Anorexia Nervosa
Anorexia nervosa is an eating disorder which predominantly affects females, and is caused by an obsession with weight loss, often driven by a distorted body image. It can be defined as being present when the body weight is more than 15 per cent below that which is normal for the height. Once the body weight drops below 48 kg, there may be failure of menstruation (since the onset of menstruation - call the menarche - is determined by body mass) and associated changes in the levels of the hormones secreted by the pituitary which stimulate the ovaries. In some cases it maybe precipitated by the fear of adolescence, fertility and subsequent responsibility, so that in effect the girl reverts to the childhood state. It more commonly occurs in people with a perfectionist personality who have low self-esteem and a previous history of being mildly overweight. The initial success in weight loss through dieting and exercise produces a reward in itself which then becomes repetitive.
Besides nutritional support psychological therapy and anti-depressant treatment may be necessary in order to restore body weight. It may be necessary to stimulate ovulation using agents such as clomiphene. Since weight loss may occur in association with other diseases such as an overactive thyroid or diabetes mellitus, it might be wise to exclude these before considering someone anorexic.
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