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==Descriptions, definitions, synonyms, organizer terms, types of==

Anorexia nervosa is an eating disorder characterized by the unyielding pursuit of being thin. It is also commonly known as simply anorexia. An anorexic does not maintain normal body weight according to body height, type, and age. In fact, anorexics typically weigh 85% or less than their normal body weights.

This disorder causes a person to have a distorted body image. Despite its actual size, the body is thought to be fat. This causes panic reactions and results in losing weight by dieting and possible exercise. When the goal weight is achieved, the anorexic does not feel thin or thin enough and continues further dieting.  When more weight is lost, the anorexic feels like an accomplishment has been reached and when gaining weight is a setback. There is an irrational fear of gaining weight or being fat. Those with anorexia nervosa can also be afflicted with bulimia nervosa as well as other eating disorders.

Causes of Anorexia (National Women's Health Information Center):

Anorexia is more than just a problem with food. It's a way of using food or starving oneself to feel more in control of her life and to ease tension, anger, and anxiety. While there is no single known cause of anorexia, several things may contribute to the development of the disorder:

-Biology. Several biological factors, including genetics and other related hormones, may contribute in the onset the disorder.

-Culture. Some cultures in the U.S. have an ideal of extreme thinness. Women may define themselves on how beautiful they are.

-Personal feelings. Someone with anorexia may feel badly about herself, feel helpless, and hate the way she looks. She has unrealistic expectations of herself and strives for perfection. She feels worthless, despite achievements and perceives a social pressure to be thin.

-Stressful events or life changes. Things like starting a new school or job or being teased to traumatic events like rape can lead to the onset of anorexia.

-Families. People with a mother or sister with anorexia are more likely to develop the disorder. Parents who think appearance is very important, diet themselves, and criticize their children's bodies are more likely to have a child with anorexia. 


Signs of Anorexia ([http://www.womenshealth.gov/about/ National Women's Health Information Center]):

A person with anorexia will have many of these signs:

-Looks a lot thinner

-Uses extreme measures to lose weight

-Makes him/herself throw up

-Takes pills to urinate or have a bowel movement (BM)

-Takes diet pills

-Doesn’t eat or follows a strict diet

-Exercises a lot

-Weighs food and counts calories

-Moves food around the plate; doesn't eat it

-Thinks she's fat when she's too thin

-Wears baggy clothes to hide appearance

-Fears gaining weight

-Weighs herself many times a day

-Acts differently

-Talks about weight and food all the time

-Won't eat in front of others

-Acts moody or depressed

-Doesn't socialize

Eating disorders are complex and can be a result of numerous factors. Once an individual develops anorexia, a pattern of self-destruction begins and needs to be treated professionally before it cycles out of control. Generally, anorexic patients go through periods of recovery and relapse. Without treatment, anorexics die from the effects of self-starvation.
It is highly unlikely that someone will exhibit all the possible symptoms for anorexia nervosa, but many of the symptoms will be prevalent. The sooner an eating disorder is identified, the more likely that recovery will be less difficult. The longer a pattern of an eating disorder is established and unrecognized, the more difficult it is for the anorexic to overcome these problems.

Those looking for solutions by changing outward appearances through eating disorders are masking more serious internal problems. They seek to feel better about themselves in ways that ultimately cause more emotional pain and stress. The way to improve what is on the inside is to get the psychological and/or spiritual treatment needed to realize one’s self worth without physically hurting the body.  A new therapy, currently nearing completion of the clinical trials phase in England, is on the horizon.  This enhanced form of cognitive behavioural therapy (CBT-E)may be an effective treatment for as much 80% of adults afflicted by eating disorders. [[http://www.sciencedaily.com/releases/2008/12/081215074404.htm
]]

==Application in and effects on classrooms and similar settings==

Educators need to be aware of students with potential eating disorder symptoms. Symptoms of anorexia nervosa that can be observed at school or on school field trips include skipping meals, eating only a few types of foods that the anorexic considers acceptable, always drinking diet sodas, use of diet pills, wearing bulky clothing, and unusual interest of food and caloric intake among others. These symptoms can also be observed in a home environment along with eating patterns such as excessive dieting, frequenttly checking weight, lying about food, unnatural obsession with certain body parts, strong anxiety about becoming fat, depression, isolation from family and/or friends, need for control, and low self-esteem. (anred)

Because of certain expected demands, students involved in wrestling, cheerleading, dancing, gymnastics, running, modeling, acting, and other entertaining may under more than average risk for developing an eating disorder.  

Social environments can also contribute to the development of eating disorders. Many cultures today encourage thin bodies and place much importance on having a slim physique. Models, acrors/actresses, singers, and other role models today are normally thin and often too thin, providing unnatural examples for normal people to look up to. When comparing the proportions of average women  to Barbie doll, store mannequin, or air-brushed photgraph  proportions, one can see the unrealistic expectations that people try to emulate. Society also judges individuals on outward appearrances first, inner beauty is something that is looked upon after the first impression has been deemed acceptable. 

Teachers and parents need to keep their obsevation skills honed in order to stay afront of popular culture in order to counteract the parts of popular culture that negatively influence our students and children. Educators can counteract these societal influences by making students aware of unrealistic examples set by popular culture. Being consistent, persistent, and insistant on the importance of inner beauty rather that physical appearance provides younger generations with values that will improve society’s view of a healthy body image.



==Critics and their rationale==

Studies in anorexia nervosa and other eating disorders are relatively new. The information available on long-term recoveries is not yet founded on years of research. Doctors are not bound to report eating disorders to health agencies and those afflicted with eating disorders are usually extremely private, often not even admitting to their afflictions. Small groups are studied with percentages applied to large popuations as estimates.

There are pro-anorexia websites that offer visitors support for believing that anorexia nervosa is a lifestyle choice, not an illness. These sites offer tips on starvation strategies and keeping family and friends from discovering there is a problem. Pictures of anorexics are posted with praises singing their dieting processes. Pro-anorexics celebrate their “choice" and provide support for each other on these internet sites. Read the following article about a women who has been a supporter of anoerexic websites and now supports websites that help recovering anorexics [http://www.post-gazette.com/pg/05173/525994.stm Thin Girls Online].

==Alternative explanations due to '''Diversity''' considerations==

Reasons for anorexia nervosa tend to be controversial in both medical and social environments. Extremists either believe that anorexia is caused either physiologically or psychologically. Most now concede that it is both – a psychological disease that usually has its roots in physiological condictions. 

Researchers are finding increasing rates of eating disorders in non-Western cultures due, at least in part, to the increasing avaiability of Western media such as television, movies, and magazines. 

Also important to note is that about 10% of those afflicted with an eating disorder are male. The fact that so few of those with eating disorders are male may be a reflection of cultural expectations between men and women. Men are expected and want to be large and strong, while women yearn to be tiny and delicate. Crosscope-Happel, Hutchins, Getz, and Hayes (2000) state that anorexia nervosa is a major disorder that in a period of a year can affect over one million males. Anorexia nervosa is often undiagnosed in males because of the misconception that only females experience this disorder. Approximately five to ten percent of males report cases of anorexia nervosa, this number may be incorrect because males do not tend to report the disorder or they may be misdiagnosed. Although there has been numerous publications written on this subject there has been very little connection of the disorder to males [http://www.cyc-net.org/cyc-online/cycol-0304-anorexia.html Anorexia in Males]

==''Signed'' "life experiences", testimonies and stories==

My second year of teaching, I had a student who had anorexia. She was bright, talented, A student, perfect GPA, and quiet in my classroom.  I would have never guessed she would have had anorexia until she was gone for a week and was suprised a week later when all the teachers had a meeting with her parents to discuss the issue. I would have NEVER guessed that she would have an eating disorder but as teachers we really need to be aware of what truly is going on in our classrooms, or we could miss it. The girl is now  in my class this year, and she is alot more outgoign, talkative, and seems to have changed in personality since I've had her last year.C McCulley

This year is the first year I have dealt with anorexia.  We had one 7th grade student who would not eat hardly anything.  She began looking very sick and her face was sunken in.  To make matters worse she was also an athelete and continued to go out for sports.  The school actually let her continue going with the team, but would not let her practice or play.  Fortunately, with counseling and various medical interventions she is getting better, but is not back to her normal size.  One of the interesing things is her personality completely changed while she was suffering from anorexia.  She was very moody and almost mean spirited.  I coached this girl the year before all of this happened and she was not like this at all.  Since she has been recovering her personality has improved a lot as well.  B.M.

When I was in high school, my friend's sister was in college and began losing weight.  She lost a great deal actually and I remember seeing her in church and thinking that she was looking really nice.  Within a month it was made known that she had anorexia nervosa.  I saw her again at church within the same month  and she had to lay her head on her mom's shoulder during the service because it was too much effort to hold her head erect.  I don't know that I will ever forget seeing her sitting there like that.  Something jolted me and made me wonder what was wrong with my thinking.  Less than four weeks ago I thought she was looking good.  What standard was I using?  Where had it come from?  Why was I buying into it.  When I saw the reality of this girl's actual suffering I never thought about thinness the same way again.  I no longer think of someone who is thin as neccessarily being healthy or even looking good.  It can be a very fine line that many girls are walking in this area.  - V.C.

I feel that society and often one's family  plays an influential role in the perception of how young girls feel about their bodies.  I remember when my niece was in grade school.   Whenever she would come over to  "grandma's  house", if  there were any sweets or snacks around she would eat them.  Then I started noticing  that she refused to drink regular pop, and eat sweets and certain food.  I asked her why she had chosen to do this.   She said that she was on a diet.   This would prevent her from becoming fat.   Her grandmother was standing beside me and told her it was good that she had chosen to do this.  Especially after this, I always let her know that she is unique and special.      C. Unzicker

Many websites currently exist aimed at helping the recovery process. These are run by current sufferers trying to recover, former anorexics, and professionals. With the current popularity of blogs, it is certain that there are many sharing their experiences daily in dealing with anorexia nervosa as well as other eating disorders.  Go to References for link to helpful websites

As an adolescent I wanted to be skinny like many of the other girls.  I was never fat, but I was muscular from being active in sports and weight lifting.  There was a period of time where I did not eat any food at all.  After a few weeks I realized that I did not want to be one of those people.  I came to realize I liked myself for how I was and if nobody else did, who cared?--M.Hicks

I have some experience with eating disorders, not on a personal stand point, but by knowing someone suffering from Anorexia.  My brother's long-time girlfriend has been struggling with the disease for the past few years. At her worst point she was down to 85 pounds and it was very difficult to watch her do that to herself and not be able to do anything about it.  I felt very out of control and helpless.  Recently she has gone to a treatment facility and is on her way back to a health lifestyle.-- J. Brewczynski

I think it's important to address eating disorders in school.  I remember my older brother was sent home after fainting in his health class the day they watched a movie about eating disorders.  I think it is also important to mention that even when you throw up right after you eat, you still absorb about 50% of the calories.  Finally, I think it would be great to show a video in health class.  The video I have in mind (of course, I can't remember the name of it) is about the people who touch-up the ads and commercials.  Then they bring these ads to men who are convinced that these women in the photographs have not had their picture touched at all, and they list reasons why they think they are right.  Then the video brings the audience back to the people who do the touch-ups, and they say why they leave certain things, just to make people believe the pictures weren't touched.  I think this video is a great way to introduce body image into a high school classroom.  It could spark a discussion about body image and the role of the media.  -L. Weinstein

In recent years, I have had an increase in athletes who have eating disorders.  Many of them are girls who start trying to lose a few extra pounds to be like the other girls in the sport and it rapidly increases until it becomes a major problem.  Most people do not realize that they have a problem even when they are confronted with the truth.  I think that there has to be an increase in addressing this in schools so people have a better understanding of how to cope and handle the stresses of peer pressure.  -N. Hartz

Writing in the spring of 2006, I feel as if our popular idols are drowning in the problems of anorexia. I have seen many of my students read People and US magazine which are filled with images of girls who are super skinny and somehow dropped weight dramatically. The headline from Nicole Ritchie's recent magazine cover quotes her as saying: "I'm Thin, So What?" now says, "I am much more healthy these days." (http://movies.msn.com/gossip) But if you look at her picture, it tells a different story. Young girls in middle school are always asking why they can't do like she does: eat anything and loose weight. Because students are not given appropriate nutritional information, they don't realize that what she says is a complete lie. It's an extreme cover up for the problem. This is unfortunate because middle school age girls feel their self esteem fall around these perfect airbrushed images.-L. Keener

It is interesting that the number of anorexia cases is up in other countries because of the availability of Western television, movies and magazines.  As a country, do we realize what an influence we are on other countries? When super thin "characters" like Paris Hilton, icole Ritchie and Mary Kate and Ashley Olsen are seen as American role models for the body perfect, not only our children are damaged, but those of children around the world!  M. Hay

Anorexia is a very important issue that needs to be dealt with, and I am glad to see that it is part of WikEd. However, I would like to better this page by pointing out that most of the references on it are made towards girls in the symptoms section. Anorexia in males accounts for at LEAST 6% of diagnosed cases, (http://www.ltspeed.com/bjblinder/anmales.htm) and when the focus is put just on girls it will create a lot more problems. S. Peduzzi

My best friend suffered from severe Anorexia in high school and weighed close to 80 lbs at 5'4". I met her in college (after she recovered) where she began a panel of college students who traveled to local high schools to discuss eating disorders, depression, self mutilation, etc. All the panel members had experience in one area or another and they openly discussed thier issues with young girls to heighten awareness. One particular story that my friend told me stood apart from the others: she was in a prodominantly black high school and was talking about her bout with anorexia and some of the high school girls got up and left. Apparently this eating disorder does not usually effect black teenage girls so they didn't want to listen to her. After she told me this story I did a little researc and found that white, upper middle class, teenage girls are the most likely to suffer from anorexia. This was shocking to me and then I started looking closely at all the magazine covers: white, young women, beautiful, and extremely THIN.....interesting...
-N.R.

As a middle and high school student I was an avid wrestler. During my time around the mat I saw wrestlers participate in a large variety of unhealthy behaviors to maintain or reduce their weight. For example, I saw wrestlers wear trash bags to increase their internal body temperature and sweat output. Of all the behaviors I witnessed, none was more frightening than when a wrestler would refuse to eat. Some wrestlers would lose tremendous amounts of weight (20-25% of their body mass), by refusing to eat for extended periods of time. I remember feeling pressured to keep my weight down using similar methods. Some of these wrestlers became obsessed with their caloric intake, their exercise regimen, and their weight. It is important for people to talk about these kinds of experiences because they happen every day in schools. Students can do serious damage to their minds and bodies by refusing to eat. Educators should constantly be on the lookout for students who may be struggling with eating disorders because help is available, and there is hope for those who seek it. – Jeremiah Johnson

This is topic that is very near and dear to my heart.  During my junior year in college, I began to notice a change in a friend of mine from high school who also attended the same university.   I noticed that she began to obsess over her weight and was exercising for two to three hours everyday.  She was loosing weight and not acting like herself.  When I brought this up to several close friends who also knew her, they convinced me that she was just getting healthy.  Even though deep down in my stomach I knew there was something else going on, I let them convince me that everything was fine.  Several months later my friend did confide in me that she was battling with an eating disorder.  My heart sank and I questions whether in intervention months ago would have helped.  She reassured me that everything was fine and promised she would let me help her.  Unfortunately no one could have helped her.  On December 3, 2002 she took her life and a part of me as well.  I will never forget getting that call and the lasting impact it has had on my life.  I never had the chance to help her overcome this devastating disease. I look at body image in a whole new light now.  As a teacher in a middle school, I feel more of a discussion needs to take place with students both male and female.     - M. Hafenrichter

This is a touchy subject in schools.  I have suspected several students of having eating disorders.  Our guidance counselor has pulled them aside and discussed this with them.  Some have handled it well, others have become irate.  He takes much criticism for "saying that girls are too skinny" or noticing - "why is he looking at me".  Of course, I know that this is often a cover-up for the real problem.  What is a teacher to do, when concern is met with such resistance.  Parents are also very resistant to the suggestion that their child may have a problem.  Anorexia is a dangerous and devastating disease, what can we do if the child and the parent are resistant to the facts.  I guess we continue to try - no matter what.  R. Grunloh

==References and other links of interest==
[http://www.people.com/people/article/0,,20009611,00.html?pkw=PSPEGLTX011507BTND1036 Tyra Banks in People Magazine]

[http://en.wikipedia.org/wiki/Anorexia_nervosa Anorexia nervosa- Wikipedia]

[http://www.nationaleatingdisorders.org National Eating Disorders]

[http://www.anred.com Anorexia nervosa and related eating disorders, Inc.]

[http://www.mentalhealth.com/dis/p20-et01.html Mental Health]

[http://moodle.ed.uiuc.edu/wiked/index.php/Weight_control Link to Nick's site on weight control - Many websites pertaining to eating disorders including anorexia.]

[http://sev.prnewswire.com/health-care-hospitals/20050823/CGTU01523082005-1.html Counceling in schools]

[http://www.4woman.gov/faq/easyread/anorexia-etr.htm National Women's Health Information Center]

[http://www.angelfire.com/amiga/anorexiasupport/egroup.html The Anorexia On-Line Support Group]

[http://movies.msn.com/gossip Link to L Keener's site about Nicole Ritchie]

[http://www.anad.org/site/anadweb/ ANAD – National Association of Anorexia Nervosa and Associated Disorders ~ The oldest national non profit organization dedicated to alleviating the problems of eating disorders.]

== Support Groups==

[http://www.raderprograms.com/anorexia.aspx?gclid=CLX6hqLGjYoCFQgTWAodGGvRQg/ Anorexia Support Group]

[http://www.pale-reflections.com/?gclid=CK-Cpa7GjYoCFQkxSQodU08bgg/ Pale Reflections]