The pathology characteristic of people of adolescence and youth, mainly girls, expressed in an overly stubborn desire to lose weight. To achieve this goal, patients limit themselves to eating up to a complete refusal of food, apply intense physical exercise, walking or long-distance running, take large doses of laxatives and diuretics. If it is impossible to endure prolonged fasting, patients eat, even overeat, but cause artificial vomiting.
Anorexia nervosa is very closely associated with another pathology - dysmorphomania (see corresponding section). The painful conviction of excessive completeness leads patients to the idea of getting rid of this shortcoming. This belief can arise on real ground, i.e. in the presence of a certain excess weight, as a rule, psychogenic (insulting remarks addressed to the patient - “as thick as a barrel”, “fat”, “eat less”, etc.). In other cases, the fullness is imaginary, and the thought of losing weight is overvalued or delusional, and the condition itself is the initial stage in the development of schizophrenia (see).
Symptoms At first, patients very carefully hide from their parents both motives for their behavior and methods of losing weight. They try to feed the dog with their portion of food, hide the food, and then throw it away, quietly transfer food to other people's plates. Try to adhere to the most low-calorie diets. Even having achieved significant weight loss, they are not satisfied. Persistently continue to lose weight, using other methods (enemas, laxatives, debilitating physical exertion). After 1.5-2 years, diseases lose from 20 to 50% of their previous body weight and look extremely exhausted. The most typical manifestation of anorexia nervosa is amenorrhea (absence of menstruation), manifested either immediately or after a period of scanty rare menstruation. Such patients, at the insistence of their parents, turn to gynecologists, not knowing the true cause of menstrual irregularities. Only proper nutrition and weight gain to a certain critical mass (usually 48-50 kg) will help get rid of this.
For such patients, the desire to overfeed other family members is typical: mother, younger brothers and sisters. They enjoy watching others eat and gain weight (how a cured alcoholic enjoys drinking and drinking others while they are intoxicated).
Treatment:With sharp weight loss, inpatient treatment is necessary, since there is a real threat to life from exhaustion and gross metabolic and endocrine disorders. It is necessary to prescribe fractional 6-7 meals a day in small portions under the supervision of staff. Prescribe vitamins, small doses of insulin (4-6 units) to increase appetite. With the neurotic nature of anorexia, tranquilizers, small doses of antipsychotics (sonapax, neuleptil), psychotherapy of an explanatory nature about the dangers of starvation, the consequences of the disease with a reorientation of values, and in some cases hypnosis are indicated. For the treatment of anorectic syndrome in schizophrenia, antipsychotics (stelazine, triftazine, haloperidol, semap) are of great importance. Drugs and their dosages are selected individually, taking into account the tolerance and severity of the condition.