psychiatric disorders
Anorexia Nervosa
Key Points
Patients with anorexia nervosa have an intense fear of gaining weight or becoming fat that persists despite all evidence to the contrary. In the restricting type of anorexia nervosa, patients restrict food intake and sometimes exercise excessively but do not regularly engage in binge eating or purging. In the binge eating/purging type, patients regularly binge eat and/or induce vomiting and/or misuse laxatives, diuretics, or enemas in an attempt to purge themselves of food. In adults, BMI is significantly low (usually BMI of<17 kg/m2), and in adolescents, BMI percentile is low (usually<5th percentile) or does not increase as expected for normal growth. Endocrine or electrolyte abnormalities or cardiac arrhythmias may develop, and death can occur. Treat with nutritional supplementation, psychotherapy (eg, cognitive behavioral therapy), and, for adolescents, family-based therapy;olanzapinemay be helpful. 