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Anorexia Nervosa
Approximately five to 15% of diagnosed anorexics are male.
Darcy McLurg, BSc Pharm, Clinical Pharmacist,
The Ottawa Hospital, General Campus
Anorexia nervosa is an eating disorder in which the person affected
is excessively focused on body shape, weight and food intake.
They have an inaccurate perception of their own body size. A
person with anorexia nervosa has an intense fear of weight gain
and will severely restrict the amount of food they eat to the
point of self-starvation. In addition, they may attempt to control
their weight through over-exercising, bingeing, purging, or with
medications such as diuretics or laxatives.
Anorexia nervosa is most commonly seen in young women living
in industrialized societies. Approximately five to 15% of diagnosed
anorexics are male. The cause of anorexia is unknown. People
at risk for developing this illness may have a family history
of anorexia or a family/personal history of depression or manic-depressive
disorder.
Severe weight loss (i.e., less than 85% of expected weight),
continuous dieting, and/or excessive exercise are the most obvious
signs of anorexia nervosa. Other typical symptoms are fatigue,
cold-sensitivity, loss of appetite, hair loss, depression, trouble
sleeping, and irregular or absent periods.
The continued nutritional deprivation takes a heavy toll on
the body. Anorexic patients suffer from muscle spasms, kidney
problems
and heart problems as a result of low sodium and potassium in
the blood. Bone loss and an increased risk of bone fractures
in the long term are a possibility. Extremely low weight is associated
with low blood pressure, slow heart rate, and low body temperature.
Inadequate protein in the diet may result in excessive facial
or body hair. The most common cause of death in an anorexic patient
is due to low potassium in the blood causing heart failure. Severe
depression may also lead to suicide.
The treatment of a person with anorexia nervosa can be very
difficult. The primary goal of treatment is weight gain. Patients
with anorexia will often be initially unwilling to participate
in their treatment and may have trouble maintaining motivation
to continue the treatment program. Individual psychotherapy and
family therapy are helpful. Medication is generally not effective
in treating anorexia, but may have a role in treating anxiety
and mood changes associated with the disease. However, efficacy
of these medications is limited while nutrition remains inadequate.
Fluoxetine (Prozac) has been shown to aid in the recovery of
patients who have already attained greater than 85% of their
expected body weight. Other agents such as zine, cyproheptadine
(Periactin), and other antidepressants have not been show to
improve symptoms.
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The information in this newsletter was prepared and reviewed
by pharmacists for the Canadian Pharmaceutical Journal.
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Ask Your Pharmacist newsletter is produced through
an unconditional educational grant from APOTEX/PACE. |
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