Anorexia nervosa is the result of a complex interplay between biological, psychological, and social factors, which tend to affect women more than men, and adolescents more than older women. Some evidence suggests a higher rate of the disorder in monozygotic twins than in dizygotic twins, which may indicate a biologic predisposition.
Psychologically, prepubescent patients who subsequently develop anorexia nervosa have a high incidence of premorbid anxiety disorders. The onset of the disorder during puberty has led to the theory that, by exerting control over food intake and body weight, adolescents are attempting to compensate for a lack of autonomy and selfhood. Individuals with anorexia nervosa maintain a lifelong increased incidence of anxiety, depressive disorders, and obsessive-compulsive disorder. Neurobiologists hypothesize that disruption of serotonergic pathways in the brain mediate the development of anorexia nervosa and may account for the frequent coexistence of other psychological disturbances.
The patient’s altered body image results in a perception of fatness despite being normal or underweight. Attempts to correct this flaw through food restriction or purging lead to progressive starvation. Modern preoccupation with slenderness and beauty in the Western world may contribute to the mindset of slenderness as a valued quality in adolescents; however, this link has not been proven.
Malnutrition subsequent to self-starvation leads to protein deficiency and disruption of multiple organ systems. In addition to hypoglycemia and vitamin deficiencies, starvation results in release of endogenous opioids, hypercortisolemia, and thyroid function suppression. Neuroendocrine disturbances result in delayed puberty, amenorrhea, anovulation, low estrogen states, increased growth hormone, decreased antidiuretic hormone, hypercarotenemia, and hypothermia. Decreased gonadotropin levels and hypogonadism may occur among males who are affected.
Cardiovascular effects include mitral valve prolapse, supraventricular and ventricular dysrhythmias, long QT syndrome, bradycardia, orthostatic hypotension, and shock due to congestive heart failure.
Renal disturbances include decreased glomerular filtration rate (GFR), elevated BUN, edema, acidosis with dehydration, hypokalemia, hypochloremic alkalosis with vomiting, and hyperaldosteronism.
Gastrointestinal findings include constipation, delayed gastric emptying, and gastric dilation and rupture when binge eating. Patients who induce vomiting develop dental enamel erosion, palatal trauma, enlarged parotids, esophagitis, Mallory-Weiss lesions, and elevated transaminase levels.
Anorexia nervosa is a disease that affects all organ systems. The principal systems affected are the cardiovascular and the endocrine systems. However, complications from other systems, including the GI, renal, reproductive, neurologic, orofacial, dermatologic and hematologic, are noted as well
PICKY EATERS CLINIC Yudhasmara Foundation www.childrenclinic.wordpress.com/ WORKING TOGETHER SUPPORT TO THE HEALTH OF ALL CHILDREN BY CLINICAL, RESEARCH AND EDUCATIONS. Advancing of the future pediatric and future parenting to optimalized physical, mental and social health and well being for fetal, newborn, infant, children, adolescents and young adult
Email : email@example.com
- CLINIC FOR CHILDREN, JL Taman bendungan Asahan 5 Bendungan Hilir Jakarta Pusat 10210 Phone : (021) 70081995 – 5703646
- CHILDREN GROW UP CLINIC, MENTENG AQUARE Jl Matraman 30 Jakarta Pusat
- Children’s Allergy Center Online www.childrenallergyclinic.wordpress.com/
Picky Eaters Clinic, Klinik Kesulitan makan Pada Anak www.mypickyeaters.wordpress.com/
Children Foot Clinic http://footclinic.wordpress.com/
Children Rehabilitation Clinic http://rehabilitationclinic.wordpress.com/
Clinical – Editor in Chief :
Dr WIDODO JUDARWANTO, pediatrician
- email : firstname.lastname@example.org
- curriculum vitae
- For Daily Newsletter join with this Twitter https://twitter.com/WidoJudarwanto
Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider
Copyright © 2012, Picky Eaters Clinic Information Education Network. All rights reserved