Symptoms of anorexia include unexplained loss of more than 25 percent of body weight, fear of being overweight, thinking of one's body as being fat when it is not, compulsive exercising, and cessation of menstruation in females (Sifton, 2001). Other physical symptoms include weakness, dizziness, fatigue, osteopenia and osteoporosis (Seidenfeld and Rickert, 2001). The amenorrhea is thought to be due to a disruption of the hypothalamic-pituitary axis due to severe caloric restriction. Since the teenage years are a major time period for bone deposition, this caloric restriction would also explain the osteoporosis in terms of reduced calcium intake. Anorexia can also cause anemia, dehydration, constipation, dry skin, dull and brittle hair, low blood pressure and an irregular heart beat (Sifton, 2001).

Treatment for anorexia consists of trying to restore normal body weight before it does irreparable harm, and in extreme cases, causes death (Sifton, 2001). Hospitalization is often necessary in the early stages, and counseling and psychotherapy are also part of a treatment program for anorexia. Sometimes the patients require tranquilizers or antidepressants to control psychological problems which may be causing the disordered eating pattern. The success ra

Sifton, D. W. (2001). Battling anorexia, bulimia and obesity. In The PDR Family Guide to Women's Health and Prescriptive Drugs. Montvale, NJ: Medical Economics.

Ben-Tovim, D. I., Walker, K., Gilchrist, P., Freeman, R., Kalucy, R., & Esterman, A. (2001). Outcome in patients with eating disorders: a 5-year study. Lancet, 357, 1254-1257.

Miller, K. E. (2000). Treatment guideline for eating disorders. Am. Family Physician, 62, 185.

The symptoms and effects of bulimia are not as severe as those of anorexia because body weight is usually maintained (Sifton, 2001). However, physical symptoms such as dehydration, fainting spells, indigestion, bloating, internal bleeding and infections, liver and kidney damage, upset of the body fluid/mineral balance, and rupture of the esophagus can occur (Sifton, 2001). About half of bulimic women have menstrual dysfunction, but the exact cause of this has not been elucidated. Bulimia is rarely fatal.

A five year study of patients with anorexia and bulimia and other eating disorders carried out by Ben-Tovim, Walker, Gilchrist, Freeman, Kalucy, and Esterman (2001) showed that interventions and treatments are not very effective in any of these disorders. The patients in the study were 95 anorexics, 88 bulimics, and 37 patients with eating disorders not otherwise specified (EDNOS). Five years after recruitment in the study, three patients with anorexia and two patients with EDNOS had died, but no patients with bulimia had died. Although more than half of the surviving anorexia patients did not meet diagnostic criteria for eating disorders at this time, they had intermediate or poor Morgan-Russell-Hayward scores, which indicated that anorexia was still present in these patients, and they still had psychological problems. In contrast, almost three quarters of bulimics had no diagnosable eating disorder by the end o