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Anorexia Nervosa Under the guidance of , Dr. K.Ravishankar M.Pharm,ph.D Professor, And Principal, Sri Sai Aditya College Of Pharmaceutical Sciences And Research , Surampalem. By V K C KIRAN PULLELA Reg No. 133H1S0610

Anorexia Nervosa

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Anorexia NervosaUnder the guidance of ,

Dr. K.Ravishankar M.Pharm,ph.DProfessor, And Principal,Sri Sai Aditya College Of Pharmaceutical Sciences And Research , Surampalem.

By V K C KIRAN PULLELAReg No. 133H1S0610


IntroductionAnorexia nervosa is an eating disorder that makes people lose more weight than is considered healthy for their age and height.Persons with this disorder may have an intense fear of weight gain, even when they are underweight. They may diet or exercise too much or use other ways to lose weight.

IntroductionSubtypes of Anorexia NervosaTwo SubtypesRestricting Subtypeplace severe restriction on the amount and type of food they consumeRestricting certain types of foods (e.g. carbohydrates, fatty foods)Counting caloriesSkipping mealsObsessive rules and rigid thinking (e.g. only eating food that is one colour)Excessive exercise.

IntroductionBinge Eating/Purging SubtypeIn addition to severe food restriction, the person will also have binge eating/purging behaviour. These behaviours include:Binge eating eating a large amount of food accompanied by a feeling of loss of control Self induced vomiting, deliberately misusing laxatives, diuretics or enemas to compensate for eating food


multifactorial with a combination of biological, psychological, and sociocultural factors.disturbances in a number of different neurotransmitters including serotonin, norepinephrine, and dopamineLess efficient transport of Ghrelin to the brainGene, transporter, receptor PolymorphismsSome infections like Lyme Disease (Caused by Borrelia Spp)

Biophysical Model for Anorexia Nervosa

Risk FactorsAge: Often begins during the pre-teen or teen years or young adulthood.Sex: More common in females, but may also be seen in males.Hereditary factors.Being more worried about, or paying more attention to, weight and shapeHaving an anxiety disorder as a childHaving a negative self-imageHaving eating problems during infancy or early childhood

SymptomsTo be diagnosed with anorexia, a person must:Have an intense fear of gaining weight or becoming fat, even when he/she is underweightRefuse to keep weight at what is considered normal for her age and height (15% or more below the normal weight)Have a body image that is very distorted, be very focused on body weight or shape, and refuse to admit the danger of weight lossHave not had a period for three or more cycles (in women)

SymptomsBehavioral:Cutting food into small pieces or moving them around the plate instead of eatingExercising all the time, even when the weather is bad, they are hurt, or their schedule is busyGoing to the bathroom right after mealsRefusing to eat around other peopleUsing diuretics, laxatives, diet pillsSuicidal tendency

SymptomsOther Symptoms:FatigueInsomniaskin that is yellow or blotchyLanugo (very fine, soft, and usually unpigmented on the body)hair thinning or falling outConstipationAmenorrheaXerodermaHypotension

SymptomsOther Symptoms:Hypotension and/or orthostatic hypotensionBradycardia or tachycardiaDepressionenlargement of the salivary glands (caused by excessive vomiting)Swollen jointsHalitosis (Bad Breath) from vomiting or starvation-induced ketosis.Abdominal DistensionRapid mood swings

Possible Complicationsleads to death in 10% of cases (estimate)Osteoporosis (Serious)Leucocytopenia, which leads to increased risk of infectionHypokalemia, which may predispose to arrhythmiasdehydrationmalnutritionSeizures due to fluid or sodium loss from repeated diarrhea or vomitingThyroid gland problemsTooth decayIncreased risk of infertility

DiagnosisTests should be done to help find the cause of weight loss, or see what damage the weight loss has caused. Many of these tests will be repeated over time to monitor the patient. AlbuminBone density test to check for thin bones (osteoporosis)Complete Blood CountElectrocardiogram (ECG or EKG)ElectrolytesKidney and Liver function testsTotal proteinThyroid function testsUrinalysisTests for any underlying infections which are likely to cause anorexia

TreatmentMedical and nutritional interventionNutritional rehabilitationWeight restorationReversal of the acute medical complicationsPsychological interventionfamily psycho educationinterpersonal therapyfamily therapy Pharmacological treatmentSSRIs:FluoxetineSertralineParoxetineFluvoxamineCitalopramthere are some recent reports that the atypical neuroleptic medications such as Risperidone, Olanzapine, and Quetiapine may be effective in adolescents with anorexia nervosa

Referenceshttp://www.webmd.com/mental-health/anorexia-nervosahttp://www.nlm.nih.gov/medlineplusPubMED Health http://www.ncbi.nlm.nih.gov/http://peds.stanford.edu/Rotations/adolescent_medicine/documents/EDArticle.pdf