Practical Practitioner
By: Pamela Egan, FNP-C CDE
Anorexia has the highest death rate of any psychiatric illness
Dear Pam,
I am very concerned about my high school daughter who barely eats. She is frail and thin but complains that she is fat. Who can evaluate her for anorexia?
You are to be commended for your insightful assessment of your daughters’ behavior. It is much easier for parents to remain in denial and not deal with this very complex condition.
Report your concerns to you Primary Care Provider, but schedule an evaluation with a Psychiatrist that specializes in Eating Disorders.
Anorexia Nervosa has reached epidemic proportions in high schools and colleges. Women who suffer from anorexia have increased chemical activity in a part of the brain that controls reward and reinforcement, which may explain why they are driven to lose weight but don’t get any pleasure out of it, according to a new study.
Researchers in Pittsburgh used brain imaging technology and found over-activity of dopamine receptors in a part of the brain known as the basal ganglia.
They reported their findings this month in the journal of Biological Psychiatry after examining the brains of 10 women who had recovered from anorexia and 12 healthy women.
Anorexia Nervosa is a condition that includes an individual, usually female but not always, developing an entrenched distorted perception of their physical being, one which they set out to remedy by attempting to eliminate food and nutritional intake.
The anorexic will develop a pathological perception of food and will exhibit peculiar behaviors such as finely cutting up foods, moving pieces around in the plate, and ultimately not eating them.
I was told by a patient with bulimia, that she gets high while vomiting.
Bulimia is a condition that is similar to anorexia in that a person has an inordinate level of focus on food and eating, however, unlike anorexia, a bulimic the victim has urges to overeat or binge, then experiences subsequent depression, negative feelings relieved by purging, self induced vomiting, or laxatives. According to Dr. Walter Kaye, a psychiatry professor at the University of Pittsburgh Medical Center and one of the researchers involved in the study, dopamine in this area may be very important in how we respond to stimuli, how we view positive and negative reinforcement.
The hope is that the study can lead to the development of drugs to treat anorexia. It’s very, very hart to treat. The individuals recognize that it’s wrong, but they still don’t eat. About 1 percent of American women suffer from anorexia, a disease that can also affect men, especially wrestlers and power lifters. It has the highest death rate of any psychiatric illness. While in Ireland recently, my husband was told by a neighbor that his 11 year old daughter was on the verge of dying from anorexia. This condition is affecting younger and younger females.
Women suffering from anorexia have obsessive-compulsive personalities, avoid harm and prefer routine. These women tend to resist therapy and have a distorted perception of themselves.Although such a small number of women get anorexia in its purest form, there are many more people out there suffering from some form of an eating disorder. Making the connection between anorexia and what’s happening in the brain is important for understanding and treating eating disorders.
There is considerable stigma attached to these disorders, parents think it reflects something you did as a parent.
Researchers still don’t know what is causing the dopamine receptor to be overactive, but the answer may lie in further research.
A massive, multi-year study is trying to establish a genetic link to the disease and an eventual cure. Researchers, funded with $10 million by the National Institute of Mental Health, are studying hundreds of families that have two or more members with anorexia.
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