Word: anorexia
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Cause and effect are tricky to separate in mental illness, and anorexia, which kills between 5% and 10% of its victims, is no exception. Doctors don't know what causes the condition, though for a long time they've had a fair idea about who's prone to developing it. To some extent it runs in families, though it may be that some parents pass on to their children, genetically or by example, tendencies toward perfectionism, hypersensitivity and perseverance - traits that, combined with low self-esteem, appear to be preconditions for anorexia. Typically striking in adolescence, the disorder is more...
...groups looked at photos of themselves. Put simply, confronted with her own image, the anorexic's brain partly shuts down. The implications for our understanding of the illness are significant, argues Mondraty, a psychiatrist at the Peter Beumont Centre for Eating Disorders. Once it's full-blown, he says, anorexia "is not really about societal pressures to be thin or about the patient being vain. There is a neurological disturbance here that makes it very hard for patients to get better...
...this phenomenon a cause - even the cause - of anorexia, or is it a consequence? Mondraty sees it like this: the personality traits and self-esteem problems mentioned earlier "are reasons that a girl might go on a diet," he says. Nearly all girls diet during their teenage years, but only about 1% of them develop anorexia. "What I'm guessing," Mondraty says, "is that when those with an underlying biological vulnerability lose a certain amount of weight, then something happens ... this [brain abnormality] clicks in. The significance of this is that it takes a bit of blame away from...
Just to show that this is a complex field, Mondraty's coauthor sees things slightly differently. "I think what we've observed," says Sachdev, "is a functional abnormality that probably follows, rather than precedes, the development of anorexia." The pair plan to conduct a follow-up study on the 10 anorexic patients in about two years to see whether brain activity has normalized in those who've recovered. If it has, that would suggest that what they've observed is a product of the disease - triggered, perhaps, by malnutrition - rather than a hardwired abnormality. Brain-imaging skeptics would argue that...
Marcia Johnson, 62, of Wellington, Fla., a married mother of three and a former dancer, received a diagnosis of anorexia a dozen years ago, although she now recognizes that she showed symptoms of it by puberty. Binckley and Johnson note that their nonstop focus on food and body image slowed down when they were cooking meals for their growing children. Then as middle age set in, a sense of loss--a feeling that's particularly acute for anorexics at midlife--set off a flare-up. "The loss of order--brought on by a change in job status, marriage, children...