Anorexia Nervosa: The Disorder of Self-Starvation

Anorexia nervosa is a serious eating disorder characterized by:

• Restriction of energy intake relative to needs → significantly low body weight.
• Intense fear of gaining weight or becoming fat.
• Disturbance in body weight/shape perception (body image distortion).

Subtypes

• Restricting type: weight loss via diet/fasting/exercise.
• Binge-eating/purging type: also binge/purge behaviors.

Medical Complications

• Cardiac: arrhythmias, bradycardia, hypotension, cardiomyopathy.
• Endocrine: amenorrhea, bone loss (osteoporosis), thyroid dysregulation.
• Electrolyte: hypokalemia, hyponatremia (purging).
• GI: gastroparesis, constipation, superior mesenteric artery syndrome.
• Neurologic: brain volume loss (partially reversible).
• Highest mortality of any psychiatric disorder (suicide + medical).

Treatment

• Multidisciplinary: medical stabilization, nutritional rehabilitation (refeeding syndrome prevention), psychotherapy (CBT-E, FBT for adolescents), psychiatric meds (comorbidities; no FDA-approved for AN core).
• Levels of care: outpatient → IOP → PHP → residential → inpatient (medical/psychiatric).

Early intervention improves recovery odds. Full recovery is possible but requires sustained, specialized care.