Dr. Erik Chen Su, MD

-Abnormally low BMI (body mass index)

-Vitamin deficiency

-Fatigue

-Fainting

-Amenorrhea (lack of menstruation in women)

-Emaciation

-Poor wound healing

-Anemia

-Irregular heart rhythms

Anorexia may also cause bluish discoloration of the hands, brittle and falling out hair, yellowish skin, and lanugo (fine, downy hair). These physical symptoms are frequently accompanied by altered behaviors and emotions. Those with anorexia may feel compelled to hide their weight and actions from others. For example, someone with anorexia may wear oversized or baggy clothing to conceal weight loss or may deny hunger or lie about the amount of food that he or she consumes. Some people with anorexia may withdraw from social activities and may experience irritability and depression.

People of all ages, genders, and races may be diagnosed with anorexia; however, the condition affects more women than men. There is no single known cause for anorexia, but biological, psychological, and environmental factors may play a role. Athletes who participate in certain sports that emphasize body shape and size (such as ballet, figure skating, and wrestling) may be more likely to develop anorexia.

Anorexia has two subtypes that are referred to as the restrictive type and binge-purge type.

Restrictive type is the more frequently represented form of anorexia, involving the extreme restriction of food. Binge-purge type anorexia is food restriction accompanied by episodes of binging (eating large quantities of food) and purging (vomiting). Binge-purge type anorexia differs from bulimia as people with this type of anorexia severely limit calories and purge most of what they eat and are generally underweight, while those with bulimia are in a normal weight range. Left untreated, both types of anorexia have severe and life-threatening effects on health. Anorexia can lead to heart failure and even death.

Many people do not consciously develop anorexia, and have difficulty seeking treatment. For this reason, early detection and treatment helps with long-term recovery outcomes. Treatment for anorexia can vary from therapy visits to inpatient treatment, depending on the severity of a person's anorexia. Severe anorexia is typically treated in inpatient rehabilitation facilities, where patients increase their food consumption and gain weight under medical supervision. Eating disorder specialists provide therapy sessions and oversee a physical and mental treatment plan. Outpatient programs help patients return to a healthy weight through frequent talk therapy or cognitive behavioral therapy (CBT) sessions, specialized nutrition plans, and eating disorder support groups. Anorexia treatment aims to not only restore physical health and correct negative behaviors, but to also promote psychological well-being and self-confidence.

Anorexia nervosa, frequently referred to as anorexia, is a disorder where people severely restrict the types and quantity of food they eat. Those with anorexia have an extreme fear of eating and gaining weight and may repeatedly weigh themselves or engage in harmful behaviors such as excessive exercise or starvation. Those with anorexia often find themselves preoccupied with food, but unable to consume a healthy amount of it. This results in symptoms such as abnormally low BMI, vitamin deficiency, fatigue, fainting, and amenorrhea (lack of menstruation in women). Anorexia may cause bluish discoloration of the hands, brittle and falling out hair, yellowish skin, and lanugo (fine, downy hair). Left untreated, anorexia can lead to organ failure, brain damage, and even death.

Bulimia nervosa, typically called bulimia, is a disorder where people binge (eat large quantities of food) and purge the food that they just consumed by vomiting, laxative abuse, fasting, or excessive exercise. This behavior is usually motivated by a feeling of powerlessness over eating and a fear of weight gain or desire for weight loss. Bulimia can occur in underweight, normal weight, and overweight people. Symptoms of bulimia include acid reflux, intestinal distress, dehydration from purging, amenorrhea, and dental erosion from vomiting. Some people with bulimia have swollen parotid glands (salivary glands near the cheeks) and red scars and marks on the backs of their knuckles. Electrolyte imbalance from bulimia can be particularly severe and may lead to heart attack or stroke.

Binge eating disorder (BED) is the most common eating disorder. People with BED feel that they are unable to control the amount of food they eat and may continue to binge after reaching a point of fullness. BED binges (consuming large amounts of food) are often accompanied by feelings of sadness, guilt, and shame. Symptoms of BED include obesity, acid reflux, weight gain, and dissatisfaction with one's body. People with BED tend to experience cycles of negative emotions and binges. Binges or BED episodes can be provoked by stress, boredom, restrictive dieting, depression, and other triggers.

Other common eating disorders include:

• Pica, eating things that are not food, such as paper, ice, or soil
• Avoidant/Restrictive Food Intake Disorder (ARFID), disinterest in eating and avoidance of food
• Other Specified Feeding or Eating Disorder (OSFED), abnormal eating that does not fall under any disorder

Many people with eating disorders do not consciously develop them, and have difficulty seeking treatment. For this reason, it's important to detect and treat eating disorders as early as possible. Treatment for eating disorders can vary from therapy visits to inpatient treatment, depending on the disorder and its severity. Treatment aims to not only restore physical health and correct negative behaviors, but to also promote psychological well-being and self-confidence.

Despite the name, not everyone with polycystic ovarian syndrome develops cysts on their ovaries. It is also possible to have ovarian cysts without having PCOS. The symptoms of polycystic ovarian syndrome are actually related to insulin resistance, a condition where the insulin made by the body is not effectively recognized by the cells. This causes the pancreas to release higher levels of insulin in order to keep blood sugar levels stable, and the excess insulin interferes with hormone production in the pituitary and ovaries, causing the PCOS symptoms.

The symptoms of PCOS include:

• Weight gain
• Acne
• Facial or body hair
• Thinning head hair
• Missing or irregular periods
• Infertility

PCOS is a syndrome, which means that if patients have PCOS, they might not have each and every symptom. Even a few of them might be enough to have physicians check for polycystic ovarian syndrome. A doctor might perform an exam and order blood tests to measure hormone levels.

Treatment for PCOS may include:

• Insulin sensitizers, which help the body use insulin more effectively, lowering hormone levels. The most commonly used insulin sensitizer is metformin.
• Weight loss. Being overweight does not cause PCOS, and PCOS can make losing weight difficult. Still, weight loss can improve symptoms for many women.
• Birth control pills to regulate menstruation and sometimes reduce symptoms such as acne.
• Fertility medications, especially medications to stimulate ovulation such as clomiphene.
• Anti-androgen medications, which work to treat symptoms such as acne and facial hair.
• Low-carb diets, which work similarly to insulin sensitizers to lower hormone levels and help reduce weight.
• Ovarian drilling or resectioning, surgical procedures sometimes performed if infertility is a persistent problem. These procedures open up the wall of the ovary to temporarily make ovulation more likely.

Polycystic ovarian syndrome is one of the most common endocrine disorders affecting women. Left untreated, it can increase the risk of diabetes, heart disease, and certain cancers. Fortunately there are many good treatment options available.