Anorexia nervosa

Alternative Names

Symptoms

Most individuals with anorexia nervosa refuse to recognize (deny) that they have an eating disorder.

Symptoms may include:

• Weight loss of 15% or greater below the expected weight
• Inappropriate use of laxatives, enemas, or diuretics (water pills) in an effort to lose weight
• Self-imposed food intake restrictions, often hidden
• No menstruation
• Skeletal muscle atrophy
• Loss of fatty tissue
• Low blood pressure
• Dental cavities due to self-induced vomiting
• Blotchy or yellow skin
• Depression

Exams and Tests

A diagnosis of anorexia nervosa is not made until other causes of weight loss are ruled out. The health care provider will determine if endocrine, metabolic, digestive, and central nervous system abnormalities can explain the weight loss. (For example, extreme weight loss could be due to celiac disease, inflammatory bowel disease, Addison's disease, and many other possible conditions.)

Tests will be done to help determine the cause of weight loss or to determine what damage the weight loss has caused cause. They may include:

• CHEM-20
• Urinalysis
• Thyroid function tests
• ECG
• LH response to GnRH

References

American Psychiatric Association. Treatment of patients with eating disorders, third edition. American Psychiatric Association. Am J Psychiatry. 2006 Jul;163(7 Suppl):4-54.

Marcus MD. Eating disorders. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders; 2007:chap 238.

Morris J, Twaddle S. Anorexia nervosa. BMJ. 2007 Apr 28;334(7599):894-8.