Definition

Anorexia nervosa is a psychophysiological disorder – usually of young females – characterized by a prolonged refusal to eat or maintain normal body weight, an intense fear of becoming obese, a disturbed body image in which the emaciated patient feels overweight, and the absence of any physical illness that would account for extreme weight loss. The term “anorexia” is actually a misnomer, because genuine loss of appetite is rare and usually does not occur until late in the illness. In reality, most anorectics are obsessed with food and constantly struggle to deny natural hunger.

In anorexia nervosa, normal dieting escalates into a preoccupation with being thin, profound changes in eating patterns, and a loss of at least 25 percent of the original body weight. Weight loss is usually accomplished by a severe restriction of caloric intake, with patients subsisting on fewer than 600 calories per day. Contemporary anorectics may couple fasting with self-induced vomiting, use of laxatives and diuretics, and strenuous exercise.

The most consistent medical consequences of anorexia nervosa are amenorrhea (ceasing or irregularity of menstruation) and estrogen deficiency. In most cases amenorrhea follows weight loss, but it is not unusual for amenorrhea to appear before noticeable weight loss has occurred. The decrease in estrogen causes many anorectics to develop osteoporosis, a loss of bone density that is usually seen only in postmenopausal women (Garfinkel and Garner 1982).