 |
|
|
 |
 |
|
|
 |
|
 |
 |
 |
 |
 |
 |
Frequent questions | |
|
He asks the doctor | |
 |
Beginning | |
 |
 |
 |
|
|
|
|
|
|
|
 |
ANOREXIA NERVOSA | |
||
|
|
 DEFINITION ORIGIN SYMPTOMS EVALUATION TREATMENT TO SEE TO CONSULT |
|
|
|
|
|
|
|||
|
|
It consists of a serious alteration of the perception of the proper image, with a morbid fear of the obesity, what determines an alteration. The principal characteristics of the anorexia nervosa are the rejection to support a minimal corporal weight, an intense fear of gaining weight and a significant alteration of the perception of the body. The women affected by this disorder suffer, also, amenorrea (lacking in rule) although they have spent the menarche (the first rule). Generally the loss of weight is obtained by means of a decrease of the entire ingestion of food. Although the anorexic ones start for excluding from his diet all the food with caloric suppressed high place, the majority finishes with a very restricted diet limited to a few food. There exist other ways of losing weight, like the use of purges, provoked vomiting or excessive physical exercise. In the anorexia nervosa two subtypes differ:
The first one describes clinical pictures in which the loss of weight is obtained by diet or intense exercise, while the second one is used to identify the individual who resorts regularly to stuffings or purges. In the restrictive type the patients with anorexia nervosa do not resort to stuffings you nor purge, while in the compulsive purgative one some of them do not present stuffings but if they resort to purges even after consuming small meal quantities. His cause is not known, but there is a series of causative factors of the anorexia that are a combination of biological elements (genetic and biological predisposition), psychological (familiar influences and psychic conflicts) and social (influences and social expectations). The loss of weight drives to the malnutrition, which in turn he contributes to the physical and emotional changes of the patient and perpetuates the vicious circle that is synthesized in the psychosocial model of the anorexia nervosa. The biological vulnerability of the adolescence and the familiar and social problems they can get together with a social climate determined to cause the typical food conduct of the anorexic ones. The western society is much influenced by the notion of which the obesity is insane and slightly attractive, while the thinness is perceived as something desirable. The diagnosis of the anorexia is based not only on the absence of a definite organic origin, but on the presence of certain characteristics. In this sense it is convenient to remember the criteria considered by the American Society of Psychiatry for the diagnosis of the psychic anorexia:
In general, the family describes some of the following symptoms: amenorrea, constipation, worry for the calories of the food, abdominal pain, worry for the cold, vomiting, worry for the preparation of the meals - proper and of the others - progressive restriction of food and obsession for the scales, worry for the image, conflict between the image and the idea, plenty of pitfalls and lies, hyperactivity and obsessive worry for the studies, without enjoyment of it. In most of occasions they are the pediatricians those who usually have the first contact with the patient, although the initial consultations can be determined by the symptom that more worries the family and the patient. This way, when over what it predominates is the amenorrea (lacking in rule) they will come to the gynecologist, before the abdominal pain to the digestive doctor, before the weight decrease to the endocrinologist... It is not infrequent that come to all the specialists, carry an authentic medical peregrination out and do not fulfill the recommendations. The evaluation of the anorexic patient must include an exhaustive history and a finished physical examination. The questions on the behavior as regards the control of the weight that can be useful are of this type:
The signs and symptoms of the anorexia nervosa, as it has been indicated previously, must be investigated. At the same time, also there must be looked those who could suggest an organic process. Of these, capable of making a mistake with the anorexia there are the hiper or hipotiroidismo, the states of malabsorción, mellitus diabetes, cerebral tumors, gastroesofágicas obstructions and illness of Addison. The sociological impact of the anorexia nervosa is marked and it reverberates in the identity of the young adult. The individual and social narcissism is in game. The diagnosis, since one has seen, is not difficult. The really difficult thing the treatment is, given the individual, familiar and social implications of the syndrome. Many treatments have practised in the anorexic patients: psychotherapy, therapy comportamental, medicamentosa, hyperfeeding, familiar therapy, etc... The most important targets of the treatment are the correction of the malnutrition and the resolution of the psychic malfunctions of the patient and his family. The defeat in short and long term can lead the solution of these problems to the therapeutic mistake. Normally, considering the difficulties that appear, the familiar isolation is advised. It is necessary to consult with an expert and professional person so that it directs and faces the treatment. |
|
|
|
DEFINITION AND CHARACTERS |
|
|
|
|
