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Anorexia nervosa primarily affects young women, with onset generally between the ages of 12 and 25 years. Perfectionist lifestyle and performance-related stress predispose to anorexia nervosa.
Prevalence is between 2-5% among adolescent and young adult women. Untreated, mortality can approach 20%.
Family History: There is an increased incidence of affective disorders; one or both parents is usually obese; occurs most often in patients of upper-middle socioeconomic status.
Signs and Symptoms of Anorexia Nervosa:
Amenorrhea, emesis, aversion to meats; cold sensitivity, compulsive behavior; overactivity, hoarding of food, over-exercise (often to exhaustion).
Patients often have a distorted body image, and a need to maintain an ultra-thin silhouette; the patient sees herself as obese regardless of the degree of emaciation.
"Paradoxic Satiety" -- the patients reports no hunger when fasting and may feel satiated when she does not eat.
Secondary sexual characteristics are suppressed or even reversed; emaciated body habitus, hair loss, multiple upper respiratory infections and constipation are common.
DSM IV Diagnostic Criteria for Anorexia Nervosa:
Refusal to maintain body weight