Loretta F. Kasper, Ph.D.
Directions: Today you will be doing a different kind of reading practice. You will read the following text on Anorexia, an eating disorder. Then you will search the Internet to find THREE additional texts on Anorexia. After you read BOTH this text and the ones you find on the Internet, you will answer a series of comprehension questions.
Read the following essay. Find one additional text on Anorexia and Read it. Then CLICK HERE to answer the comprehension questions. You will type the answers to the questions directly into the computer screen. When you are finished, click the button that says "Submit your answers." This will take you to a page that has the correct answers. To keep a copy of your answers, you will need to print them out.
Anorexia Nervosa is a disruption in normal eating habits characterized by an all consuming fear of becoming "fat." It typically starts in teenage women as a normal attempt to diet but gradually leads to more and more weight loss, often more than 25% of original body weight. There is an intense preoccupation with food and body size, which may involve compulsive exercising. Anorexics intentionally starve themselves, for although they are emaciated, they are convinced that they are overweight. As the eating disorder progresses, many normal activities may stop. Menstruation ceases in women and there are a number of physical symptoms of malnutrition such as lowered heart rate, low blood pressure, decreased metabolic rate and sensations of coldness particularly in the extremities.
People with anorexia nervosa are obsessed with food and deny that they have a problem or that they are too thin. They may be able to work or study and have some social life but usually function far below their potential. Frequently they are also depressed. Sometimes anorexics must be hospitalized to prevent starvation. Other anorexics are able to check the downward spiral of weight loss and maintain a steady but seriously underweight condition. In all cases, even severe weight loss does not diminish the perception of being "fat."
Consider the following case of Deborah, a young woman suffering from anorexia nervosa:
-- Deborah developed anorexia nervosa when she was 16. A rather shy, studious teenager, she tried hard to please everyone. She had an attractive appearance, but was slightly overweight. Like many teenager girls, she was interested in boys but concerned that she wasn't pretty enough to get their attention. When her father jokingly remarked that she would never get a date if she didn't take off some weight, she took him seriously and began to diet relentlessly --never believing she was thin enough even when she became extremely underweight.
-- Soon after the pounds started dropping off, Deborah's menstrual periods stopped. As anorexia tightened its grip, she became obsessed with dieting and food and developed strange eating rituals. Every day she weighed all the food she would eat on a kitchen scale, cutting solids into minuscule pieces and precisely measuring liquids. She would then put her daily ration in small containers, lining them up in neat rows. She also exercised compulsively, even after she weakened and became faint. She never took an elevator if she could walk up steps.
-- No one was able to convince Deborah that she was in danger. Finally, her doctor insisted that she be hospitalized and carefully monitored for treatment of her illness. While in the hospital, she secretly continued her exercise regimen in the bathroom, doing strenuous routines of sit-ups and knee-bends. It took several hospitalizations and a good deal of individual and family outpatient therapy for Deborah to face and solve her problems.
Deborah's case is not unusual. People with anorexia typically starve themselves, even though they suffer terribly from hunger pains. One of the most frightening aspects of the disorder is that people with anorexia continue to think they are overweight even when they are bone-thin. For reasons not yet understood, they become terrified of gaining any weight.
Food and weight become obsessions. For some, the compulsiveness shows up in strange eating rituals or the refusal to eat in front of others. It is not uncommon for people with anorexia to collect recipes and prepare gourmet feasts for family and friends, but not partake in the meals themselves. Like Deborah, they may adhere to strict exercise routines to keep off weight.
Loss of monthly menstrual periods is typical in women with the disorder. Men with anorexia often become impotent.
In patients with anorexia, starvation can damage vital organs such as the heart and brain. Excessive thirst and frequent urination may occur. Dehydration contributes to constipation, and reduced body fat leads to lowered body temperature and the inability to withstand cold. Mild anemia, swollen joints, reduced muscle mass, and light-headedness also commonly occur in anorexia. If the disorder becomes severe, patients may lose calcium from their bones, making them brittle and prone to breakage. They may also experience irregular heart rhythms and heart failure. In some patients, the brain shrinks, causing personality changes. Fortunately, this condition can be reversed when normal weight is reestablished.
Scientists have found that many patients with anorexia also suffer from other psychiatric illnesses. While the majority have co-occurring clinical depression, others suffer from anxiety, personality or substance abuse disorders, and many are at risk for suicide. Obsessive-compulsive disorder (OCD), an illness characterized by repetitive thoughts and behaviors, can also accompany anorexia. Individuals with anorexia are typically compliant in personality but may have sudden outbursts of hostility and anger or become socially withdrawn.
Treatment of Eating Disorders
An important first step in overcoming an eating disorder is for the person to acknowledge to him or herself and to helping professionals that an eating disorder is a problem. Medical and psychological help should be sought from individuals experienced in the treatment of such disorders. A complete physical examination including lab tests will often be necessary.
Psychotherapy is also usually necessary. It may include individual and/or group therapy. One immediate benefit of such therapy is the feeling of relief at no longer having to keep such an important part of one's life a secret. Psychotherapy will often focus on improving self-esteem. It may be supplemented by nutrition education, discussions of eating habits, and food selection.
This combination of medical, psychological, and educational treatments can be effective on an outpatient basis. In extreme cases, e.g., a person with anorexia nervosa whose weight is extremely low, temporary hospitalization may be required. What is most important is that professional treatment be sought as quickly as possible. Attempts at self-help are rarely successful, and the longer the disorder remains unchecked the harder it may be to overcome.
BEFORE you answer the comprehension questions, search the Internet for additional information on Anorexia. Find and read THREE additional texts on Anorexia. Use the information in this text AND in the additional text you find to answer the comprehension questions. Go to Vivisimo.com to search.
Now go to the questions at http://kccesl.tripod.com/hypertextstudy/anorexiafreeques.html