Characteristics of anorexia in patients with functional hypothalamic amenorrhea

Anorexia in patients with functional hypothalamic amenorrhea is a psychogenic eating disorder characterized by deliberate dieting leading to weight loss and has the following features:

Medical history features

It is common in women, especially those aged 12 to 18 years old in pre-adolescence or early puberty. It is rare to develop after the age of 30. About 1/3 of patients have mild obesity before the onset of the disease. The patients come from middle- and upper-class families, are obsessed with thin bodies, restrict their diet excessively, induce vomiting, and even almost do not eat. The weight loss is obvious, at least 25% or even 40% less than the original weight. The patients have anorexia, stubborn refusal to eat, or other symptoms of eating dysfunction.

Psychological changes

It may be accompanied by obsessive-compulsive symptoms and depression; patients refuse to admit that they are ill and are unwilling to cooperate with diagnosis and treatment, especially refusing to admit that being underweight and eating too little are pathological. The reason for patients to seek medical treatment is often secondary symptoms such as amenorrhea.

Gastrointestinal symptoms

Accompanied by vomiting or abdominal distension, abdominal pain, nausea, hiccups and other abdominal symptoms, and may be complicated by esophagitis or ulcers, pancreatitis, etc. It is often accompanied by dry skin, yellowing, hair loss, thin and soft hair, low blood pressure, low body temperature, constipation, and may also have diarrhea, chills, bradycardia, emotional irritability, introversion, depression, bulimia nervosa or other neurological symptoms.

Sexual dysfunction

Patients have sexual function and sexual development disorders; women have amenorrhea, men have decreased sexual sensitivity or impotence; prepubertal patients have delayed sexual psychological and physiological development; there are hypothalamic-pituitary-gonadal axis disorders, such as absent luteinizing hormone cycle changes, desuppression in flumethasone suppression test, and elevated cortisone and growth hormone levels.