Question
| A. |
Phobic avoidance of normal weight |
| B. |
Overperception of body image |
| C. |
Self induced vomiting |
| D. |
Menorrhagia |
|
Correct Answer » D Explanation |
 |
Clinical Reasoning for the Correct Answer
– Menorrhagia (heavy menstrual bleeding) is not characteristic of anorexia nervosa. Instead, patients usually have amenorrhea (absence of menstruation) due to hypothalamic-pituitary axis suppression caused by low body fat and nutritional deficiency.
– This amenorrhea results from decreased gonadotropin-releasing hormone (GnRH) secretion → reduced LH and FSH → low estrogen → endometrial atrophy and absence of menstrual bleeding.
– Menorrhagia suggests increased estrogen or other pathologies, which are not typical in anorexia nervosa patients.
Why Option A is Incorrect
– Phobic avoidance of normal weight is a recognized feature of anorexia nervosa.
– Patients have an intense fear/avoidance of gaining weight or becoming fat, even if underweight.
– This fear drives restrictive eating behaviors.
Why Option B is Incorrect
– Overperception of body image is classic in anorexia nervosa.
– These patients perceive themselves as overweight despite being underweight (body image disturbance).
– This cognitive distortion perpetuates disordered eating.
Why Option C is Incorrect
– Self-induced vomiting may occur in some anorexia nervosa subtypes (binge-eating/purging type).
– Though not universal, it is a recognized behavior for weight control in these patients.
– Its presence does not exclude anorexia nervosa diagnosis.
