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“Food is my enemy”: Anorexia

She walked slowly and reluctantly into my consultation room with her parents. She looked thin and listless.

H, a 17-year-old teenager came to see me because her mother had noticed that she had drastic weight loss and her menses had stopped for the past 4 months.

She was the youngest of 3 children. She was bright academically and had been of normal body weight. Eight months ago, she started to get conscious about her body image after her cousin commented that she had put on weight during a social gathering. Thereafter, she started comparing her body weight with her peers. She tried to lose weight by becoming a vegetarian and began to eat less and exercise more. She felt good about herself only when she lost weight.

She weighed herself almost daily. She spent most of her time worrying about her weight. As a result, she spent less time on the social activities she used to enjoy. She became very quiet and withdrawn, often keeping to herself in her room.

H was undernourished with sunken eyes. Her BMI was way below normal  and her skin was dry with soft downy hairs. Her nails were brittle. Her blood pressure was low and her heart rates were slow and sometimes irregular.

H was diagnosed with anorexia nervosa, an eating disorder characterized by

· An abnormally low body weight

· Extreme restriction of food intake

· Intense fear of gaining weight or becoming fat

· Distorted perception of weight

How does anorexia affect the reproductive health?