Anorexia Nervosa
Medical Author: Roxanne Dryden-Edwards, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR, and Melissa Conrad Stöppler, MD
Drunkorexia, Manorexia, Diabulimia: New Eating Disorders?
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
In recent weeks, I have read media reports that mentioned both "drunkorexia"
and "manorexia." I have fielded questions about "diabulimia" from coworkers and
friends. From the sound of these terms, it appears that there are a lot of new
and recently discovered eating disorders. I certainly did not hear the word drunkorexia in medical school.
Actually, these new terms (which, by the way, are not official or standard
medical terms) simply refer to subcategories of the well-known eating disorders
anorexia nervosa and bulimia nervosa, both of which affect up to 1% of women and
a lower percentage of men at some point in their lives.
The term drunkorexia has been coined to describe the condition of binge
drinking combined with the typical self-imposed starvation seen with anorexia
nervosa. It has also been used to refer to individuals who use purging (as seen
with bulimia nervosa) or who have other eating disorders and try to reduce
caloric intake to offset the calories consumed in alcohol. The typical
individual described as a drunkorexic is a college-aged woman who is a binge
drinker, starving all day in order to get drunk at night.
Manorexia simply refers to a male suffering from anorexia nervosa. Estimates
suggest that males make up about 10% of those with anorexia nervosa. The disease
is similar in males and females and is characterized by a refusal to maintain a
normal body weight and distorted perspectives of appropriate body shape and
size.
What is anorexia nervosa?
Anorexia nervosa, commonly referred to simply as anorexia, is one type of eating disorder. More importantly, it is
also a psychological disorder. Anorexia is a condition that
goes beyond out-of-control dieting. A person with anorexia often initially begins
dieting to lose weight. Over time, the weight loss becomes a sign of mastery and
control. The drive to become thinner is actually secondary to concerns about
control and/or fears relating to one's body. The individual continues the endless cycle of restrictive eating, often accompanied by other behaviors such as excessive exercising or the overuse of
diet pills, diuretics, laxatives, and/or enemas in order to reduce body weight, often to a point close to starvation in order to feel a sense of control over
his or her body. This cycle becomes an obsession and, in this way, is similar to any type of addiction.
Who is at risk for anorexia?
Approximately 95% of those affected by anorexia are
female, but males can develop the disorder as well. While anorexia typically
begins to manifest itself during early adolescence, it is also seen in young
children and adults. In the U.S. and other countries with high economic status,
it is estimated that about one out of every 100 adolescent girls has the
disorder. Caucasians are more often affected than people of other racial
backgrounds, and anorexia is more common in middle and upper socioeconomic
groups. According to the U.S. National Institute of Mental Health (NIMH), an estimated 0.5%-3.7% of women will suffer
from this disorder at some point in their lives.
Many experts consider people for whom thinness is especially desirable, or a
professional requirement (such as athletes, models, dancers, and actors), to be
at risk for eating disorders such as anorexia nervosa.
What causes anorexia?
At this time, no definite cause of anorexia nervosa has been determined.
However, research within the medical and psychological fields continues to
explore possible causes.
Studies suggest that a genetic (inherited) component may play a more significant role in determining a person's susceptibility to anorexia than was previously thought. Researchers are currently attempting to identify the particular gene or genes that might affect a person's tendency to develop this disorder, and preliminary studies suggest that a gene located at chromosome 1p seems to be involved in determining a person'
s susceptibility to anorexia nervosa.
Other evidence had pinpointed a dysfunction in the part of the brain, the hypothalamus (which regulates certain metabolic processes), as contributing to the development of anorexia. Other studies have suggested that imbalances in neurotransmitter (brain chemicals involves in signaling and regulatory processes) levels in the brain may occur in people suffering from anorexia.
Feeding problems as an infant, a general history of undereating, and maternal
depressive symptoms tend to be risk factors for developing anorexia. Other personal characteristics that can predispose
an individual to the development of anorexia include a high level of negative feelings and perfectionism. For many individuals with anorexia, the destructive cycle begins with the pressure to be thin and attractive. A poor self-image compounds the problem. People who suffer from any eating disorder are more likely to have been the victim of childhood abuse.
While some professionals remain of the opinion that family discord and high demands from parents can put a person at risk for developing this disorder, the increasing evidence against the idea that families cause anorexia has mounted such that professional mental-health organizations no longer ascribe to that theory. Possible factors that protect against the development of anorexia include high maternal body mass index as well as personal high self-esteem.
Next: How is anorexia diagnosed? »
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