Take the case of 17 year old Kerry, whose boyfriend casually mentioned to her that he is upset over her being overweight and that all his friends make fun of her. Kerry, who in reality was only chubby, was pretty hurt and started losing her self-esteem. She soon went into guilt pangs for being over-weight and went on a crash diet, skipping breakfast, having only a fruit or two for lunch and slice of bread for dinner. She was petrified of gaining weight and losing her boy friend. Slowly and gradually she became a victim of a disorder called anorexia nervosa.

The ideal image of a woman's body has changed radically in the past years. Like Kerry, most teenage girls struggle to feel good about their bodies. They tend to emulate models on glamorous magazine covers and hoardings without realizing the ill effects of it on their health.

Anorexia nervosa is an eating disorder centred of an obsessive fear of weight gain. Approximately 95 per cent of those affected by anorexia nervosa are female, but males can develop the disorder as well.

Causes:

. Psychological factors such as fear of sexuality at this age. Past negative experiences, perceived loss of control in some aspect of life can lead to anorexia.

. Families that are over-protective or focus on over-achievement can produce an anorexic family member.

. Constantly criticizing one's own body and appearance combined with low self-esteem.

. Societal pressures to look and behave in certain manner at an adolescent.

. Certain personality traits like perfectionism, approval -seeking behavior, and obsessiveness are associated with this disorder.

There is a possibility of genetic pre-disposition that usually becomes apparent at the time of puberty.

Symptoms:

. Excessive dieting, exercising usually beyond a reasonable control

. Significant weight loss.

. Self-perception that is grossly distorted and weight loss that is not acknowledged.

. Avoidance of social gatherings where food is involved.

. Weighing oneself several times in the day and focusing on the smallest fluctuation.

. Misuse of laxatives, diuretics or enemas

. Decrease in attention spans and concentration.

. Developing of food rituals that allow for eating very little, eating in secrecy, eating food in certain order, excessive chewing.

. Disturbed sleep leading to fatigue during the day.

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Effects:

. Girls may experience loss on menstrual cycles (amenorrhea). Disturbances in the menstrual cycle can affect not only fertility but also bone density growth.

. Muscle loss and weakness.

. Lowered resistance

. Digestive problems such as constipation

. Severe dehydration, which can result in kidney failure.

. Feelings of guilt and depression.

. Isolation from friends and family.

. Brittle hair and nails

. Dry and yellow skin.

. Mild anaemia, swollen joints and light-headiness.

. Overuse of laxatives.

. Changes in kidney function, resulting in potassium deficiency, increased or decreased urination.

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Treatment:

. The primary goal is to ensure a person's physical health, which involves restoring a healthy weight. This may require hospitalisation.

. Once the physical condition is stable, intensive psychotherapy needs to be put in place.

. Behavior therapy.

. Family therapy.