Symptoms of anorexia
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Symptoms of Anorexia Nervosa
Physical Symptoms of Anorexia Nervosa
Skin Signs in Anorexia Nervosa
Anorexia nervosa (AN) often manifests through various skin signs, which can be crucial for early diagnosis. These signs include xerosis (dry skin), lanugo-like body hair, telogen effluvium (hair loss), carotenoderma (yellowing of the skin), acne, hyperpigmentation, seborrhoeic dermatitis, acrocyanosis (bluish discoloration of the extremities), perniosis (chilblains), petechiae (small red or purple spots), livedo reticularis (mottled skin), interdigital intertrigo (inflammation between the toes), paronychia (nail infection), acquired striae distensae (stretch marks), and acral coldness. A particularly characteristic sign is Russell's sign, which consists of knuckle calluses from self-induced vomiting.
Gastrointestinal Symptoms
Gastrointestinal (GI) symptoms are prevalent and particularly bothersome for individuals with AN. These symptoms include delays in gastric motility, gastric emptying, and intestinal transit. Patients often report high rates of GI discomfort, although medical testing does not always correlate these symptoms with measurable pathology. GI complications can occur throughout the entire GI tract and may derive from severe malnourishment, self-induced purging, or the refeeding process .
Psychological Symptoms of Anorexia Nervosa
Depression and Anxiety
Depressive and anxiety symptoms frequently co-occur with AN. These psychological symptoms are often linked to biological changes caused by starvation, such as reduced availability of tryptophan, which can decrease serotonin activity. During refeeding, an increase in tryptophan availability can help restore serotonin neurotransmission, potentially reducing depressive symptoms. There is also a positive correlation between serotonin levels and symptoms of both anxiety and depression.
Obsessive-Compulsive Symptoms
Individuals with AN often exhibit obsessive-compulsive symptoms, which can be related to altered serotonin and dopamine metabolism. These symptoms may include a relentless preoccupation with dieting and weight loss, which can lead to severe emaciation and sometimes death. Brain imaging studies suggest that dysfunction in ventral and dorsal neural circuits, particularly in the insula and striatum, may contribute to these symptoms.
Atypical Anorexia Nervosa
Similarities and Differences with Typical AN
Atypical anorexia nervosa (atypical AN) shares many psychological and physiological characteristics with typical AN. Individuals with atypical AN experience similar levels of eating disorder-specific psychopathology and many of the same physiological complications, although some complications may be less frequent. Despite significant weight loss, individuals with atypical AN are not underweight, which differentiates them from those with typical AN.
Conclusion
Anorexia nervosa presents a complex array of symptoms that affect both the body and mind. Physical symptoms include various skin signs and gastrointestinal complications, while psychological symptoms encompass depression, anxiety, and obsessive-compulsive behaviors. Understanding these symptoms is crucial for early diagnosis and effective treatment, which can significantly improve the prognosis for individuals suffering from this severe eating disorder.
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