Framework for Organizational Assessment

Eating Disorders
Anorexia

The current system of psychiatric classification, the Diagnostic and Statistical Manual of Mental

Disorders–Fourth Edition (DSM-IV; American Psychiatric Association [APA], 1994), includes two

official eating disorder (ED) syndromes: anorexia nervosa and bulimia nervosa, and a third (still

provisional) diagnosis, binge-eating disorder.

Anorexia nervosa (AN) is defined by a relentless pursuit of thinness and a morbid fear of the

consequences of eating (usually expressed as a dread of weight gain or obesity). An eating

disorder where preoccupation with dieting and thinness leads to excessive weight loss while

the individual continues to feel fat and fails to acknowledge that the weight loss or thinness is

a problem. Symptoms of anorexia, or anorexia nervosa, include significant weight loss,

continuation of weight loss despite thinness, persistent feeling of being fat even after

weight loss, exaggerated fear of gaining weight, loss of menstrual periods, preoccupation

with food, calories, nutrition and/or cooking, dieting in secret, compulsive exercising, sleep

disorders, and a pattern of binging and purging.

The condition also has psychosexual effects. The sexual development of anorexic adolescents

is arrested, while adults who have the disease generally lose interest in sex. While the term

anorexia literally means “loss of appetite,” anorexics generally do feel hunger but still refuse to

eat.

The great majority of anorexics (about 95 percent) are women. Risk factors for the disorder

may include a history of alcoholism and/or depression, early onset of puberty, tallness,

perfectionism, low self-esteem, and certain illnesses such as juvenile diabetes. Psychosocial

factors associated with the disease are over-controlling parents, an upwardly mobile family,

and a culture that places excessive value on female thinness. Emotionally, anorexia often

involves issues of control; the typical anorexic is often a strong-willed adolescent whose

aversion to food is a misdirected way of exercising autonomy to compensate for a lack of

control in other areas of his or her life.

Medical consequences of anorexia may include infertility, osteoporosis, lower body

temperatures, lower blood pressure, slower pulse, a weakened heart, lanugo (growth of fine

body hair), bluish hands and feet, constipation, slowed metabolism and reflexes, loss of muscle

mass, and kidney and heart failure. Anorexics also have been found to have abnormal levels

of several neurotransmitters, which can, in turn, contribute further to depression. People

suffering from anorexia often must be hospitalized for secondary medical effects of the

condition. Sometimes the victim must be force-fed in order to be kept alive. Due to medical

complications as well as emotional distress caused by the disorder, anorexia nervosa is one of

the few mental disorders that can be fatal.

The Antidepressants

The body of a woman with anorexia. (Biophoto Associates/ Science Source. Photo

Researchers, Inc. Reproduced with permission.) ance. Treatment and cure for anorexia are

possible through skilled psychiatric intervention that includes medical evaluation,

psychotherapy for the individual and family group, nutritional counseling, and possibly

medication and/or hospitalization. With treatment and the passage of time, about 70 percent

of anorexics eventually recover and are able to maintain a normal body weight. The American

Anorexia and Bulimia Association is the principal and oldest national non-profit organization

working for the prevention, treatment, and cure of eating disorders. Its mission is inclusive of

sufferers, their families, and friends. The AABA publishes a quarterly newsletter reviewing

developments in research and programming. It also organizes a referral network which

includes educational programs and public information materials, professional services and

outpatient programs, patient and parent support groups, and training of recovered

patients as support group facilitators. See also Body image; Bulimia

Further Information

1. American Anorexia and Bulimia Association (AABA). 418 E. 78th Street, New York, New York 10021, (212) 734–
1114.
2. American Dietetic Association (ADA) NCDC-Eating Disorders. 216 W. Jackson Blvd., Chicago, Illinois 60606, (800)
366–1655.
3. National Anoretic Aid Society. 445 E. Dublin-Granville Road, Worthington, Ohio 43229, (614) 436–1112.
4. National Association of Anorexia Nervosa and Associated Disorders (ANAD). Box 7, Highland Park, Illinois 60035,
(708) 831–3438.