Anorexia nervosa and bulimia

Anorexia nervosa may occur in one of 200 white adolescent girls, and bulimia appears to be much more common, particularly in older adolescents and young women. These disorders are distinctly uncommon in the male population. Current opinion supports a psychological basis for these disorders, although there are some findings that suggest a primary hypothalamic defect. Early warning signs of anorexia nervosa include an arrest in weight gain during puberty, increasing social isolation, hyperathleticism, and increasing concern over academic performance. Bulimia may exist concomitantly with anorexia nervosa or as an entirely separate disorder characterized by a recurrent binge-purge cycle. The signs and symptoms of these eating disorders are mainly those associated with weight loss, dehydration, and electrolyte imbalance. Because of the complex psychological issues involved, an experienced psychotherapist should be involved while the primary care clinician provides anticipatory and supportive medical care.