Post by Mel on Dec 22, 2005 22:04:14 GMT -5
Characteristics
The causes of anorexia are a matter of debate in medical circles and society in general. General perspectives fit between the poles of it being physiological or psychological (with the potential for sociological and cultural influences being a cause to various degrees) in origin. Some now take the opinion that it is a mix of both, in that it is a psychological condition which is often (though not inherently) borne of certain conducive neurophysiologic conditions.
[edit]
Physiological
The primary physiological characteristics of anorexia nervosa are:
voluntary starvation
exercise stress
obsessive-compulsive behavior
autism spectrum disorder
In addition to intentional starvation, subjects will also take part in a high level of physical activity. Anorexia nervosa also has a negative impact on the immune system and the central nervous system (CNS).
It is also thought to be linked to serotonin and dopamine abnormalities.
Many individuals develop obsessive-compulsive symptoms as part of their disease. Some have an eating-disordered parent, presumably connected with shared genetic characteristics.
Additionaly, some 1/3 of anorexic people meet diagnostic criteria for an autism spectrum disorder, a sub-group that is especially difficult to treat successfully [1]. Thus, anorexia may be the result of undetected autism in women [2].
Anorexic subjects will often go through a cycle of recovery and relapse, unless weight is restored long-term.
[edit]
Neurochemistry abnormalities
There is increasing speculation that the onset of anorexia has a genetic component, with a certain gene linked to abnormalities with the neurotransmitter chemical serotonin being shown to be more common amongst sufferers than the general population. Such genetic characteristics might potentially equate to an easier path towards overly high serotonin levels, thus instilling heightened levels of anxiety and the like. Biologically, when a person is in a state of starvation, their levels of serotonin decrease, and thence increase again upon the consumption of food because of the tryptophan amino acids contained therein (tryptophan is used by the body to synthesise serotonin). This raises the spectre that the anorexic is conditioned into avoiding food to reduce his or her anxiety, and that there may be yet another layer of complexity with respects to the cause/effect relationship between physiological factors and the mental beliefs of the anorexic.
Blood chemistry abnormalities: dietary minerals and heavy metals
Victims of mercury, lead, beryllium and arsenic poisoning have been known to develop anorexia as a symptom thereof. Some psychological traits associated with anorexia are consistent with deficiencies in important vitamins and minerals, such as magnesium and the B vitamins. Zinc deficiency is common among anorexics, thereby resulting in heightened levels of copper which is associated with depression and nervousness. That these deficiencies (or untoward exposure to heavy metals) can produce powerful psychological effects, such as depression, anxiety, and loss of appetite, is not widely known. Conversely, overexposure is also harmful.
Animal model
There exists an animal model of anorexia nervosa that closely mimics the physiological effects of the disease. In the animal model, subjects are intentionally subject to starvation and given unlimited access to exercise. Under these conditions, without intervention, subjects will eventually run and starve themselves to death. Compared to cases of food restriction without exercise access, the subject will not starve themselves to death.
In the animal model of anorexia nervosa, it has been shown that repeated cycling of recover and relapse will lead to physiological adjustments from the subject. Subjects under these conditions will eventually become "resistant" to the animal model, and will not starve themselves to death. Subjects under these conditions show a metabolic adjustment.
Physiological effects in the animal model include:
Negative impact on the immune system
Negative impact on the Central Nervous System
Serotonin deficiency
[edit]
Dangers
Anorexia has the highest death rate of any psychiatric illness. Starvation can cause major organs to shut down. A heart attack is one of the most common causes of death in those suffering with an eating disorder. People can die from eating disorders at any body weight.
Osteoporosis is another danger of anorexia. Low calcium intake is only part of the problem. Even in those who take in adequate calcium through food or supplements, amenorrhea prevents the body from absorbing it fully.
Since depression accompanies anorexia, suicide is also a risk factor. Approximately 25% of all anorextics attempt suicide, and about 50% of anorexic deaths result from suicide.
[edit]
Psychological, Sociological, and Cultural
Psychological
Anorexia nervosa alters an individual's body image to the point where it is perceived as being fat and bilious irrespective of their actual size. This distorted body image is a source of considerable anxiety, and losing weight is considered to be the solution. However, when a weight-loss goal is attained, the anorexic still feels overweight and in need of further weight loss.
The attainment of a lower weight is typically viewed as a victory, and the gaining of weight as a defeat. "Control" is a factor strongly associated with anorexia nervosa, and an anorexic typically feels highly out of control in his or her life. However, the nature of the condition with respect to such psychological factors is highly complicated.
It is often the case that other psychological difficulties and mental illnesses exist alongside anorexia nervosa in the sufferer. Mild to severe manifestations of depression are common, partly because an inadequate food energy-intake is a well-known trigger for depression in susceptible individuals. Other afflictions may include self-harm and obsessive-compulsive disordered thinking (aside from such disordered thinking connected to their eating disorder). However, not all anorexics have any such problems besides their eating disorder.
Many anorexics reach a low level of body weight at which hospitalisation and forced-feeding are required on a long-term or recurring basis in an attempt to keep them from literally starving themselves to death. Prolonged starvation will result in death as the body's systems shut down, this in itself being the major danger factor of anorexia aside from intense mental suffering and the risk of suicide.
Some anorexics may incorporate bulimic behaviours into their illness: binge-eating and purging themselves of food on a regular or infrequent basis at certain times during the course of their illness. Alternatively, some individuals might switch from having anorexia nervosa to having bulimia. While bulimia poses less of a mortal danger to life and limb, many who have suffered both say that bulimia involves more mental suffering.
Anorexia alters ones body image so that one does not see the truth about oneself even when one looks in the mirror — to the anorexic mindset, there is no such thing as being too thin. Anorexics acknowledge their condition to different degrees — at one extreme, they do not see their "disease" as dangerous and resent being labelled as psychologically ill; at the other, they understand and accept that they have a problem, yet the anorexia still takes control over their thinking to fluctuating degrees. In ways not too dissimilar from people who have had cult programming or post-traumatic stress disorder, an anorexic may be "triggered" into manic disordered thinking by being exposed to certain words or conditions.
Some people eat unusually small amounts of food for reasons other than their own perceived obesity. Examples include those who fast for religious reasons, execute a hunger strike as a political statement, or are attempting to lengthen their lifespan through caloric restriction. Such individuals are not ordinarily considered anorexic, although some modern critics of religious asceticism have likened habitual fasting to anorexia nervosa
Sociological and Cultural
Anorexia can be traced back to or connected with 19th century American society. Joan Jacobs Brumberg, in her article "The Appetite as Voice", stresses the importance of the history of anorexia nervosa. "A history of anorexia nervosa must consider the ways in which different societies create their own symptom repertoires and how the changing cultural context gives meaning to a symptom such as non-eating" (Brumberg, p.159). During the Victorian era, medical examiners were more interested in physical characterics, or what the patient's body had to say, rather than his/her description of their illness. Young women were also viewed as a non-reliable source for information. Related to the section below on contemporary culture, doctors of the 19th century viewed the connection between culture and the disease very differently. "In effect, nineteenth-century medicine did not relate anorexia nervosa to the cultural milieu that surrounded the Victorian girl. The ideas of Victorian women and girls about appetite, food, and eating, as well as the cultural categories of fat and thin, were not mentioned as contributing to the disease. Only in the twentieth century has medicine come to understand that society plays a role in shaping the form of psychological disorders and that behavior and physical symptoms are related to cultural systems" (Brumberg, p.160).
The causes of anorexia are a matter of debate in medical circles and society in general. General perspectives fit between the poles of it being physiological or psychological (with the potential for sociological and cultural influences being a cause to various degrees) in origin. Some now take the opinion that it is a mix of both, in that it is a psychological condition which is often (though not inherently) borne of certain conducive neurophysiologic conditions.
[edit]
Physiological
The primary physiological characteristics of anorexia nervosa are:
voluntary starvation
exercise stress
obsessive-compulsive behavior
autism spectrum disorder
In addition to intentional starvation, subjects will also take part in a high level of physical activity. Anorexia nervosa also has a negative impact on the immune system and the central nervous system (CNS).
It is also thought to be linked to serotonin and dopamine abnormalities.
Many individuals develop obsessive-compulsive symptoms as part of their disease. Some have an eating-disordered parent, presumably connected with shared genetic characteristics.
Additionaly, some 1/3 of anorexic people meet diagnostic criteria for an autism spectrum disorder, a sub-group that is especially difficult to treat successfully [1]. Thus, anorexia may be the result of undetected autism in women [2].
Anorexic subjects will often go through a cycle of recovery and relapse, unless weight is restored long-term.
[edit]
Neurochemistry abnormalities
There is increasing speculation that the onset of anorexia has a genetic component, with a certain gene linked to abnormalities with the neurotransmitter chemical serotonin being shown to be more common amongst sufferers than the general population. Such genetic characteristics might potentially equate to an easier path towards overly high serotonin levels, thus instilling heightened levels of anxiety and the like. Biologically, when a person is in a state of starvation, their levels of serotonin decrease, and thence increase again upon the consumption of food because of the tryptophan amino acids contained therein (tryptophan is used by the body to synthesise serotonin). This raises the spectre that the anorexic is conditioned into avoiding food to reduce his or her anxiety, and that there may be yet another layer of complexity with respects to the cause/effect relationship between physiological factors and the mental beliefs of the anorexic.
Blood chemistry abnormalities: dietary minerals and heavy metals
Victims of mercury, lead, beryllium and arsenic poisoning have been known to develop anorexia as a symptom thereof. Some psychological traits associated with anorexia are consistent with deficiencies in important vitamins and minerals, such as magnesium and the B vitamins. Zinc deficiency is common among anorexics, thereby resulting in heightened levels of copper which is associated with depression and nervousness. That these deficiencies (or untoward exposure to heavy metals) can produce powerful psychological effects, such as depression, anxiety, and loss of appetite, is not widely known. Conversely, overexposure is also harmful.
Animal model
There exists an animal model of anorexia nervosa that closely mimics the physiological effects of the disease. In the animal model, subjects are intentionally subject to starvation and given unlimited access to exercise. Under these conditions, without intervention, subjects will eventually run and starve themselves to death. Compared to cases of food restriction without exercise access, the subject will not starve themselves to death.
In the animal model of anorexia nervosa, it has been shown that repeated cycling of recover and relapse will lead to physiological adjustments from the subject. Subjects under these conditions will eventually become "resistant" to the animal model, and will not starve themselves to death. Subjects under these conditions show a metabolic adjustment.
Physiological effects in the animal model include:
Negative impact on the immune system
Negative impact on the Central Nervous System
Serotonin deficiency
[edit]
Dangers
Anorexia has the highest death rate of any psychiatric illness. Starvation can cause major organs to shut down. A heart attack is one of the most common causes of death in those suffering with an eating disorder. People can die from eating disorders at any body weight.
Osteoporosis is another danger of anorexia. Low calcium intake is only part of the problem. Even in those who take in adequate calcium through food or supplements, amenorrhea prevents the body from absorbing it fully.
Since depression accompanies anorexia, suicide is also a risk factor. Approximately 25% of all anorextics attempt suicide, and about 50% of anorexic deaths result from suicide.
[edit]
Psychological, Sociological, and Cultural
Psychological
Anorexia nervosa alters an individual's body image to the point where it is perceived as being fat and bilious irrespective of their actual size. This distorted body image is a source of considerable anxiety, and losing weight is considered to be the solution. However, when a weight-loss goal is attained, the anorexic still feels overweight and in need of further weight loss.
The attainment of a lower weight is typically viewed as a victory, and the gaining of weight as a defeat. "Control" is a factor strongly associated with anorexia nervosa, and an anorexic typically feels highly out of control in his or her life. However, the nature of the condition with respect to such psychological factors is highly complicated.
It is often the case that other psychological difficulties and mental illnesses exist alongside anorexia nervosa in the sufferer. Mild to severe manifestations of depression are common, partly because an inadequate food energy-intake is a well-known trigger for depression in susceptible individuals. Other afflictions may include self-harm and obsessive-compulsive disordered thinking (aside from such disordered thinking connected to their eating disorder). However, not all anorexics have any such problems besides their eating disorder.
Many anorexics reach a low level of body weight at which hospitalisation and forced-feeding are required on a long-term or recurring basis in an attempt to keep them from literally starving themselves to death. Prolonged starvation will result in death as the body's systems shut down, this in itself being the major danger factor of anorexia aside from intense mental suffering and the risk of suicide.
Some anorexics may incorporate bulimic behaviours into their illness: binge-eating and purging themselves of food on a regular or infrequent basis at certain times during the course of their illness. Alternatively, some individuals might switch from having anorexia nervosa to having bulimia. While bulimia poses less of a mortal danger to life and limb, many who have suffered both say that bulimia involves more mental suffering.
Anorexia alters ones body image so that one does not see the truth about oneself even when one looks in the mirror — to the anorexic mindset, there is no such thing as being too thin. Anorexics acknowledge their condition to different degrees — at one extreme, they do not see their "disease" as dangerous and resent being labelled as psychologically ill; at the other, they understand and accept that they have a problem, yet the anorexia still takes control over their thinking to fluctuating degrees. In ways not too dissimilar from people who have had cult programming or post-traumatic stress disorder, an anorexic may be "triggered" into manic disordered thinking by being exposed to certain words or conditions.
Some people eat unusually small amounts of food for reasons other than their own perceived obesity. Examples include those who fast for religious reasons, execute a hunger strike as a political statement, or are attempting to lengthen their lifespan through caloric restriction. Such individuals are not ordinarily considered anorexic, although some modern critics of religious asceticism have likened habitual fasting to anorexia nervosa
Sociological and Cultural
Anorexia can be traced back to or connected with 19th century American society. Joan Jacobs Brumberg, in her article "The Appetite as Voice", stresses the importance of the history of anorexia nervosa. "A history of anorexia nervosa must consider the ways in which different societies create their own symptom repertoires and how the changing cultural context gives meaning to a symptom such as non-eating" (Brumberg, p.159). During the Victorian era, medical examiners were more interested in physical characterics, or what the patient's body had to say, rather than his/her description of their illness. Young women were also viewed as a non-reliable source for information. Related to the section below on contemporary culture, doctors of the 19th century viewed the connection between culture and the disease very differently. "In effect, nineteenth-century medicine did not relate anorexia nervosa to the cultural milieu that surrounded the Victorian girl. The ideas of Victorian women and girls about appetite, food, and eating, as well as the cultural categories of fat and thin, were not mentioned as contributing to the disease. Only in the twentieth century has medicine come to understand that society plays a role in shaping the form of psychological disorders and that behavior and physical symptoms are related to cultural systems" (Brumberg, p.160).