Last update:

   12-Nov-2004
 

Arch Hellen Med, 21(5), September-October 2004, 413-421

REVIEW

Αnorexia nervosa in women

G. STRATOUDAKIS, E. TZANAKIS
Department of Obstetrics and Gynecology, General Hospital of Sitia, Sitia, Crete, Greece

Αnorexia nervosa is common in women, especially in adolescents. The lifetime prevalence of anorexia nervosa is as high as 3.7%. The disease is much more common in females than males and is often associated with depression and other mood disorders. According to the Diagnostic and Statistical Manual for Mental Disorders-IV patients with anorexia nervosa refuse to maintain weight at or above minimally normal weight for age and height; have intense fear of gaining weight or becoming fat, even though underweight; have a distorted body image or denial of the seriousness of low body weight; suffer from amenorrhea (postmenarcheal females) with absence of at least three consecutive menstrual cycles, and have no other illnesses to account for weight loss. Complications of anorexia nervosa can include osteoporosis with pathological fractures, electrolyte disturbances, dehydration, cardiac arrhythmias, and even death. Αnorexia nervosa appears to increase the risk of miscarriage and is associated with pre-term delivery and lower birth weight neonates. Treatment for anorexia nervosa can be lifesaving and is more effective when instituted before the patient becomes severely underweight. A high index of suspicion is needed to detect patients with eating disorders because many are in denial about their illness. Hospitalization is recommended in the case of significant metabolic abnormalities and for patients who weigh under 85% of their estimated ideal body weight. Treatment for anorexia nervosa includes nutritional rehabilitation, behavioral therapy and often antidepressant therapy. The obstetrician-gynecologist must be diligent to recognize the disease so that appropriate and timely intervention can be affected.

Key words: Anorexia nervosa, Complications, Treatment, Woman.


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