A 14-year-old client was brought to clinic by her mor. Her mor expresses concern about her daughter’s weight loss and constant dieting. Nurse Kris conducts a health history interview. Which of following comments indicates that client may be suffering from anorexia nervosa?

Correct Answer: C. “I just can’t seem to get down to the weight I want to be. I’m so fat compared to other girls.”

Low self-esteem is the highest risk factor for anorexia nervosa. Constant dieting to get down to a “desirable weight” is characteristic of the disorder. Feeling inadequate when compared to peers indicates poor self-esteem. Anorexia is also more common among teenagers. Still, people of any age can develop this eating disorder, though it’s rare in those over 40. Teens may be more at risk because of all the changes their bodies go through during puberty. They may also face increased peer pressure and be more sensitive to criticism or even casual comments about weight or body shape.

• Option A: Most clients with anorexia nervosa don’t like the way they look, and their self-perception may be distorted. A girl with cachexia may perceive herself to be overweight when she looks in the mirror. Some people with anorexia may have obsessive-compulsive personality traits that make it easier to stick to strict diets and forgo food despite being hungry. They may have an extreme drive for perfectionism, which causes them to think they’re never thin enough. And they may have high levels of anxiety and engage in restrictive eating to reduce it.
• Option B: Preferring fast food over healthy food is common in this age-group. Although it’s not yet clear which genes are involved, there may be genetic changes that make some people at higher risk of developing anorexia. Some people may have a genetic tendency toward perfectionism, sensitivity, and perseverance — all traits associated with anorexia.
• Option D: Because of the absence of body fat necessary for proper hormone production, amenorrhea is common for a client with anorexia nervosa. Patients will report symptoms such as amenorrhea, cold intolerance, constipation, extremity edema, fatigue, and irritability. They may describe restrictive behaviors related to food like calorie counting or portion control, and purging methods, for example, self-induced vomiting or use of diuretics or laxatives.