Importance Of The Nourishment
Anorexia Nervosa is a mental illness in which patients become infatuated with reaching a less than healthy body weight; self-starvation is a way an anorexic patient may try to achieve this goal. Consequently, they do lose their unwanted body fat, but the deprivation of nutritional needs leads to grave consequences that outweigh their accomplished goal. Such repercussions include but are not limited to, immunological, endocrine, hematologic, myocardial, pulmonary, gastrointestinal, and reproductive complications.
A specific cause for this disease is not year clear but is said to correlate with biological, psychological, and environmental factors. “A person with Anorexia is more likely to come from a family with a history of certain health problems. These include weight problems, physical illness, and mental health problems” (Johns Hopkins Medicine). In this sense, biological and physiological factors count as one. A precedent with a similar history of illnesses can put offspring at risk for developing such disease. Said disease, whether inherited or acquired will make a person much more susceptible to developing Anorexia. For example, “Some people with Anorexia may have obsessive-compulsive personalities make it easier to stick to strict diets and forgo food despite being hungry. They may have an extreme drive for perfectionism, which causes them to think they’re never thin enough” (Morris). There is also the environmental aspect to consider. Today’s society arguably exerts more pressure on the impressionable youth to look their best than past generations. With new technological advances like social media, self-esteem goes down and the demand to look thin goes up, “adolescents who used social media more frequently were more dissatisfied with their bodies in the current study” (de Vries et al). With social media being so accessible to many, it is no surprise that many people suffer from body dysmorphic diseases like Anorexia.
The demographic of patients who suffer from Anorexia is very widespread. A popular connotation is made that Anorexia only affects females. Various studies have proved this to be untrue, “It’s estimated that 30 million Americans have struggled with an eating disorder…that breaks down to 20 million women and 10 million men” (Casares). While it is true that most patients are female, one should not overlook the millions of male patients who also bear the same disease. The affected population is further divided within varying locations, “Prevalence rates in Western countries for Anorexia nervosa ranged from 0.1% to 5.7% in female subjects… prevalence rates in non-Western countries for Anorexia nervosa ranged from 0.46% to 3.2% in female subjects” (Mariko et al). In a way these results make sense because third world countries are notorious for experiencing food scarcities, conversely, more Western countries are known for high obesity rates. As I stated before, Anorexia is said to be caused by environmental factors; it’s more logical for an individual to want to feel thin in a place where there is an obesity epidemic than one who lives in a place where the population is malnourished.
The human body needs nourishment to survive: Iron for oxygen transport, Calcium for bone health, Carbohydrates for energy, Vitamin B12 for red blood cells, Vitamin A for eyesight, and the list goes on. Deprivation of food results in the loss of these essential nutrients that help maintain a healthy homeostatic balance. Anorexic patients often disregard the loss of vital supplements in an attempt to lose weight. Consequently, it brings upon complications that can cause severe or irreparable bodily damage or in more critical cases, death.
There are many ways in which Anorexia presents itself. In some cases, it is visibly apparent that a patient has this disease by their gaunt, and unhealthy appearance. However, there are other ways this disease is exhibited, such as an underweight BMI, unexplained loss of three consecutive menstrual cycles or more, bloating/abdominal pain, hypothermia, fatigue, and dizziness (Anorexia Nervosa: Symptoms & Causes). These indicators of Anorexia may vary with each patient and the severity of each case.
In more severe and chronic cases of Anorexia, complications become more prevalent. One of these complications is immunological disorders. Anorexic patients are more prone to experience immunodeficiency, in which their immune system becomes less potent in fighting off diseases and infections. This happens because cytokines, that usually regulate communication between immune cells, do not proliferate as well. Cytokine production is usually initiated with hormonal changes such as menstruation. Amenorrhea, which is the loss of menstruation, cytokine synthesis is halted. Hence, cytokine production (or lack thereof) creates a fault in the immune system that makes the patient susceptible to immunodeficiency. Another cause of immunological diseases is Protein-energy malnutrition, which is a type of malnutrition that disrupts the balance of a normal immune system. This type of malnutrition results in delayed lymphocyte responses and decreased T-lymphocytes in peripheral blood serum tests, diluting the resistance of the immune system (Słotwińska).
Anorexia also brings a plethora of endocrine complications. One of these complications is Hypothalamic Amenorrhea. This begins with the hypothalamus which once deprived of nourishment, stops producing gonadotropin-releasing hormone. Once the gonadotropin-releasing hormone is no longer being made, the anterior pituitary gland is not able to efficiently secrete luteinizing and follicle-stimulating hormone. Eventually, this leads to ovaries not being able to produce estrogen and causing the loss of menses, also known as amenorrhea (Miller). Growth hormone resistance is also a common effect that teenage patients with Anorexia tend to experience. Several studies have concluded that individuals with Anorexia Nervosa produce more growth hormone than that of a healthy individual. It was also found that IGF-I levels are low in Anorexia. Despite the influx of growth hormone, the hormone will not be able to act because growth hormone effects need to be conveyed by Insulin-like growth factor 1 (IGF-I), which they had little of (Miller). This growth hormone resistance may have long-term consequences considering it is affecting an individual who is developing. Their growth stunt may last well until recovery and even then, may not be fully reversed. Anorexia also causes Hypercortisolemia, which is elevated cortisol in the blood for prolonged periods of time. Hypercortisolemia, more commonly known as Cushing’s disease, presented itself differently in patients with Anorexia who lacked the excess adipose tissue in their upper extremities. However, after recovery, patients with Anorexia amassed more weight gain on their upper than the lower body and still showed higher levels of cortisol in their urine even after reaching healthy weight (Miller). Anorexia also causes appetite hormone dysregulation. Because individuals with anorexia have less adipose tissue, they produce less leptin which decreases appetite. They also produce more ghrelin which increases appetite and PYY hormone that responds to food consumption, than healthy individuals. It is hypothesized that this appetite imbalance causes the development of Anorexia, however, researchers have been unable to test this theory. (Miller).
Anorexia Nervosa also causes hematologic disorders in patients. During prolonged malnutrition, the bone marrow that produces formed elements is deteriorated and therefore less of these elements are synthesized, resulting in anemia, leukopenia and thrombocytopenia. Usually, in anemia of patients with Anorexia, erythrocytes usually are normocytic and normochromic; meaning that the size of the cells is normal but insufficient in quantity and that hemoglobin concentration is normal but deficient red blood cells. (De Filippo et al.)