ABSTRACT
The third chapter provides an overview of the disorder, highlighting the more frequently associated characteristics, variants, and symptoms. Firstly, pure juvenile anorexia is described in detail, characterised by a marked restriction in both the quantity and quality of food consumed. Other important aspects include self-criticism and a general tendency to underestimate themselves, a sense of being inadequate on a personal and social level, body dysmorphia, and the refusal of every form of pleasure considered as a potentially dangerous loss of control. The second part of the chapter is dedicated to describing the different variants of the disorder. The variant with exercising is characterised by a compulsion to exercise to burn calories. This compulsion can become so pervasive to prevail over the symptomatology of the food intake restriction. Binge eating takes anorexia sufferers to alternate periods of food restriction and periods of loss of control characterised by binge eating. The variant with vomiting represents the most frequent evolution of the pathology. Vomiting is initially perceived as an effective solution for having eaten too much. However, the compulsion to eat and vomit tends to increase the quantity of food eaten and the frequency of binges followed by vomiting. In the most serious cases, vomiting becomes part of a pleasure-based pattern compulsion. In juvenile anorexia with self-harming, these behaviours are not driven by suicidal intentions, but function like a sedative in relation to negative emotional states. Juvenile anorexia with elimination is characterised by the use of laxatives to facilitate intestinal evacuation which tends to structure over time psychological and physiological dependence. Anorexia with substance abuse does not represent a variant of the disorder but a form of dangerous pathological behaviour that is frequently added to the restrictive eating disorder. Finally, polysymptomatic juvenile anorexia is diagnosed when more than one variant of the disorder is co-occurring, usually associated to borderline personality disorder.
