Anorexia Nervosa and Its Neurological Implications

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NEUROLOGICAL IMPLICATIONS
OF
ANOREXIA NERVOSA

SUBJECT: - COGINTIVE NEUROPSYCHOLGY
BY: - ANUSHREE GUPTA
ROLL NO.:- 2 (CLINICAL)
SUBMITTED TO: -PROF. NEHA BHANSALI
DATE:- 18th MARCH, 2013
ANOREXIA NERVOSA AND ITS NEUROLOGICAL IMPLICATIONS
INTRODUCTION:-
The psychological meaning of food extends far beyond its nutritive powers. In addition to physical dependence of food, humans have a strong emotional association with food. For some people food takes on inordinate significance, and they find themselves enslaved to bizarre and unhealthy rituals that revolve around the process of eating. People with eating disorders struggle to control their disturbed attitudes and behaviour regarding food and put their lives at risk. The eating disorders can occur at either extreme: excessive consumption of food or dramatic reductions of food intake. Both can have life threatening consequences. And the two of these major eating disorders are Anorexia Nervosa or Bulimia Nervosa.

Many people diet to lose weight, but people with eating disorder anorexia nervosa carry this to an extreme. They develop an intense fear of becoming fat that leads them to diet to the point of emaciation. The term anorexia nervosa was established in 1873 by Sir William Gull, one of Queen Victoria's personal physicians. The word anorexia literally means “without appetite”, a somewhat misleading term in the light of the fact that loss of appetite is not the key feature of this disorder, at least not initially. On the contrary, people with this disorder are very interested in eating and having normal appetites, although they have difficulty regarding their hunger cues. Some anorexic individuals go to great length to prepare calorie meals and baked goods for others, taking delight in handing the food as they prepare it. Others develop compulsive rituals involving food. For example, they may hide food around the house, eat meals in a ritualistic fashion, and may take hours to eat small portions of food. Aware of unusual these behaviours may seem to others, they go to extreme to conceal their eccentric eating habits.

Anorexia nervosa is characterized by low body weight, inappropriate eating habits, obsession with having a thin figure, and the fear of gaining weight. It is often coupled with a distorted self-image which may be maintained by various cognitive biases that alter how the affected individual evaluates and thinks about her or his body, food and eating. Those suffering from anorexia often view themselves as "too fat" even if they are already underweight. They may practice repetitive weighing, measuring, and mirror gazing, alongside other obsessive actions to make sure they are still thin, a common practice known as "body checking”. People with anorexia nervosa continue to feel hunger, but they deny themselves all but very small quantities of food. The average caloric intake of a person with anorexia nervosa is 600–800 calories per day, but extreme cases of complete self-starvation are known. There appear to be two sub types of with anorexia: restricters and purgers. Restricters are thin primarily because they refuse to eat, Purgers also refute to eat much of the time, but when they do eat, use vomiting and laxatives to purge what they have eaten. Often the disorder is accompanied by a variety of physical changes. The consequences of anorexia can be severe: blood pressure and body temperature maybe lowered, life threatening cardiac arrhythmias may occur, bone growth van be retarded, and anaemia is common most importantly the low level of serum potassium caused by starvation can lead to irregularities in the heart rate that may cause death. About 95 percent of those with anorexia are females. Estimates of the prevalence of this order range from a low of 0.5 % to a high of 3.7 % in women, depending on whether diagnostic criteria are narrowly or broadly defined. Apart from differences in the basis for these estimates, it is also likely...
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