Anorexia nervosa in adolescence

Obsessive fear of weight leads to eating disorders and anorexia nervosa. This disease occurs more in women than in men, and is more common during puberty.

Exhausted by Obsessive Fear of Fat

Patient NKMA, 16 years old, was brought by relatives to the Institute of Mental Health (Bach Mai Hospital) for examination in a state of fatigue, weight from 47 kg down to only 36 kg, despite being 1.57 m tall.

A.'s mother said that before, she was always cheerful and sociable, but for the past 4 months, she has lost weight and recently has not been able to eat or has vomited after eating. A.'s academic performance has also declined and she has become more and more withdrawn.

Young female patient with anorexia nervosa is consulted and examined by a doctor

According to the patient's mother, A. previously said that she wanted to lose weight to have a slim body like her idol. Since the time her weight dropped rapidly, for more than 3 months now, the patient has also lost her menstrual period. At the hospital, despite her very thin body, this 10th grade female student always thought that she was very normal. A. was diagnosed with anorexia nervosa.

According to Dr. Nguyen Phuong Linh, Department of Treatment of Emotional Mental Disorders - Institute of Mental Health, doctors here have just finished a treatment course lasting more than 1 month for a 13-year-old male patient (in Hanoi ). More than 1 year ago, the boy weighed 67 kg, 1.56 m tall. While playing, he was teased by his friends for being fat, so this male student thought a lot and was always self-conscious. After that, the boy researched weight loss methods on social networks, reduced all the food intake, and practiced high-intensity fat-burning exercises.

At this time, T. entered puberty, his height increased rapidly, his weight also decreased, and his body was well-proportioned. However, he still maintained his diet and exercise. T. gradually became thinner, but the boy was always haunted and thought that his arms, legs, and stomach were still fat. When he went to the hospital for examination, the patient was 1.73 m tall, weighed 50 kg, although his parents advised him to stop fasting and exercise, the boy did not listen, almost did not eat meat or fish, ate very few vegetables, and only ate a few spoonfuls of rice at noon and evening. Even if he did not exercise, T. felt miserable, restless, and irritable...

Seeing T. thin, tired, and more sluggish, his family took him to Bach Mai Hospital for examination and consultation. However, when he returned home, he still did not change. The family took him to the hospital again and was asked to see a psychiatrist. The patient was hospitalized with a diagnosis of anorexia nervosa/sinus bradycardia (a type of heart rhythm disorder). After more than 1 month of treatment, T. began to have interest in eating, the amount of main meals met the requirements and felt good, no longer afraid of gaining weight. Recently, when re-examined, the patient was in good health and had stable emotions.

Puberty children are susceptible

Dr. Vu Son Tung, Deputy Head of the Department of Treatment of Emotional Mental Disorders - Institute of Mental Health, said that there are two types of anorexia nervosa. The first is food restriction: the patient limits the amount of food intake by eating as little as possible. The second is eating and excreting: the patient eats food but then vomits or uses laxatives to expel the food. The patient feels afraid of gaining weight and their body image. They always think they are overweight while their weight is completely normal, even though they are often hungry but refuse food. Because there are signs of digestion, cardiovascular, endocrine..., anorexia nervosa is often misdiagnosed.

According to Dr. Tung, this disease usually begins during puberty and changes in appearance. The incidence in women is 3 times higher than in men, with 85% of patients aged 13-18. In particular, the number of people under 15 years old with the disease is increasing.

There are cases of prolonged fasting to lose weight and also amenorrhea, requiring nutritional treatment and adjustment of psychological disorders for many months, even years to return to normal. There are cases of people who are very thin but still try to lose weight by fasting, inducing vomiting, taking diarrheal drugs, increasing exercise... As a result, the patient falls into a state of fatigue, anemia, increased liver enzymes, electrolyte disorders, endocrine disorders...

Explaining the reason why anorexia nervosa often starts during puberty, Dr. Vu Son Tung said that at this age, children often compare themselves with their friends' bodies and sometimes have negative perceptions about their own appearance. From there, they decide to diet, leading to an increased risk of developing an eating disorder. In addition, the popularity of movies and magazines in promoting the standard of physical beauty as being slim and slender makes it a trend for many young people.

"For adolescents, the mental disorders that arise from anorexia nervosa can seriously affect their future personality development. Therefore, these cases need to be examined and treated at the right psychiatric department to find the cause of the disease and achieve effectiveness.

20%-25% of people with anorexia nervosa want to commit suicide

Doctor Nguyen Phuong Linh warns that anorexia nervosa affects multiple organs of the body. Patients may experience symptoms such as fatigue; insomnia; dizziness or fainting; thin, brittle or falling hair; amenorrhea or menstrual disorders; dehydration... Patients have a distorted perception of their own weight, they are wary of food, refuse to eat or even deny that they are hungry; fear of gaining weight, are easily irritated; have decreased sexual desire; have self-destructive behavior, suicidal thoughts and behaviors.

Studies also show that about 22% of people with anorexia nervosa have at least once self-harmed by cutting, scratching their skin, or burning themselves with cigarettes... About 20%-25% of people with anorexia nervosa have a history of suicide attempts.

Source: https://nld.com.vn/suc-khoe/chan-an-tam-than-o-tuoi-day-thi-20230327195724799.htm