Mona Khanna: With anorexia nervosa we see people who are underweight. In many cases girls who have been menstruating in the past lose their menstruation. They lose their period, because they don't have enough body fat to sustain the estrogen.
In anorexia nervosa we see children and or adults have distorted body images and distorted perceptions of them self. They will look in a mirror and see somebody who is fat. They wont see the same person that you or I would see if we looked at them. If we looked at this person, we would see somebody who is skinny or who was slim at the very least. But they have a distorted body image and think that there is no way they can lose enough weight. So they keep trying to lose more and more weight. That's anorexia nervosa.
What are the warning signs?
People with eating disorders have to be very clever disorders. Most of them are and that's why, it is a difficult diagnosis to make, because there is a lot, a lot of denial involved. Somebody who has anorexia though is typically underweight or they are trying to become underweight. They don't want to eat at all, so they've avoid all kinds of meal situations with large groups of people. They may not go to family dinners, because they say they are involved in an activity whether they are or not. They may not eat lunch with their friends at school, because they say they are going to study hall. They will avoid situations where others are sitting down and eating meals, because they don't want to face the kind of pressure that actually eats up.
So that's one of the hallmarks of anorexia. Others, of course is you can look at the hand and if there is scales or abrasions on the hand, you have to wonder if that person is putting their fist in their mouth to institute the gag reflex, so they can actually throw the food up. So that's one thing that we look at. Another is signs on their teeth. Signs of tooth decay, any kind of throat irritation. Any kind of irritation further down in the oesophagus. All of those are related to the acid that has mixed in the food that's in our stomach.
So when these patients actually throw up that acid corrodes the teeth and it does great damage to the oesophagus and the throat. So those are some of the other signs that we look for.
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