Community Medicine
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Community Medicine Lec - 10 -
Anorexia Nervosa and Bulimia
Anorexia nervosa and bulimia are eating disorders in young, previously healthy,
women who develop a paralyzing fear of becoming fat.
Population at risk consist largely of white women from middle-class backgrounds.
Rarely occurs in black or oriental poor women or in men.
The driving force is the pursuit of thinness, all other aspects of life being secondary.
In anorexia nervosa, there is a radical restriction of caloric intake, the end result will
be emaciation.
In bulimia, massive being eaten followed by vomiting and excessive use of
laxatives. Weight loss, however is not great despite the obsession with food.
Some authors consider anorexia nervosa and bulimia to be distinct illnesses , while
others classify bulimia as variant of anorexia nervosa . However , both disorders
are different expressions of a psychological obsession with body weight .
Prevalence of anorexia nervosa is
0.4 -1.5/100,000 population
1% among adolescent white risky women.
5% sub-clinical among highest risk group
Vomiting after eating may occur in 18% of college female students.
Self induced vomiting is 1-2%
Full-blown bulimia is less frequent.
Diagnosis is made on clinical grounds. No specific diagnostic tests exist.
Diagnostic criteria :-
1.Weight loss by 15-25% of expected ideal weight .
2.Intense fear of gaining weight or becoming fat even when under-weight.
3.Disturbance in the way , body weight ,size or shape is experienced by the individual
“feels fat”.
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Community Medicine
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4.Primary or secondary amenorrhea for at least three consecutive periods.
5.Absence of organic or psychiatric illness that might account for failure to eat.
6.Denial of hunger, fatigue or emaciation.
Malnutrition Diseases
Food security is the main world health problem in most of developing countries.
About 450 million people are suffering from sever malnutrition all over the world.
15-20 million individuals are dying yearly from hunger related problems.
Causes of malnutrition health problems are:-
1.Poverty.
2.Population growth.
3.Soil deterioration and bad farming.
4.Political problems.
5.Mal-distribution of food supply.
classification Groups of malnutrition diseases
1.Protein -energy malnutrition .
2.Nutritional anemia .
3.Vitamin A deficiency among children.
4.Endemic deficiencies such as goiter , rickets , ……etc.