Anorexia nervosa - Treatments In Herbal medicine perspective

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.
Treatments
In herbal medicine perspective

Herbs can be used to strengthen and tone the body's systems.
1. Ashwagandha also known as Withania somnifera is a nightshape plant in the genus of Withania, belonging to the family Solanaceae, native to the dry parts of India, North Africa, Middle East, and the Mediterranean. It has been considered as Indian ginseng and used in Ayurvedic medicine over 3000 years to treat tumors and tubercular glands, carbuncles, memory loss and ulcers and considered as anti-stress, cognition-facilitating, anti-inflammatory and anti-aging herbal medicine. According to the article of "Steroidal lactones from Withania somnifera, an ancient plant for novel medicine" by Mirjalili MH, Moyano E, Bonfill M, Cusido RM, Palazón J.(55). Ashwagandha root may be used to treat the stress and antioxidants causes of anorexia nervosa(56)

2. Fenugreek 
Fenugreek may be used to treat free redical cause of anorexia nervosa, In the study of total phenolics and antioxidant activities of fenugreek, green tea, black tea, grape seed, ginger, rosemary, gotu kola, and ginkgo extracts found that The total phenolics of the plant extracts, determined by the Folin-Ciocalteu method, ranged from 24.8 to 92.5 mg of chlorogenic acid equivalent/g dry material. The antioxidant activities of methanolic extracts determined by conjugated diene measurement of methyl linoleate were 3.4-86.3%. The antioxidant activity of the extracts using chicken fat by an oxidative stability instrument (4.6-10.2 h of induction time), according to "Total phenolics and antioxidant activities of fenugreek, green tea, black tea, grape seed, ginger, rosemary, gotu kola, and ginkgo extracts, vitamin E, and tert-butylhydroquinone" by Rababah TM, Hettiarachchy NS, Horax R.(57)

3. Milk thistle  
In the observation of the active extract of milk thistle, silymarin, is a mixture of flavonolignans and its antioxidant effect found that Exposure to light significantly reduced sprout growth and significantly increased the polyphenol content and antioxidative capacity. The polyphenol content was 30% higher in seeds originating from purple inflorescences than in those from white ones. We thus found milk thistle to be a good candidate source of healthy edible sprouts, according to "The potential of milk thistle (Silybum marianum L.), an Israeli native, as a source of edible sprouts rich in antioxidants" by Vaknin Y, Hadas R, Schafferman D, Murkhovsky L, Bashan N.(58)

4. Catnip 
Catnip is to calm the nerves and soothe the digestive system. The alcohol extract of catnip has a biphasic effect on the behavior of young chicks. Low and moderate dose levels (25--1800 mg/kg) cause increasing numbers of chicks to sleep, while high dose levels (i.e. above 2 g/kg) cause a decreasing number of chicks to sleep, according to the study of `The effect of an ethanol extract of catnip (Nepeta cataria) on the behavior of the young chick`by Sherry CJ, Hunter PS.(59)

5. Etc. Chinese Secrets To Fatty Liver And Obesity Reversal
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Sources
(56) http://www.ncbi.nlm.nih.gov/pubmed/9582008
(57) http://www.ncbi.nlm.nih.gov/pubmed/15291494
(58) http://www.ncbi.nlm.nih.gov/pubmed/20709593
(59) http://www.ncbi.nlm.nih.gov/pubmed/421844  

Anorexia nervosa - Treatments In conventional medicine perspective

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.
Treatments 
A. In conventional medicine perspective
A.1. Non medical therapy
1. Cognitive behavior therapy (CBT) 
In the examining psychological factors that influence the level of weight gain across the first 20 sessions of cognitive behavioral therapy (CBT) for anorexia nervosa, found that during CBT for anorexia nervosa, weight gain might be enhanced by addressing a range of aspects of axis 1 pathology (e.g., depression, hostility, and features of anxiety). However, the approach is likely to be less important at first than directly addressing eating pathology and overvalued ideas about eating, shape, and weight(51).

2. Psychodynamic therapy
In the reviews of the results of process research, outcome in psychodynamic psychotherapy is related to the competent delivery of therapeutic techniques and to the development of a therapeutic alliance. With regard to psychoanalytic therapy, controlled quasi-experimental effectiveness studies provide evidence that psychoanalytic therapy is (1) more effective than no treatment or treatment as usual, and (2) more effective than shorter forms of psychodynamic therapy. Conclusions are drawn for future research(52).

3. Interpersonal therapy 
The goals of the therapy are to improve interpersonal functioning and thereby decrease symptomatology. Factors identified as important in the development of anorexia nervosa are readily conceptualized within the interpersonal psychotherapy problem areas of grief, interpersonal disputes, interpersonal deficits, and role transitions(53).

4. Family therapy 
In six randomised controlled trials investigating the use of family therapy in the treatment of adolescents with anorexia nervosa, and these all had small sample sizes. Some, but not all, of these trials suggest that family therapy may be advantageous over individual psychotherapy in terms of physical improvement (weight gain and resumption of menstruation) and reduction of cognitive distortions, particularly in younger patients(54).

A.2. Medication
The aim of medical intervention is to treat physical problems associated with anorexia, but rarely changes behavior. There are no medications specifically approved to treat anorexia, but medical conditions caused by anorexia can be treated with certain medication depending to the condition.
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Sources
(51) http://www.ncbi.nlm.nih.gov/pubmed/22422613
(52) http://www.ncbi.nlm.nih.gov/pubmed/16096078
(53) http://www.ncbi.nlm.nih.gov/pubmed/10657886
(54) http://www.ncbi.nlm.nih.gov/pubmed/21894130

Anorexia nervosa - The Antioxidants

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.
Prventions
Antioxidants to prevent anorexia nervosa

An antioxidant is a chemical that  protect cells against damage caused by free radicals and chain reaction of free radicals by inhibiting the oxidation of other molecules

 1. In the study of the antioxidant status in female adolescents (N = 82) with anorexia nervosa, by the measurement of erythrocyte tocopherol concentration, and the determination of activities of the main antioxidant enzymes: superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase.
showed that tocopherol was significantly decreased in the anorexic patients compared to reference values (p < .02). In 21% of patients, tocopherol levels were below the reference interval. Superoxide dismutase activity was significantly decreased (p < .0001), while catalase activity was increased (p < .0001). The activity of the glutathione system enzymes did not show significant differences between patients and controls.The deficient concentration of erythrocyte tocopherol together with the altered antioxidant enzyme activities suggest a certain degree of oxidative damage in anorexia nervosa owing to both factors deficient micronutrient intake and oxidative stress(49).

2. Antioxidant vitamins in Anorexia Nervosa by V. MATZKIN¹, C. GEISSLER¹ and M. BELLO, indicated that antioxidant vitamins (tocopherol, retinol and carotene) protect against lipid peroxidation caused by free radicals and active oxygen species. Patients with Anorexia Nervosa (AN) are at a greater risk of oxidative damage due to undernutrition and stress (Moyano, et. al., 1999). There is contradictory evidence concerning concentrations of tocopherol (Mira et. al. 1987, Phillip et. al., 1998 and Moyano et. al., 1999), retinol (Robboy et. al., 1974, Lagan and Farrell, 1985 and Vaisman, et. al., 1992) and carotene (Van Binsbergen et. al., 1988, Rock et. al., 1996) in AN(50).

3. Etc.
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Sources
(49) http://www.ncbi.nlm.nih.gov/pubmed/9924658
(50) http://www.fac.org.ar/fec/foros/cardtran/gral/antioxidant.htm
 

Anorexia nervosa - The Diet and nutritional supplements

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.
Diet and nutritional supplements to prevent anorexia nervosa

The aim of the diet and nutritional supplements is to provide enough nutrients as for people with anorexia nervosa are more likely to have vitamin and mineral deficiencies which can lead to certain symptoms of the diseases.
1. Caffeine
Caffeine intake increased over time between ages 9 and 19 years across all groups and this trend was not moderated by diagnostic status. For anorexia nervosa, relative to the non-eating disorder group, the proportional intake of caffeine from soda increased significantly before onset to onset to after onset and ingestion of chocolate-containing foods decreased sharply over time(42).

2. Alcohol
While the rate of anorexia was not elevated in alcoholics after controlling for other disorders, bulimia did occur at a greater than expected rate. However, both eating disorders were relatively rare, and much of the association with alcoholism occurred in the context of additional preexisting or secondary psychiatric disorders(43).

3. Tobacco
Although malnutrition may be expected to reduce DNA methylation through its effects on one-carbon metabolism, our negative results are in line with several in vitro and clinical studies that did not show a direct relation between gene-specific DNA methylation and folate levels. In contrast, smoking has been repeatedly reported to alter DNA methylation of specific genes and should be controlled for in future epigenetic studies(44)
.
4.  Drink 6 - 8 glasses of filtered water daily as water can decrease the risk of dehydration.
Caffeine, water, and aspartame consumption can be variable in patients with AN and the consumption of these substances seems to be only modestly related to purging behavior(45).

5. Promote healthy diet for maximum nutrients absorption.
6. The important of nutritional supplements
Some researchers suggested that conservation mechanisms resulting from starvation and/or self-prescribed nutrient supplements can result in laboratory values that appear within normal limits. These artificially inflated values drop to dangerous levels in some patients once rehydration and refeeding begin. Electrolyte status must be closely monitored during this time to prevent complications. Other micronutrient deficiencies can be corrected with adequate dietary intake, but patients with eating disorders are unlikely to consume such an adequate diet immediately upon entering treatment, so they may benefit from supplementation. Depleted nutrient stores require longer supplementation than acute inadequacies in nutrient intake. This review compiles the findings reported to date regarding micronutrient deficiencies and supplementation for patients with anorexia and bulimia. Because of the widely varying eating practices from patient to patient and the current lack of data controlling for nutrient self-supplementation, nutrition assessment performed by a nutrition professional via food intake history may be more practical than laboratory tests and more accurate than current food intake for determining potential micronutrient deficiencies(46).
 a.. In the study of  20 female patients with anorexia nervosa (AN) and in 10 lean and 10 normal weight, healthy, female control subjects. Patients with AN had higher activities of L-gamma-glutamyl transferase (gamma-GT) and glutamate pyruvate transaminase (SGPT) and a higher concentration of prealbumin in serum and lower leucocyte and lymphocyte counts in blood. For the other routine clinical chemical parameters no significant differences between the groups were observed. AN patients had higher serum vitamin B12 and retinol levels. No significant differences were found for the status parameters of thiamin, vitamin B6, vitamin C, folate, vitamin E and vitamin D. Contradictory results were obtained for the riboflavin status: AN patients had a lower level of flavin adenine dinucleotide (FAD) in blood and a lower stimulation ratio of the glutathione reductase activity in erythrocytes (alpha-EGR). Patients with AN had higher serum ferritin concentration and lower total iron binding capacity (TIBC). However, haemoglobin (Hb), haematocrit (Ht) and iron saturation were not significantly different. No significant difference was found in the concentration of zinc in plasma. In spite of the poor intake of nutrients and energy, the results obtained did not indicate an inadequate status of vitamins, iron and zinc in patients with AN(47).

b.  Other study of trace metals, vitamins, and other biochemical parameters in 30 female patients hospitalized for anorexia nervosa, showed that Anorexia nervosa patients showed hypogeusia, with the bitter and sour taste most severely affected, however plasma zinc levels did not correlate with taste recognition scores. Patients showed hypercarotenemia (214 +/- 129 microgram/100 ml; P < 0.01) with normal plasma vitamin A and retinol-binding protein levels. Total iron binding capacity was depressed (261 +/- 62 microgram/100 ml; P < 0.001) in contrast to plasma iron, ceruloplasmin and folic acid, which were normal. In nine patients, who were retested before discharge, taste function improved; plasma zinc, copper, and total iron binding capacity levels increased whereas plasma carotene and cholesterol decreased to normal levels. It is concluded that the observed zinc, copper, and iron binding protein deficiencies, and hypogeusia, reflect the self-imposed nutritional restriction of anorexia nervosa patients. Zinc and other micronutrients released from catabolized tissue along with vitamin intake may mitigate against more severe deficiency states in anorexia nervosa(48).
A daily multivitamin is an essential, as it contain numbers of vitamins and trace minerals such as vitamins A, C, E, the B-vitamins,  magnesium, calcium, zinc, phosphorus, copper, and selenium which are essential for the body needed. Other supplement include Omega-3 fatty acids, Coenzyme Q10, 5-hydroxytryptophan (5-HTP), Creatine, Probiotic supplement, etc.

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Sources

(42) http://www.ncbi.nlm.nih.gov/pubmed/8540597
(43) http://www.ncbi.nlm.nih.gov/pubmed/19189405 
(44) http://www.ncbi.nlm.nih.gov/pubmed/22398003
(45) http://www.ncbi.nlm.nih.gov/pubmed/19189405
(46) http://www.ncbi.nlm.nih.gov/pubmed/20413694
(47) http://www.ncbi.nlm.nih.gov/pubmed/3074921
(48) http://www.ncbi.nlm.nih.gov/pubmed/7405882

Anorexia nervosa - The Do's and Do not's list

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.
Preventions
A. The Do's and Do not's list
A.1. Primary prevention 
Dt. Michael Sidiropoulos in the article of Anorexia Nervosa: The physiological consequences of starvation and the need for primary prevention efforts indicated that there are numerous actions that the physician, along with the family, allied health care workers and/or through a broader public health initiative can accomplish in this particular case that will have longstanding implications on the patient's future development and growth and will increase the likelihood of healthy outcomes through primary
prevention(37).
1. Minimizing social pressures
In the study to evaluation the Sociological factors in the development of eating disorders, Dr Nagel KL, andand Dr. Jones KH. at the University of Georgia indicated that professionals in the educational and physical and mental health care fields need to be aware of the influence of social pressures on teenagers' perceptions of body image and appearance. This article reviews the sociocultural, socioeconomic, and sex-related factors which contribute to the development of eating disorders. It is recommended that professionals help adolescents resist societal pressure to conform to unrealistic standards of appearance, and provide guidance on nutrition, realistic body ideals, and achievement of self-esteem, self-efficacy, interpersonal relations and coping skills(38).

2. Minimizing family issues
Dr. Yager J. in the study of the family issues in the pathogenesis of anorexia nervosa, suggested that factors residing in family systems have been implicated in the pathogenesis of anorexia nervosa. In this paper I critically review literature that bears on this issue: the transmission of anorexia nervosa in families; family stress patterns, personality and psychopathological characteristics of parents, parent-child interactions, and whole family systems. Much additional research is needed to accurately determine the precise nature of such factors and the extent to which they actually contribute to the appearance of this syndrome(39).

3. Reducing individual factors
In the study to examine which unique factors (genetic and environmental) increase the risk for developing anorexia nervosa by using a case-control design of discordant sister pairs, Dr. Karwautz A, and the research team at University of London, suggested that he sisters with anorexia nervosa differed from their healthy sisters in terms of personal vulnerability traits and exposure to high parental expectations and sexual abuse. Factors within the dieting risk domain did not differ. However, there was evidence of poor feeding in childhood. No difference in the distribution of genotypes or alleles of the DRD4, COMT, the 5HT2A and 5HT2C receptor genes was detected. These results are preliminary because our calculations indicate that there is insufficient power to detect the expected effect on risk with this sample size(40).

A.2. Secondary prevention
Secondary prevention focuses early detection and intervention as  early detection is often difficult as individuals with eating problems often attempt to conceal their behavior. People such as Parents, peers and siblings, teacher and family doctor are in good position to detect changing attitudes around food,weight, and shape for detecting eating disorder early for effective treatment(41)
 
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Sources
(37) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC483668/
(38) http://www.medicine.mcgill.ca/MJM/issues/v09n01/case_rep/Anorexia%20Nervosa.pdf
(39) http://www.ncbi.nlm.nih.gov/pubmed/1539487
(40) http://www.ncbi.nlm.nih.gov/pubmed/11232918
(41) http://www.nedic.ca/knowthefacts/documents/Preventionofeatingdisorders.pdf 

Eating Disorders: Anorexia nervosa - The Diagnosis

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.
Diagnosis and tests
The criteria of Anorexia nervosa diagnosed if a person refuses to maintain his or her body weight over a minimal normal weight for age and height, such as 15% below that expected, has an intense fear of gaining weight, has a disturbed body image, and, in women, has primary or secondary amenorrhea(33).
After taking the complex physical exam, including detail of absence of period and the examination the symptoms of Anorexia nervosa, such as skin and nails for dryness, hair, etc. If your doctor suspect that you have develop norexia nervosa, he/she may order
1. Hematological and blood coagulation tests
In a study of Red cell and haemoglobin values in 44 women with a typical picutre of anorexia nervosa showed that 20.5% presented a picture of true anaemia. Blood iron was low, sometimes very low, with a mean value of 66 mg 0/0. Clotting parameters: PTT, TT, PT, circulating platelets and TEG were normal. This finding serves to explain the low incidence of haemorrhage and the ready haemostasis noted in this disease, in spite of the considerable food deficit(33).
Other blood tests may be required to check electrolytes and protein as well as functioning of the liver, kidney and thyroid.

2. Urinary steroids
Urinalysis is to measure the levels of dehydroepiandrosterone. The increased level of the stress marker allo-tetrahydrocorticosterone refers to the involvement of stress in these diseases(34).

3. Psychological evaluation
Psychological self-assessment questionnaires are given to test  your thoughts, feelings and eating habits.
Dr. Gordon DP, and the research team in the study of A comparison of the psychological evaluation of adolescents with anorexia nervosa and of adolescents with conduct disorders indicated that Cognitive and projective psychological tests were administered to ten inpatient adolescents with anorexia nervosa and ten inpatient adolescents with conduct disorders. All subjects were selected on the basis of race, sex and overall intelligence. Results indicate that there are high numbers of neuropsychological deficits in both groups, but that neuropsychological deficits are especially numerous in the anorexia group. The two groups showed striking similarities in terms of some psychological functions, but results indicate that some aspects of personality style in the two groups are significantly different. A significant finding was that there were far more suicidal indicators on the Rorschach records of the anorectic group as compared with those found on the records of the conduct disorder group(35).


4. X-rays
X- ray may be taken to check for broken bones, pneumonia. In some cases, dual energy X-ray absorptiometry may be necessary to test for the presented osteopenia and  osteoporosis(36)

5. Electrocardiograms 
Electrocardiograms is necessary to look for heart irregularities. Anorexia nervosa caused demonstrable abnormalities of mitral valve motion and reduced left ventricular mass and filling associated with systolic dysfunction.

6. Etc.
  
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Sources
(33) http://www.ncbi.nlm.nih.gov/pubmed/869704
(34) http://www.ncbi.nlm.nih.gov/pubmed/15560936
(35) http://www.ncbi.nlm.nih.gov/pubmed/6501640
(36) http://www.ncbi.nlm.nih.gov/pubmed/22137016

Eating Disorders: Anorexia nervosa - The Consequences

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.
The Consequences
In anorexia nervosa because of malnutrition as a result of self starvation, it can cause abnormal function of the body of that can lead to serious medical consequences:
1. Cardiovascular diseases
In the stidy of 181 women: 140 women with anorexia nervosa (AN) [85 not receiving oral contraceptive pills (OCPs) (AN-E) and 55 receiving oral contraceptive pills (OCPs)(AN+E)] and 41 healthy controls [28 not receiving OCPs (HC-E) and 13 receiving OCPs (HC+E)]. Dr. Lawson EA, and the research team at Harvard Medical School, showed that although hsCRP levels are lower in AN than healthy controls, OCP use puts such women at a greater than 20% chance of having high-sensitivity C-reactive protein (hsCRP), in the high-Cardiovascular (CV)-risk (>3 mg/liter) category. The elevated mean IL-6 in women with AN and high-risk hsCRP levels suggests that increased systemic inflammation may underlie the hsCRP elevation in these patients. Although OCP use in AN was associated with slightly lower mean LDL and higher mean HDL, means were within the normal range, and few patients in any group had high-risk LDL or HDL levels. IGF-I levels appear to be important determinants of hsCRP in healthy young women(24).
Other researchers suggested that anorexia nervosa can slow heart rate and low blood pressure, because of badly underweight.

2. Osteoporosis
Badly underweight can increase the risk of  Osteoporosis, researchers at the  Uniwersytet Medyczny suggested that the consequences of low energy fractures are the main causes of death in women with AN. Hormonal disturbances (e.g. hypoestrogenism, increased levels of ghrelin and Y peptide, changes in leptin and endocannabinoid levels), as well as the mechanisms involved in bone resorption (RANK/RANKL/OPG system), are considered to be of great importance for anorectic bone quality(25).


3. Muscle dysfunction
Protein-energy malnutrition in anorexia nervosa is an under-recognised cause of muscle dysfunction and weakness. In the study to characterise the skeletal myopathy that occurs in patients with severe anorexia nervosa, muscle function and structure. All of the patients showed impaired muscle function on strength and exercise measurement(26).

4. Severe dehydration
In the study to investigate the medical history, dental examination, and saliva tests of 39 patients aged 14 to 42 years, having suffered from AN for periods of 1 to 20 years, showed dental caries, due to excessive carbohydrate consumption, in all subjects, often in a rampant form. In patients with a history of intense vomiting (27 cases) severe lingual-occlusal erosion (perimylolysis) was nearly always present. Buccal erosion, mainly due to high consumption of acid fruits and drinks to relieve thirst caused by dehydration, was more frequent in vomiting than in non-vomiting patients(27). 
5. Fainting, fatigue, and overall weakness
Fainting, fatigue, and overall weakness are expected as patients  body required to conserve energy as protect the body organs due to malnutrition.

6. Lanugo
Lanugo is the growth of fine, downy hair on the face and body of anorexics. It's a sign that the body's natural defenses are at work. Hypertrichosis refers to the amount or length of extra hair that is grown -- to the point of excessive.
At a certain point during the starvation process, some anorexics may start to notice some fine, white hair on their body. People may even call it "fur".
It's usually visible on the face first, but it can appear anywhere on the body, including the back. Extra thick hair is normally found on the legs.
In women and girls with anorexia, the hair tends appear in areas where there is typically very little hair growth, such as the face, chest and back areas(28).

7. Psychiatric health problems

In a register study based on based on socio-economic and health data was conducted for a national cohort of female residents in Sweden born between 1968 and 1977, including 748 in-patients with anorexia nervosa. At follow-up 9-14 years after hospital admission, 8.7% of patients with anorexia nervosa had persistent psychiatric health problems demanding hospital care and 21.4% were dependent on society for their main income; the stratified relative risks were 5.8 (95% CI 4.7-7.6) and 2.6 (2.3-3.0) respectively, compared with the general female population(29).

8.   Psychoactive substance use and suicide
Anorexia nervosa is a mental disorder with high mortality. Dr. Papadopoulos FC, and the research team at the University Hospital, Uppsala, showed that the overall SMR for anorexia nervosa was 6.2 (95% CI 5.5-7.0). Anorexia nervosa, psychoactive substance use and suicide had the highest SMR. The SMR was significantly increased for almost all natural and unnatural causes of death. The SMR 20 years or more after the first hospitalisation remained significantly high. Lower mortality was found during the last two decades. Younger age and longer hospital stay at first hospitalisation was associated with better outcome, and psychiatric and somatic comorbidity worsened the outcome(30).
9. Reproductive issues  
The physical and psychological demands of pregnancy and motherhood can represent an immense challenge for women already struggling with the medical and psychological stress of an eating disorder. This article summarizes key issues related to reproduction in women with anorexia nervosa, highlighting the importance of preconception counseling, adequate gestational weight gain, and sufficient pre- and post-natal nutrition. Postpartum issues including eating disorder symptom relapse, weight loss, breastfeeding, and risk of perinatal depression and anxiety(31)
 
I would like summarize this section with research from Dt. Miller KK at Massachusetts General Hospital and Harvard Medical School, Boston "Despite significant progress in the field, further research is needed to elucidate the mechanisms underlying the development of anorexia nervosa and its endocrine complications. Such investigations promise to yield important advances in the therapeutic approach to this disease as well as to the understanding of the regulation of endocrine function, skeletal biology, and appetite regulation" (32).Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve 
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Sources
(24) http://www.ncbi.nlm.nih.gov/pubmed/17519306
(25) http://www.ncbi.nlm.nih.gov/pubmed/22161979
(26) http://www.ncbi.nlm.nih.gov/pubmed/9650756
(27) http://www.ncbi.nlm.nih.gov/pubmed/14394
(28) http://www.anorexia-reflections.com/lanugo.html#axzz1wVB7hbqL
(29) http://www.ncbi.nlm.nih.gov/pubmed/17077433
(30) http://www.ncbi.nlm.nih.gov/pubmed/19118319
(31) http://www.ncbi.nlm.nih.gov/pubmed/22003362
(32) http://www.ncbi.nlm.nih.gov/pubmed/21976742