Unintentional onset of anorexia nervosa.
OBJECTIVE
The purpose of this article is to report a series of patients with an onset of anorexia nervosa precipitated by unintended weight loss rather than the more typical onset following intentional dieting, or the occasional iatrogenic beginning.


METHODS
Retrospectively, case notes of 66 consecutive outpatient evaluations at an eating disorder diagnostic clinic between 2002 and 2006 were reviewed.


RESULTS
Five cases, 7.6%, of inadvertent onset anorexia nervosa were identified. Causes of the inadvertent weight loss were varied: the mourning of a death, a parasitic infection, medication side effects and surgery. None had intended to lose weight.


CONCLUSIONS
We postulate that inadvertent weight loss may be as powerful a trigger as intentional dieting to initiating anorexia nervosa in predisposed individuals; self-induced weight loss may not be a necessary precursor to anorexia nervosa.
Brandenburg
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BM
Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA. pete6174@umn.edu
Andersen
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AE
D000328:Adult; D000856:Anorexia Nervosa / Q000209:etiology* / Q000523:psychology; D014151:Anti-Anxiety Agents / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D001262:Atenolol / Q000009:adverse effects; D001601:Bereavement; D002065:Buspirone / Q000009:adverse effects; D005260:Female; D006801:Humans; D010272:Parasitic Diseases / Q000150:complications; D011183:Postoperative Complications; D015985:Precipitating Factors
D014151:Anti-Anxiety Agents; D000889:Anti-Arrhythmia Agents; D001262:Atenolol; D002065:Buspirone