{"id":4422631,"date":"2025-01-12T08:30:43","date_gmt":"2025-01-12T14:30:43","guid":{"rendered":"https:\/\/myendoconsult.com\/learn\/topics\/anorexia-nervosa\/"},"modified":"2025-01-12T08:35:35","modified_gmt":"2025-01-12T14:35:35","slug":"anorexia-nervosa","status":"publish","type":"oen_topic","link":"https:\/\/myendoconsult.com\/learn\/topics\/anorexia-nervosa\/","title":{"rendered":"Anorexia Nervosa"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">Diagnostic Criteria of Anorexia Nervosa<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Definition<\/strong>: A psychiatric disorder marked by significantly low body weight, intense fear of weight gain, and a disturbance in body image.<\/li>\n\n\n\n<li><strong>Diagnosis<\/strong> (all four criteria):\n<ol class=\"wp-block-list\">\n<li><strong>Low body weight<\/strong>: At least 15% below ideal or BMI \u226418.5 kg\/m\u00b2.<\/li>\n\n\n\n<li><strong>Intense fear of weight gain<\/strong> or becoming fat.<\/li>\n\n\n\n<li><strong>Severe body image disturbance<\/strong>: Weight\/shape is the main measure of self-worth.<\/li>\n\n\n\n<li><strong>Amenorrhea<\/strong> in females: Absence of \u22653 consecutive <a href=\"https:\/\/myendoconsult.com\/learn\/menstrual-cycle\/\"  data-wpil-monitor-id=\"302\">menstrual cycles<\/a> if post-menarche.<\/li>\n<\/ol>\n<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Subtypes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Restricting<\/strong>: Weight loss through strict diets and\/or excessive exercise.<\/li>\n\n\n\n<li><strong>Binge-eating\/Purging<\/strong>: Recurrent binge eating followed by self-induced vomiting, laxative use, or diuretic use.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Epidemiology<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Prevalence<\/strong>: Affects ~1% of women over a lifetime; rare in men.<\/li>\n\n\n\n<li><strong>Age of Onset<\/strong>: Typically mid to late adolescence; rarely after age 40.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Etiology &amp; Risk Factors<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Multifactorial<\/strong>:\n<ul class=\"wp-block-list\">\n<li><strong>Cultural<\/strong>: Societal emphasis on thinness.<\/li>\n\n\n\n<li><strong>Biological<\/strong>: Twin studies suggest genetic predisposition.<\/li>\n\n\n\n<li><strong>Psychological<\/strong>: Stressful events may trigger onset; perfectionism is common.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Neurohormonal Changes<\/strong>: Result from malnutrition rather than cause it (e.g., low leptin, high cortisol).<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Clinical Features<\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Weight-Loss Behaviors<\/strong>\n<ul class=\"wp-block-list\">\n<li>Restrictive eating patterns or binge-purge cycles.<\/li>\n\n\n\n<li>Persistent fear of fatness, fixation on thinness.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Physical Examination<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Low BMI<\/strong> (\u226418.5 kg\/m\u00b2).<\/li>\n\n\n\n<li><strong>Vital Signs<\/strong>: Hypotension, bradycardia, hypothermia.<\/li>\n\n\n\n<li><strong>Skin\/Hair<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Lanugo on cheeks\/arms,<\/li>\n\n\n\n<li>Dry or slightly yellowish skin (\u03b2-carotene),<\/li>\n\n\n\n<li>Parotid enlargement if purging.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>GI Complaints<\/strong>: Constipation.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Laboratory Findings<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Mild anemia<\/strong> (normocytic normochromic),<\/li>\n\n\n\n<li><strong>Mild leukopenia<\/strong>,<\/li>\n\n\n\n<li><strong>Electrolyte imbalances<\/strong> with purging (e.g., hypokalemia, metabolic alkalosis),<\/li>\n\n\n\n<li><strong>Mildly elevated liver enzymes<\/strong>,<\/li>\n\n\n\n<li><strong>Normal\/low-normal glucose<\/strong>,<\/li>\n\n\n\n<li><strong>Possible increased serum cholesterol<\/strong>.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Endocrine Changes<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Hypothalamic Amenorrhea<\/strong>: Low LH, FSH, estradiol (low leptin from low fat mass).<\/li>\n\n\n\n<li><strong>Thyroid<\/strong>: Euthyroid sick syndrome (low T3, high rT3, low-normal TSH).<\/li>\n\n\n\n<li><strong>Cortisol<\/strong>: Elevated but no Cushingoid signs.<\/li>\n\n\n\n<li><strong>GH\/IGF-1<\/strong>: Increased GH, low IGF-1.<\/li>\n\n\n\n<li><strong>Bone Density<\/strong>: Decreased; osteopenia\/osteoporosis common.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Differential Diagnosis<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Medical<\/strong>: HIV, inflammatory bowel disease, diabetes, CNS lesions.<\/li>\n\n\n\n<li><strong>Psychiatric<\/strong>: Major depression, other eating disorders (e.g., bulimia).<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Summary<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Key Aspects<\/strong>: Substantial underweight status, persistent fear of fatness, distorted body image, and amenorrhea in women.<\/li>\n\n\n\n<li><strong>Systemic Effects<\/strong>: Starvation-driven neuroendocrine changes, including growth and reproductive hormone suppression, and bone density loss.<\/li>\n\n\n\n<li><strong>Management<\/strong>: Focus on medical stabilization, nutritional rehabilitation, psychological treatment, and addressing any comorbidities.<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Diagnostic Criteria of Anorexia Nervosa Subtypes Epidemiology Etiology &amp; Risk Factors Clinical Features Differential Diagnosis Summary<\/p>\n","protected":false},"featured_media":0,"template":"","oen_topic_chapter":[689],"class_list":["post-4422631","oen_topic","type-oen_topic","status-publish","hentry","oen_topic_chapter-obesity-medicine","post-wrapper","thrv_wrapper"],"_links":{"self":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic\/4422631","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic"}],"about":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/types\/oen_topic"}],"version-history":[{"count":3,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic\/4422631\/revisions"}],"predecessor-version":[{"id":4422635,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic\/4422631\/revisions\/4422635"}],"wp:attachment":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media?parent=4422631"}],"wp:term":[{"taxonomy":"oen_topic_chapter","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic_chapter?post=4422631"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}