Anorexia nervosa

Background

• Associated with body image disturbance
• Adolescent girls
  • Life long risk
• Body image is predominate measure of self worth
• Mortality 6-20%

Symptoms

• Constipation
• Abdominal pain
• Fatigue
• Weakness
• Amenorrhea
• Depression
• Hair loss

Signs

• Fine facial and body hair (lanugo)
• Brittle hair and nails
• Dry, scaly skin
• Loss of subcutaneous fat
• Breast and vaginal atrophy

Workup

• Exclude: Inflammatory bowel disease, hyperthyroidism, chronic infection, diabetes mellitus, and Addison’s disease
• CBC
• Chem 10
• EKG

Management

• inpatient management
  • Extremely low weight (<75% of expected body weight) or rapid weight loss
  • Severe electrolyte imbalances
  • Cardiac disturbances
  • Acute medical disorders
  • Severe or intractable purging
  • Psychosis or a high risk of suicide

Also See

• Bulimia nervosa

Sources

• John F. Bober, Scott E. Moser: Rakel: Textbook of Family Medicine, 8th ed., Saunders, 2011 (Ch)24: p452