Anorexia Nervosa

Anorexia is a disorder of eating disorders . Patients suffering from anorexia nervosa assess their excess weight and choosing lean figure as an ideal shape . DSM - IV distinguishes two types of anorexia nervosa . In this type of limited , weight loss is achieved by severely restricting food intake ; - type eating in excessive - depletion , the people concerned are also routinely overeat and then remove it . Various differences between the two subtypes of this reinforces the validity of separation . Subtype - draining overeating seems more psychopathological nature ; patients showed personality disorders , impulsive behavior , stealing , abuse of alcohol and drugs , withdrawal from social interaction , and attempt suicide more than the limited type anorexia patients .

The criteria of the DSM - IV - TR for anorexia Nervosa , namely :

1 . Refusal to maintain normal body weight

2 . Although his weight is very less , but experiencing profound fear of becoming obese .

3 . Body image disturbance

4 . In women who have experienced menstruation , amenorrhea occurs .

Anorexia nervosa usually occurs in the early to late teens , often arise after a series of diet and the stress in her life . This condition is at least ten times more common in women than men , with a lifetime prevalence below 1 % ( Striegel - Moore et al . , 1999; Waltres & Kendler , 1994) . When anorexia nervosa occurs in males , symptomatology and a range of other characteristics , such as the story of the family conflict , broadly similar to that spoken women who suffered with the disorder ( Olivardia et al . , 1995) .

The anorexia nervosa patients are often diagnosed with a bunch of depression , obsessive - compulsive disorder , phobias , panic disorders , alcoholism , and various other personality disorders ( Godart et al . , 2000; Ivarsson et al . , 2000; Walters & Kendler . , 2004) . Although he was skinny , women who suffer from anorexia nervosa feel that some part of their body is too fat and spend a lot of time observing critically their bodies in front of the mirror .

physiological disorders

A lot of biological disorders can occur in underweight patients , but most seem normal physiological response to starvation . clinically significant
abnormalities may occur in cardiovascular , gastrointestinal , reproductive , and fluid and electrolyte systems . This disorder usually does not require specific external treatment , and they returned kenormal in weight restoration . A possible exception worrying reduced bone density , as is usually the peak bone density is achieved during young adulthood , prolonged episodes of anorexia nervosa during the development stage
may have long-term impact on the risk of osteoporosis .

What Factors Cause Anorexia ?

1 . Biological factors

Genetic . Anorexia may occur in one family . First-degree relatives of adolescent girls who suffer from anorexia nervosa has a ten times greater likelihood than the average to suffer from anorexia nervosa (ie , Storober et al . , 2000) . Studies of twins related eating disorders also suggests a genetic influence . Most of the studies on anorexia nervosa showed a higher level of concordance in MZ twins compared to DZ ( Fichter & Naegel , 1990; Holland et al . , 1988) and the gene has a greater effect on people who suffer from eating disorders twins compared with factor - environmental factors ( Wade et al . , 2000) .

Eating Disorders and the Brain . The hypothalamus is the brain center that is important in regulating hunger and eating . Levels of some hormones regulated by the hypothalamus , such as cortisol , are not normal in patients with anorexia nervosa , but m not cause anorexia , but due to the condition starve themselves , and return to normal levels with increasing body weight ( Doerr et al . , 1980; Stoving et al . , 1999) . Endogenous opioids are substances produced by the body to mengurasi pain , improve mood , and suppress appetite , at least in those who meimiliki low weight . Opioids are produced under conditions of starvation and considered instrumental in snoreksia and bulimia , but in a different way . Hunger in patients with anorexia can raise the levels of endogenous opioids menyebkan euphoria conditions that provide positive reinforcement ( Marrazzi & Luby , 1986) .


2 . influence of Sociocultural

Throughout history various standards have been established community about the ideal body , especially the female body ideal , highly variable . By modern standards the women were overweight. In the last times the ideal standard in American culture moving toward an increased trim . For example , the participants increasingly slim beauty contest since 1988 . Several studies in the 1990s showed that this trend has decreased ( Wiseman et al . , 1992) . Nevertheless , a recent study failed to support these ideas .

Influence of gender . One of the main alsan over the prevalence of eating disorders in women greater likelihood is the fact that the standard Western culture reinforces the desire to be thin in women than men .

Various cross-cultural studies . Eating disorders seem to occur more in the industrialized societies , such as the United States , Canada , Japan , Australia , and Europe . , Compared nonindustri society . In a study conducted in Switzerland epidemiologisyang , the incidence of anorexia nervosa increased four-fold from the 1950s to the 1970s ( Will & Grossman . , 1983) .

Ethnic differences . In the United States , have been reported incidents of anorexia carry eight times more common in white women than in black women ( Dolan , 1991) . A variety of more recent studies confirm more eating disorders and dissatisfaction with body shape larger among white women compared among African American women , but the difference in the actual eating disorders , especially bulimia , it was not as big as reported ( Wildes , Emery , & simons , 2001) .



How to view Psychological Theory Against Anorexia ?

· The views psychodynamics

There are many theories about the psychodynamics of eating disorders . Most of the main causes are found in parent-child relationships are disrupted and agreed that some important personality characteristics , such as low self-esteem and perfectionism , found in individuals who have eating disorders . Various psychodynamic theory also states that the symptoms of the eating disorder becomes a fulfillment of some needs , just as increasing the sense of self-efficacy through successful maintaining a strict diet or not grow sexually by being very thin so it does not achieve the body shape of a woman in general ( Goodsitt , 1997 ) .

· Cognitive - Behavioral views

A variety of cognitive-behavioral theory of anorexia nervosa covers many of the factors described above . fear of obesity and body image disturbance hypothesized as factors that motivate the self- starvation conditions make weight as a full-power amplifier . Behavior to achieve or maintain the collapsed skinny negatively reinforced by anxiety reduction will be obese . What's more , dieting and weight loss can be positively reinforced by feelings , own, control or self-control thereof ( Fair - burn , Shatran & Cooper , 1999; Garner , Vitousek & Pike , 1997) . Another important factor that produces a strong urge to trim and body image is disturbed criticism from peers and parents about overweight is experienced ( Paxton et al . , 1991; Thompson et al . , 1995) .

What To Do Against the Prevention of Anorexia ?

Actually there is no specific prevention can be done to prevent disruption of Anorexia Nervosa , but anorexia can perform handler - handler early in order not to get worse , among others :



1 . Biological handler

The drugs used in an attempt to deal with anorexia nervosa , unfortunately , it was not very successful . There is only very little success with drugs to increase the weight significantly , also did not alter the main symptoms of anorexia , or provide significant additional benefits in the standard program management of inpatients ( Attia et al . , 1998; Johnson , Tsoh & Varnado , 1996) .

2 . Anorexia Nervosa Psychological Treatment

Therapy for anorexia nervosa is generally believed to be a two-stage process . The immediate goal is to help patients gain weight in order to prevent medical complications are very necessary ( and also to ensure that the patient eat foods ) . Program operant -conditioning behavioral therapy successful enough to gain weight in the short term ( Hsu , 1991) . The second objective in the management of maintaining weight gain in the long term , can not be reliably achieved through a variety of medical interventions , behavioral , psychodynamic or traditional ( Wilson , 1995) . Family therapy is the main form in the treatment of anorexia , rooted in the theory that the interaction between the patient's family members , keep in mind that most of the patients are young women who lived with the family . One influential theory in this field is Salvador Minuchin .

According to Minuchin et al . ( 1975) families of children who suffer from eating disorders show some of the following characteristics :

a) Entanglement

b ) Too protective

c ) Rigidity

d ) Lack of conflict resolution

The therapist met with the family in a family luncheon because of conflict -related anorexia is believed to be most noticeable when the meal takes place . The luncheon has three major objectives :


1 ) Changing the role of anorexic patients ;

2 ) Defines re- feeding problems as interpersonal problems ;

3 ) Prevent parents utilize her experienced anorexia as a means to avoid conflict .