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Anorexia usually refers to a semi-starved state involving loss of body mass, resulting from voluntary starvation from fear of weight-gain. A more technically correct term is 'Anorexia Nervosa', which adds to the above definition, a nervous system disorder as the cause of this phenomenon.
Anorexia is classically seen in the age-group of 13-18 years, just after puberty, is more common in females, and can affect people from all races. In some cases, it can also affect much older females too, with worse prognosis.
A patient of anorexia usually show the symptoms of weight loss without any specific disease. Often the patient tends to hide the weight loss by way of loose or bulky clothing. The emaciation of the body is apparent by physical appearance and is often associated with features like dry skin and poor skin turgor. In extreme cases, there can be peripheral edema of the body.
Anorexia is of two main subtypes: 'restricting type', wherein the patient refuses to take food; and the 'purging type', wherein the patient goes on binge eating and then resorts to voluntary forced purging. In the second variety, side effects of purging may also be apparent.
In both types, constipation and gastric dilatation is common.
As the term Anorexia Nervosa refers, there is generally associated pre-morbid anxiety disorder, that extends to fear of weight gain, and occasionally other depressive neuroses or personality disorders.
It effects many organs and can lead to amenorrhea, anovulation, hypoglycemia, hypothermia. Investigations may also reveal defects in renal function and hormone levels. There can be acidosis or alkalosis, depending upon the degree of forced vomiting. Many of the patients are diagnosed or seek medical care for the first time only in case of a life threatening situation.
Treatment may begin with general stabilization of electrolyte balance in a life threatening situation, or may begin with dealing with cardiac arrhythmia's (anomalous rhythm of heart), or even attempted suicide. However, in the longer run, a multidisciplinary treatment strategy incorporating medical / pharmacological treatment with psychiatric counseling and nutritional discipline is the only way out. The most important challenge is to keep the patient under constant evaluation till she shows signs of coming out of the anxiety condition.
Overall, around half of the patients fully recover with time and medical support, while a third show reasonable improvement without reaching a state of 'cure'. Around 20% of the less fortunate patients continue to show some symptoms of anorexia though their condition has also shown some improvement. These are the ones who need to be on continuous evaluation and care.
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