A Patient with Anorexia Nervosa

Anorexia nervosa – a refusal to eat that can lead to extreme loss of weight, hormonal disturbances and even death – is primaly an illness of adolescent girls. Although generally treated as a disease in itself , it is often a symptom of a psychological problem closely associated with family background.

Although the cause of the illness is not yet understood, one explanation is that it arises from a subconscious desire to retreat from oncoming maturity. The teenage girl diets in order to make her body retain its pre-adolescent shape. This rejection of normal sexuality may be trigerred by an early sexual experience that has led to feelings of fear or guilt. Or , sometimes, an emotionally insecure girl may decide she must lose weight to gain friends.
What are the symptoms?

The illness usually stars with dieting in a normal way but the girl eats less and less every day. She gives false reasons for doing so, insisting, for example that her legs or arms are still too fat. The less she eats, the less she wants. Even if she becomes skeletally thin, she still sees herself as plump and doesnot eat sensibly. Sometimes , however, she may go on “binges” , gobbling up quantities of a particular food and then vomiting . to counter family pressure , she may hide food and throw it away, claiming she has eaten it. When her weight drops about 12kg (almost 2stone) below normal, she stops having periods and her body may develop lanugos hair (the fine, downy hair that covers a fetus).

At the beginning of the illness, a sufferer from anorexia nervosa is often abnormally energetic. She may cook large meals for others while starving herself, and she will insist that she feels fine. But her skin begins to look sallow and papery, and she eventually becomes obviously ill. Constipation is likely to develop, but whether or not she is constipated , she may take large doses of a laxative in the belief that by hurryng food through her system she will keep from growing fat. In later stages of the illness, she may lapse into full-scale depression. (Taken From Course Book 2 -English for The Profesional Nurses 2-Published by EPN Consultant Jakarta)

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