Other Disorders of Childhood
The essential features are intense fear of becoming obese, disturbance of body image, significant weight loss, refusal to maintain normal body weight, and amenorrhea (in females). The disturbance cannot be accounted for by a known physical disorder. (The term “anorexia” is a misnomer, because loss of appetite is usually rare until late in the illness).
Individuals with this disorder say they “feel fat” when they are of normal weight or even emaciated. They are preoccupied with their body size and often gaze at themselves in a mirror. At least 25% of their original body weight is lost, and a minimal normal weight for age and height is not maintained. The weight loss is usually accomplished by a reduction in total food intake, with a disproportionate decrease in high carbohydrate and fat-containing foods, self-induced vomiting, use of laxatives or diuretics, and extensive exercising. The individual usually comes to medical attention when weight loss becomes significant. When it becomes profound, physical signs such as hypothermia, dependent edema, bradycardia, hypotension, lanugo (neonatallike hair), and a variety of metabolic changes occur. Amenorrhea often appears before noticeable weight loss has occurred.
KeywordsAnorexia Nervosa American Psychiatric Association Eating Binge Tourette Syndrome Physical Disorder
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