DRG Category: 883

Mean LOS: 8.2 days

Description MEDICAL: Disorders of Personality and Impulse Control

classification section:



Anorexia nervosa is an eating disorder of complex and life-threatening proportions. It is an illness of starvation brought on by a severe disturbance of body image and a morbid fear of obesity. One in 250 adolescents is affected, and tragically, about 5% of those affected die. Anorexia nervosa is characterized by a person's refusal to maintain a minimally normal body weight for her or his height and age. This is done through inadequate food intake with no medical reason to account for weight loss. A distorted body image, dominated by an intense fear of obesity, leads to a relentless pursuit of an unreasonable and unhealthy thinness. Anorexia has four primary characteristics: fear of becoming obese despite weight loss; a distorted body image; body weight 15% less than normal because of a refusal to eat; and in females past puberty, the absence of three consecutive menstrual periods.

Weight is lost three ways in this condition: by restricting food intake, by excessive exercise, or by purging either with laxatives or by vomiting. Initially, individuals receive attention and praise for their extreme self-control over food intake, but as the illness progresses, this attention is replaced by worry and efforts to monitor the patient's food intake. The increased negative attention and attempts at control of the patient serve to reinforce the patient's need for control and contribute to the progression of the illness. Adverse consequences of anorexia nervosa include possible atrophy of the cardiac muscle and cardiac dysrhythmias, alteration in thyroid metabolism, and estrogen deficiencies (those with long-standing estrogen deficiencies may develop osteoporosis). Refeeding may lead to slowed peristalsis, constipation, bloating, and fluid retention. Only half of people with anorexia nervosa recover completely.