there are many similar characteristics of young people afflicted by anorexia nervosa. A child with anorexia is often a driven perfectionist and a highly accomplished person who excels in academics, sports and/or the arts.

She is usually one who seeks to please others and enjoys approval of others as a measure of her own worth. And she may have relatives who suffer from an eating disorder – there is a genetic component to anorexia nervosa. Your child will almost certainly be the last to admit she has a problem with food or body image. Parents and friends, who normally notice first, need to take appropriate steps to help. Look for the following symptoms and behaviors.

Symptoms and behaviors

Symptoms include:

• Weight loss or failure to gain weight during a period of growth, leading to a body weight of less than 85 percent of normal – or quickly going from overweight to a normal or low body weight.
• Intense fear of gaining weight.
• Disturbed body image – seeing herself as fat even when she is thin (and sometimes very thin).
• Going three or more months without a period in girls who are menstruating.
• Fatigue.
• Losing hair, skin breakouts.
• Blue or gray, cold hands and feet.

Behaviors include:

• Decreased food intake.
• New food fetishes – strictly avoiding certain foods, especially fats and carbs.
• Fascination with food labels, obsessive calorie counting.
• Preoccupation with food – reading cookbooks or cooking for the family without eating, or as a substitute for eating.
• Avoidance of eating in front of people.
• Avoidance of eating in a restaurant – calories are harder to count and control when eating out.
• Rigid and controlling attitude about food and exercise.
• Intense exercise.
• Depression, irritability, withdrawal.
• Change in friendships.
• Irritation when friends or family of friends express concern regarding her weight and behavior.
• Being cold all the time and dressing heavily, both to keep warm and to hide her body.

Treatment

The first and most important step in treatment is recognizing the signs and bringing your child to medical attention. If a diagnosis of anorexia nervosa is made, we will work with your child to help her understand her diagnosis, its gravity and treatment options. Without treatment, anorexia is a dangerous disorder with a death rate of 6 percent each decade. With early treatment, the chance for recovery is good.

Treatments options include:

• Outpatient: A team that includes a doctor, a dietician and a psychologist works closely with your child and your family to help her recover. In some cases, a psychiatrist can also be helpful.
• Inpatient: Certain signs and symptoms of severe anorexia will require us to hospitalize your child for monitoring and medically supervised feedings. The average length of stay for our patients admitted to Sacred Heart Medical Center at RiverBend is one week. This time is spent ensuring that your child’s internal organs are stable to continue recovery. This stay must be followed either by outpatient or residential care.
• Residential: A child who cannot recover from anorexia without constant supervision by trained professionals will be a candidate for one of many good residential programs in the U.S. We can help you select an appropriate residential program for your child.