ED Deep Dive #1: Anorexia nervosa
As part of my ED Deep Dive series of blog posts, let’s focus on the first classification on the DSM-V’s list of eating disorders: anorexia nervosa (AN).
Clinical definition & presenting symptoms of anorexia nervosa
The DSM-V defines anorexia nervosa as:
Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health (less than minimally normal/expected).
Intense fear of gaining weight or persistent behavior that interferes with weight gain.
Disturbed by one’s body weight or shape, self-worth influenced by body weight or shape, or persistent lack of recognition of the seriousness of low body weight.
The diagnosis can be broken down further into two subtypes:
Restricting type: Weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.
Binge-eating/purging type: During the last three months the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting, or the misuse of laxatives, diuretics, or enemas).
Physiological effects of anorexia nervosa
Anorexia nervosa can adversely affect every system of the body:
Cardiovascular (heart and blood vessels) — anemia, low blood cell counts, slow heart rate, cold hands and feet, electrolyte imbalances that can lead to cardiac arrest or death
Gastrointestinal (stomach) — stomach cramps, constipation, acid reflux, swelling of the salivary glands
Integumentary (skin) — cuts and calluses across the top of finger joints (a result of induced vomiting), dry skin, dry and brittle nails, fine hair appearing on the body (“lanugo”)
Neurological (brain and spinal cord) — difficulty concentrating, dizziness, fainting, sleep problems
Musculoskeletal — enamel erosion, cavities, tooth sensitivity, muscle weakness
Reproductive — amenorrhea (absence of a menstrual period), menstrual irregularities
To see a full list of physiological effects of anorexia nervosa, click here.
