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Saturday, 30 November 2013

Eating Disorders: Anorexia nervosa - Cause and Risk factors

Anorexia nervosa
Anorexia nervosa is a type of eating disorder usually develop in the teen years and effect over 90% of female, because of excessive food restriction and irrational fear to become fat due the wrongly influenced media as attractiveness is equated to thinness.
Cause and Risk factors
A. Causes
Some researchers suggested that The most commonly mentioned perceived causes were dysfunctional families, weight loss and dieting, and stressful experiences and perceived pressure(12). Others showed that Eating disorders (EDs) manifest as abnormal patterns of eating behavior and weight regulation driven by low self-esteem due to weight preoccupation and perceptions toward body weight and shape and Several lines of evidence indicate that brain-derived neurotrophic factor (BDNF) plays a critical role in regulating eating behaviors and cognitive impairments in the EDs(13).

B. Risk factors
1. Virtue of thin-ideal internalization, body dissatisfaction
Dr. Stice E, and the researchers team at the Oregon Research Institute, in the treatment of Anorexia nervosa showed that there is evidence that selective prevention programs that target young women at elevated risk for eating pathology by virtue of thin-ideal internalization, body dissatisfaction, and negative affect produce significant larger intervention effects than do universal programs offered to unselected populations(14)

2.  Gender
If you are girls and women, you are at higher risk to develop Anorexia nervosa, because of growing social pressures. In a community sample of young adults (n = 1,056) completed a questionnaire that contained the Drive for Thinness, Bulimia, and Body Dissatisfaction subscales of the Eating Disorder Inventory, as well as probes for inappropriate compensatory behaviors, excessive exercise, and episodes of binge eating, showed that Women had substantially elevated scores on all of the factors except excessive exercise, for which men had significantly higher scores(15).

3. Gene mutation
Mutation of certain genes can cause increased risk of Anorexia nervosa, but certain gene change have been rule out such as , but some have been confirmed including Allele 13 of the marker D11S911 as it is significantly over represented in the anorexia nervosa population suggesting that a mutation in linkage disequilibrium with this locus may form part of the genetic component of AN. Further work is now required to try to reproduce these data in a second independent cohort and to further characterise this region of the human genome(15). Others found the linkage regions on chromosomes 1, 3, and 4 (anorexia nervosa) and 10p (bulimia nervosa)(16).

4. Family history
If you parent or siblings Anorexia nervosa, you are at increased risk to develop the disease. In the tduy to evaluate 420 first-degree relatives of 14 patients with anorexia nervosa, 55 patients with bulimia, and 20 patients with both disorders, Dr. Hudson JI, and the research team showed that the morbid risk for affective disorder in the families of the eating disorder probands was similar to that found in the families of patients with bipolar disorder; but was significantly greater than that found in the families of patients with schizophrenia or borderline personality disorder. These results add to the growing evidence that anorexia nervosa and bulimia are closely related to affective disorder(17).

5. Loss Weight intentionally
Dr. Müller MJ, and the team of scientists suggested that In regard to clinical practice, dietary approaches to both weight loss and weight gain have to be reconsidered. In underweight patients (e.g., patients with anorexia nervosa), weight gain is supported by biological mechanisms that may or may not be suppressed by hyperalimentation. To overcome weight loss-induced counter-regulation in the overweight, biological signals have to be taken into account. Computational modeling of weight changes based on metabolic flux and its regulation will provide future strategies for clinical nutrition(18).

6. Stress
People who are at stress and anxiety for what ever reason are at higher risk to anorexia nervosa. There is a case of report of athirty-five-year-old woman suffering from anorexia nervosa visited our hospital complaining of severe general weakness. She was diagnosed with stress-induced cardiomyopathy and mural thrombus using a transthoracic echocardiogram(19).

7. Occupations 
Certain occupation such as Athletes, actors and television personalities, dancers, and models are at higher risk of anorexia. In a detailed interview (the Eating Disorder Examination), models reported significantly more symptoms of eating disorders than controls, and a higher prevalence of partial syndromes of eating disorders was found in models than in controls. A body mass index below 18 was found for 34 models (54.5%) as compared with 14 controls (12.7%). Three models (5%) and no controls reported an earlier clinical diagnosis of anorexia nervosa. Further studies will be necessary to establish whether the slight excess of partial syndromes of eating disorders among fashion models was a consequence of the requirement in the profession to maintain a slim figure or if the fashion modeling profession is preferably chosen by girls already oriented towards symptoms of eating disorders, since the pressure to be thin imposed by this profession can be more easily accepted by people predisposed to eating disorders(20).

8. Etc.  
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Sources
(13) http://www.ncbi.nlm.nih.gov/pubmed/15209840
(14) http://www.ncbi.nlm.nih.gov/pubmed/22614677
(15) http://www.ncbi.nlm.nih.gov/pubmed/1502972
(16) http://www.ncbi.nlm.nih.gov/pubmed/17950174
(17) http://www.ncbi.nlm.nih.gov/pubmed/15785332
(18) http://www.ncbi.nlm.nih.gov/pubmed/16380317
(19) http://www.ncbi.nlm.nih.gov/pubmed/2323585
(20) http://www.ncbi.nlm.nih.gov/pubmed/15282695

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