kaAnorexia manaʻo he ʻāpana ia o nā maʻi ʻai a i ʻole nā ​​maʻi ʻai (ADD) e like me ka ʻai ʻana o bulimia a me binge.

ʻO ke kanaka e ʻehaʻeha i ka anorexia alakaʻi i kahi hakakā ʻino a weliweli hoʻi e kūʻē i kekahi loaʻa kaupaona. ʻO ia ka mea i hōʻoweliweli ʻia i nā makaʻu kūpono ʻole e hiki ke hoʻohālikelike ʻia me nā phobias maoli e pili ana i nā hopena o ka ʻai ʻana, e like me ka loaʻa ʻana o ke kaumaha a lilo i ka momona. ʻO ka hopena paʻakikī a pinepine i ka kapu ʻana o ka meaʻai.

ʻO ke kaohi i hoʻokau ʻia e ka poʻe me ka anorexia ma luna o kā lākou papaʻai he nui a paʻa mau. ʻO ka makemake ka hapa nui o ka manawa i mālama ʻia akā paʻakikī ke kanaka me ka pono a me ka makemake i ka meaʻai. Pono ia i kahi emi o ke kaumaha e hiki ke hele a hiki i ka emaciation (lahilahi loa).

Ma ka puʻuwai o ke ʻano anorexic, aia kahi phobia maoli o ke kaupaona, ikaika loa e hoʻoneʻe i ke kanaka e hōʻalo i nā kūlana a i ʻole nā ​​lawena e hiki ai ke loaʻa i ke kaupaona: ka ʻai ʻana i nā meaʻai kamaʻāina ʻole, ka ʻai ʻana me ka hana ʻole i ka hoʻoikaika kino, a pēlā aku. nalowale iki ke kanaka i ke kaupaona akā ʻo ka leʻaleʻa a lākou e manaʻo nei he holo wale a ʻimi koke lākou e lilo hou kaupaona.

ʻO ka ʻike i loaʻa i kona kino i kuhi hewa, ke kamaʻilio nei mākou ʻelemuphophobie. ʻO kēia mau hana kūpono ʻole e hoʻoulu ai i nā pilikia olakino koʻikoʻi a koʻikoʻi (hōʻoluʻolu ʻole, hōʻeha weliweli, amenorrhea, a pēlā aku) a alakaʻi i ke kanaka e noho kaʻawale i ka nohona.

Anorexia a i ʻole Anorexia nervosa?

Hoʻohana hewa ʻole ʻia ka huaʻōlelo anorexia e kuhikuhi i ka anorexia nervosa, akā ʻo anorexia nervosa kahi ʻano lapaʻau i kāna pono ponoʻī. ʻO Anorexia kahi hōʻailona i loaʻa i nā maʻi he nui (gastroenteritis, maʻi ʻaʻai, a me nā mea ʻē aʻe) i kūlike i ka nalo o ka makemake ʻole. I ka anorexia nervosa, mālama ʻia ka makemake akā hōʻole ʻole ke kanaka e ʻai. 

Nā kumu

ʻO Anorexia nervosa kahi mea i aʻo nui ʻia i ka maʻi ʻai. ʻO nā kumu kikoʻī ma hope o ka hoʻomaka ʻana o kēia maʻi he paʻakikī a hoʻopili pinepine ʻia.

ʻAe nā kānaka noiʻi e ʻōlelo i nā kumu he nui ma ke kumu o ka anorexia e pili ana i nā genetical, neuroendocrine, psychological, ʻohana a me nā mea pili kaiaulu. 

ʻOiai ʻaʻohe moʻo i hōʻike akāka ʻia, kuhikuhi nā noiʻi i a pilikia o ka ʻohana. Inā i loko o ka ʻohana kekahi o kāna mau lālā wahine e ʻeha i ka anorexia, aia he 4 mau manawa ʻoi aku ka makaʻu¹¹ ua loaʻa kekahi wahine ʻē aʻe o kēia ʻohana e kēia maʻi ma mua o ka ʻohana “olakino”.

ʻO kekahi haʻawina i mālama ʻia ma nā māhoe like (monozygotic) e hōʻike ana inā ʻeha kekahi o nā māhoe i ka anorexia, aia he 56% ka manawa e hoʻopili ʻia kāna māhoe. Hoʻonui kēia likelike i 5% inā he māhoe ʻokoʻa lākou (dizygotes)¹. 

ʻO nā mea endocrine e like me ka hemahema hormonal me he mea lā ke pāʻani nei i kēia maʻi. Hōʻike ʻia ke kulu ʻana o kahi hōmona (LH-RH) e pili ana i ka hoʻoponopono ʻana i ka hana ovarian. Eia nō naʻe, ʻike ʻia kēia hemahema ke loaʻa ka hoʻēmi kino a hoʻi ka pae LH-RH i ka maʻamau me ka loaʻa o ke kaumaha. No laila ua like kēia hopena me he hopena o ka anorexia ma mua o kahi kumu. 

Au pae neurological, nui nā noiʻi i hoʻokau i kahi disoton seric hana. ʻO Serotonin kahi mea e hōʻoia i ka hele ʻana o ka leka hopohopo ma waena o nā neurons (i ke kiʻekiʻe o nā synapses). Pili pū ia i ka hoʻoulu ʻana i ke kikowaena satiety (kahi o ka lolo e hoʻokele ai i ka makemake). No nā kumu ʻike ʻole ʻole he nui, aia ka hoʻemi ʻana o ka hana serotonin i ka poʻe me ka anorexia.².

I ka pae psychological, ua hana nā noiʻi he nui i ka loulou ma waena o ka hiʻona o anorexia nervosa a me kahi manaʻo maikaʻi ʻole (manaʻo o ka pono ʻole a me ka hemahema) a me kahi pono nui no ka perfetism.

Hypotheses a me nā anamanaʻo noiʻi loaʻa kekahi mau o ka pilikino a me nā manaʻo i ʻike ʻia e ka poʻe me ka anorexia. Hoʻopili pinepine ʻo Anorexia i ka poʻe ʻōpio e pale i nā kūlana o ka weliweli haʻahaʻa loa a kaukaʻi loa i ka hoʻokolokolo a haʻi. Hoʻokū pinepine nā kākau Psychoanalytic i ka hōʻole ʻana i ke kino ma ke ʻano he mea moekolohe. Makemake ʻole kēia mau kaikamahine ʻōpio e noho mau lākou i mau kaikamahine liʻiliʻi a loaʻa iā lākou ka pilikia e kūkulu i kahi ʻike a loaʻa ka mana kū kaʻawale. ʻO nā maʻi i hoʻokumu ʻia e nā maʻi ʻai e hōʻeha i ke kino a "regresses" (ka loaʻa ʻole o ka menstruation, nalowale o ke ʻano me ka pohō kaumaha, a pēlā aku.).

ʻO ka mea hope loa, ua mālama ʻia nā noiʻi e pili ana i ka pilikino o ka poʻe i hoʻopilikia ʻia e ka anorexia, e ʻike i kekahi ʻano pilikino i hoʻopili ʻia e kēia pathology e like me: ke ʻano ʻalo ), ke kanaka hilinaʻi (pono e pale ʻia ka nui, makaʻu i ka hoʻokaʻawale, ...) a me ke ʻano obsessive (perfectism, control, rigidity, attention to detail, scrupious attitude, ...). 

Au pae noʻonoʻo, hōʻike nā haʻawina i nā manaʻo maikaʻi ʻole e alakaʻi ana i nā hilinaʻi wahaheʻe pinepine i nā anorexics a me nā bulimics e like me "lahilahi ka hōʻoia o ka hauʻoli" a "maikaʻi ʻole kekahi momona".

ʻO ka mea hope loa, ʻo ka anorexia kahi pathology e hoʻopili i ka heluna kanaka o nā ʻoihana hana ʻoi aku. No laila ke pāʻani nei nā kumu Sociocultural i wahi nui i ka ulu ʻana o anorexia. ʻO nā pae kaiāulu o ka nani i lawe ʻia e nā hiʻohiʻona ʻōpio me nā kino lahilahi a ʻaneʻane like ʻole e hoʻohuli i ka poʻe ʻōpio i ka ʻimi ʻana i ka ʻike. ʻO ka hoʻomana o ka lahilahi ka mea i loaʻa i ka pāpāho, ka mea "kūʻai" iā mākou me ka nui o nā papa hana mana a kākoʻo pinepine i ka kaupaona no ka lōʻihi o ka uhi makasina ma mua, i ka wā a ma hope o ka wā hoʻomaha a me ka hoʻomaha kauwela.

Nā maʻi pili

Aia kekahi mau maʻi psychopathological pili i ka anorexia nervosa. Eia nō naʻe, paʻakikī e ʻike inā ʻo ka hoʻomaka o ka anorexia ka mea e hoʻokumu i kēia mau maʻi a i ʻole inā ke kū nei kēia mau maʻi e alakaʻi i ke kanaka e lilo i anorexic.

Wahi a kekahi mau noiʻi^{3, 4,5}, nā maʻi psychological nui e pili ana i ka anorexia:

• maʻi hoʻoweliweli
• phobia ʻ sociallelo 
• kaumaha e hiki ai iā 60 a 96% o nā anorexics i kekahi manawa i ka maʻi 

ʻO nā wā hoʻokēʻai a me nā hana compensatory (hoʻomaʻemaʻe, hoʻohana i nā laxatives, a me nā mea ʻē aʻe) e alakaʻi i nā pilikia e hiki ai ke hōʻeha i nā puʻuwai koʻikoʻi, puʻuwai, gastrointestinal a me nā niho.

ʻO ke kuhikuhina

Ua wehewehe ʻia no ka manawa mua me kahi hihia hihia ma 1689 na Richard Morton, ʻaʻole ia a hiki i ka 50 e loaʻa kahi wehewehe kikoʻī o ka anorexia nervosa mahalo i nā hana nui a Hilde Bruch e pili ana i kēia kumuhana. 

Mai ia manawa, ua hoʻonui mau ka maʻi o ka maʻi. Wahi a nā noiʻi hou, 

ka laha honua o ka anorexia ma ka heluna wahine i koho ʻia ma 0,3%, me ke kiʻekiʻe o ka make (ma waena o 5,1 a me 13%). Hoʻopili ia i nā wahine he 10 mau manawa ma mua o nā kāne^{6, 7,8}.

PalekanaEND_LINK

Loiloi Psychopathological

No ka hōʻoia ʻana i ka anorexia nervosa, pono e mālama ʻia nā ʻano like ʻole i ka lawena o ke kanaka.

Ma ʻAmelika ʻĀkau, ʻo ka mea hana maʻa mau ka Ka Papa Hana Hoʻonaʻauao a me Heluhelu o nā Mino Lō (DSM-IV) i paʻi ʻia e ka American Psychiatric Association. Ma ʻEulopa a me nā wahi ʻē aʻe o ka honua, hoʻohana ka poʻe ʻoihana olakino i ka International Classification of Diseases (ICD-10).

I ka hōʻuluʻulu manaʻo, e hoʻāla i kahi maʻi anorexic, pono e nānā i ke kū ʻana o kekahi mau pae, ʻo ka mea nui he hōʻole e mālama i kahi kaupaona maʻamau. ʻO ka maʻamau, hōʻole ka mea anorexic e noho ma 85% o kā lākou kaumaha kūpono (i loaʻa mai ke kiʻekiʻe a me nā iwi). Aia kekahi makaʻu ikaika a phobic paha i ka loaʻa ʻana o ke kaumaha e pili ana i kahi maʻi nui o ke kino kino (ʻike hewa e pili ana i ke kaupaona, ka nui a me nā ʻano o ke kino). ʻO ka hope loa, nā ʻano ʻokoʻa e pili ana i ka meaʻai ka mea maʻamau i ka poʻe me ka anorexia e like me peʻe i ka meaʻai a i ole e kiʻi i ka poʻe ʻē aʻe e ʻai. Ukali ʻia kēlā me kēia meaʻai e kahi manaʻo o ka lawehala e hoʻouka i ke kanaka anorexic a alakaʻi iā ia e lawe hana hoʻopaʻi (ka hoʻomaʻamaʻa haʻuki ikaika, e lawe ana i nā purgatives…).

Loiloi Somatic

Ma waho aʻe o ka loiloi psychopathological, pono pono kahi loiloi kino holoʻokoʻa i mea e ʻike ʻia ai ka anorexia nervosa a me ka loiloi i ke kūlana undernutrisi a me nā hopena o ka hoʻonele ʻana i ka meaʻai i ke olakino o ke kanaka.

I nā keiki ma lalo o 8 mau makahiki, e nānā ke kauka i nā hōʻailona e ʻōlelo paha i ka anorexia. ʻO ka lohi o ka ulu ʻana o ke kino, kahi stagnation a hāʻule paha i ka BMI, e ʻimi ʻia ke alo o ka nausea a me ka ʻeha ʻole o ka ʻōpū e wehewehe ʻole ʻia.  

Kū me kahi ʻōpio e hōʻike ana i kahi anorexia nervosa, e nānā ka loea no ka lohi o ka wā ʻōpio, amenorea, a me / a i ʻole hyperactivity ʻike.

I nā mākua, hiki i kekahi mau hōʻailona ke kuhikuhi i ke kauka i kahi diagnostical o anorexia nervosa. Ma waena o nā mea maʻamau, e makaʻala ke kauka i ke alo o ka pohō kaumaha (ʻoi aku ma mua o 15%), hōʻole e loaʻa kaupaona ʻoiai ʻo ka papa haʻahaʻa o ke kino haʻahaʻa (BMI), kahi wahine me ka amenorrhea lua, kahi kāne me ka hōʻemi nui ʻia o libido a me erectile hana, kino a me / a i ʻole ka noʻonoʻo hyperactivity a me ka infertility.

ʻO nā ʻano i hoʻonohonoho ʻia e ka mea e ʻimi ana e hōʻemi i ka lawe ʻana o ka meaʻai i ʻoi aku ka nui a i ʻole ka hopena koʻikoʻi i ke olakino. E mālama ka kauka i kahi hoʻokolohua a me ka paraclinical (hōʻike i ke koko, a me nā mea ʻē aʻe) i ka ʻimi ʻana i nā pilikia.

• nā pilikia puʻuwai e like me nā haunaele o ka naʻau
• kahua niho, e like me ka ʻaʻai ʻana o ka enamel niho
• nā maʻi gastrointestinal e like me nā maʻi ʻōpū o ka ʻōpū
• iwi, me ka hoʻēmi ʻana i ka nui o ka mineral o ka iwi
• kopa
• dermatologic

Hōʻike loiloi ʻo EAT-26

Hiki i ka hoʻāʻo EAT-26 ke pale i ka poʻe e ʻeha paha i nā maʻi ʻai. He nīnau ninaninau he 26 kēia e hoʻopihapiha ka mea hoʻomanawanui a laila hāʻawi iā ia i kahi loea nāna e kālailai iā ia. E ʻae nā nīnau iā mākou e nīnau i ke alo a me ke alapine o nā papaʻai, nā hana compensatory a me ka kaohi a ke kanaka e hoʻomaʻamaʻa ai i kāna ʻano ʻai.

Puna: No ka mana Palani o ka hoʻāʻo loiloi EAT-26, Leichner et al. 1994⁹

Nā pilikia

ʻO nā pilikia nui o ka anorexia ʻoi aku ka liʻiliʻi o nā maʻi physiological koʻikoʻi i hoʻopili ʻia e ka pohō kaumaha.

I nā keiki me ka anorexia, hiki i ka pohō kaumaha ke kumu i ka ulu ʻana o ka ulu.

ʻO nā pilikia nui o ka anorexia ʻoi aku ka liʻiliʻi a ʻoi paha o nā maʻi physiological koʻikoʻi i hoʻopili ʻia e nā hana kapu a me nā hoʻomaʻemaʻe hoʻomaʻemaʻe.

Hiki i nā kapu meaʻai ke alakaʻi i ka hōʻino ʻana i nā mākala, anemia, hypotension, lohi o ka puʻuwai, a me nā pae calcium liʻiliʻi e hiki ai i ka osteoporosis. Eia hou, ʻo ka hapa nui o ka poʻe me ka anorexia he amenorrhea (ka hakahaka ʻole o nā manawa) akā ʻaʻole ʻike pinepine ʻia kēia, hūnā ʻia e nā wā kūpili i hana ʻia e ka lawe ʻana i ka pill contraceptive.

Hiki i ka luaʻi hou ʻana ke kumu i nā maʻi like ʻole e like me: ka lū ʻia ʻana o ka enamel niho, ka hoʻā ʻana o ka esophagus, ka pehu ʻana o nā aʻa salivary a me ke kulu o nā pae potassium e hiki ai ke hoʻopilikia i ka ritme a i ʻole ka holo pono ʻole o ka puʻuwai. .

Lawe pū ʻia ka laxatives i nā maʻi he nui i hiki i kekahi ke nānā i ka atony ʻōpū (nele o ke kani o ka digestive tract) ke kumu o ka paʻa ʻana o ka wai, dehydration, edema a me kahi kulu o ka pae sodium e hiki ai ke hōʻeha ʻole i nā puʻupaʻa.

ʻO ka hope loa, ʻo ka mea ʻoi loa a me nā mea ʻoi loa o nā kūpikipiki o ka anorexia nervosa e mau ana ka make e nā pilikia a i ʻole ka pepehi kanaka ʻana, ka mea e hoʻopili nui i ka poʻe me ka anorexia mau. ʻIke ʻia a mālama ʻia ka anorexia ma mua, ʻoi aku ka maikaʻi o ka wānana. Pēlā i mālama ʻia ai, nalo nā ʻōuli i ka hapanui o nā hihia ma kahi o 5 a 6 mau makahiki ma hope o ka hoʻomaka ʻana.