Anorexia nervosa is a self-imposed starvation. The term 'anorexia' is a misnomer since (at least initially) these patients are hungry. Anorexia nervosa is different from other forms of malnutrition because it is voluntary, resistant to nutritional treatments, accompanied by increased physical activity, without an initial organic cause (such as malignancy or surgery), and without associated infections. Because anorexia nervosa is a state of pure malnutrition without associated increased energy expenditure due to fever, immune response, or tissue reconstruction, these patients have a lowered metabolic rate and do not tend to develop opportunistic infections.
The exact mechanism by which these patients are able to control their hunger is unknown. Disturbed brain neurotransmitter activity may be implicated primarily or secondarily.
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